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| Name | Class |
|---|---|
| The Claude D. Pepper Older Americans Independence Centers | OTHER |
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Recent studies showed that a non-invasive, low-intensity brain stimulation called transcranial direct current stimulation (tDCS) can effectively increase motor neuron excitability in the brain and therefore promotes functional recovery after stroke. Thus, the overall purpose of this research project is to examine the effect of brain stimulation on motor skill learning in stroke survivors.
The specific aims and hypotheses are:
Aim 1: To explore the trends of locomotor skill acquisition in stroke survivors after anodal tDCS (a-tDCS, real brain stimulation), stroke survivors after sham tDCS (s-tDCS), and stroke with no brain stimulation (control; CON). Hypothesis (Aim 1): Stroke participants who receives a-tDCS will show a faster rate of learning a locomotor task compared to stroke participants who receive s-tDCS and stroke participants with no brain stimulation.
Aim 2: To explore different trends of stimulation-induced improvements in learning capacity and neural activities between three groups: stroke group, healthy young group, and healthy older group. Hypothesis (Aim 2): Healthy young adults will have a greater degree of stimulation-induced improvements in learning capacity and neural excitation compared to older adults and stroke participants.
Aim 3: To explore the trends of functional improvements post a-tDCS in stroke survivors. Hypothesis (Aim 3): Stroke participants who receives a-tDCS will show a greater improvements in functional performances compared to stroke participants who receive s-tDCS and stroke participants with no brain stimulation.
Aim 4: To explore the accumulated, longitudinal trends of a four-week visuomotor stepping training in conjunction with brain stimulation on treadmill walking training and gait improvements for persons with chronic stroke. Hypothesis (Aim 4): Stroke participants who receives a-tDCS will show a greater degree of gait improvements compared to stroke participants who receive s-tDCS and stroke participants with no brain stimulation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| To explore the effect of brain stimulation on locomotor skill acquisition in stroke survivors | Experimental | To explore the trends of locomotor skill acquisition in stroke survivors after anodal tDCS (a-tDCS, real brain stimulation), stroke survivors after sham tDCS (s-tDCS), and stroke with no brain stimulation (control; CON). |
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| To explore improvements in learning capacity between healthy adults and stroke participants. | Experimental | Compare stimulation-induced improvements in learning capacity between three groups: stroke group, healthy young group, and healthy older group. |
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| To explore the trends of functional improvements after single a-tDCS session in stroke survivors. | Experimental | To explore functional improvements (gait performance, brain neural activation) between a-tDCS, s-tDCS, and control groups. |
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| To explore the accumulated effects of brain stimulation on gait improvements in stroke survivors | Experimental | To explore the accumulated, longitudinal trends of a four-week visuomotor stepping training in conjunction with brain stimulation on treadmill walking training and gait improvements for persons with chronic stroke. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| anodal transcranial direct current stimulation (a-tDCS) | Combination Product | Stroke participants will be randomly assigned into one of three groups: anodal transcranial direct current stimulation (a-tDCS), sham tDCS (s-tDCS), or control groups (i.e. no brain stimulation). Young and older healthy adults will be randomly assignments into a-tDCS or s-tDCS groups. Stroke participants in each group will receive a four-week of the assigned brain stimulation combined with visuomotor stepping training and treadmill training |
| Measure | Description | Time Frame |
|---|---|---|
| Mean change from baseline in stepping motor control after a single brain stimulation and locomotor learning session. | stepping motor control will be quantified by the time (seconds) that each participant takes to initiate a forward step onto a visual target displayed on the wall screen | 0 minute, 30 minutes, and 24 hours a single brain stimulation session |
| Mean change from baseline in gait performances after a single brain stimulation and locomotor learning session. | Gait performances will be quantified by gait speed (meters/second) during ground walking tests | 0 minute, 30 minutes, and 24 hours a single brain stimulation session |
| Mean change from baseline in brain neuronal network activations after a single brain stimulation and locomotor learning session. | The neuronal activations will be quantified by oxygen consumption changes locally detected by surface infrared diodes. | 0 minute, 30 minutes, and 24 hours a single brain stimulation session |
| Mean change from baseline in brain neuronal activations after a single brain stimulation and locomotor learning session. | The neuronal activations will be quantified by peak-to-peak electrical signals detected by surface electromyographic (EMG) electrodes on leg muscles after transcranial magnetic stimulations | 0 minute, 30 minutes, and 24 hours a single brain stimulation session |
| Mean change from baseline in stepping motor control after a four-week brain stimulation combined with visuomotor stepping training and treadmill walking training | stepping motor control will be quantified by the time (seconds) that each participant takes to initiate a forward step onto a visual target displayed on the wall screen | Day 1, Day 7, Day 30, Day 90 post a four-week brain stimulation combined with visuomotor stepping and treadmill walking training |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Shih-Chiao Tseng, PhD | University of Texas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Texas Medical Branch | Galveston | Texas | 77555 | United States |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D065908 | Transcranial Direct Current Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D003295 | Convulsive Therapy |
| D013000 | Psychiatric Somatic Therapies |
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Stroke participants will be randomly assigned into one of three groups: anodal transcranial direct current stimulation (a-tDCS), sham tDCS (s-tDCS), or control groups (i.e. no brain stimulation). Young and older healthy adults will be randomly assignments into a-tDCS or s-tDCS groups.
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Participants and outcome assessors will be blinded to their assigned brain stimulation protocols.
|
| Mean change from baseline in gait performances after a four-week brain stimulation combined with visuomotor stepping training and treadmill walking training | Gait performances will be quantified by gait speeds (meters/second) during ground walking tests | Day 1, Day 7, Day 30, Day 90 post a four-week brain stimulation combined with visuomotor stepping and treadmill walking training |
| Mean change from baseline in brain neuronal network activations after a four-week brain stimulation combined with visuomotor stepping training and treadmill walking training | The neuronal activations will be quantified by oxygen consumption changes locally detected by surface infrared diodes | Day 1, Day 7, Day 30, Day 90 post a four-week brain stimulation combined with visuomotor stepping and treadmill walking training |
| Mean change from baseline in brain neuronal activations after a four-week brain stimulation combined with visuomotor stepping training and treadmill walking training | The neuronal activations will be quantified by peak-to-peak electrical signals detected by surface electromyographic (EMG) electrodes on leg muscles after transcranial magnetic stimulations | Day 1, Day 7, Day 30, Day 90 post a four-week brain stimulation combined with visuomotor stepping and treadmill walking training |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D004191 | Behavioral Disciplines and Activities |
| D004597 | Electroshock |
| D011580 | Psychological Techniques |