tACS and Upper Limb Rehabilitation in Chronic Stroke

Pilot Study Investigating the Neuromodulatory Effects of Transcranial Alternating Current Stimulation (tACS) on Upper Limb Motor Rehabilitation in Chronic Stroke Patients

This study tests whether a brain stimulation technique called tACS can help stroke patients recover movement in their affected arm.

Patients receive either real or fake brain stimulation three times a week for about a month (12 sessions total). During each session, they wear a cap with electrodes that deliver mild electrical currents tailored to their individual brain patterns, while researchers monitor their brain activity.

The study measures progress at three time points: before treatment, right after treatment, and one month later. Researchers use brain stimulation tests to check how well the brain controls muscles, and conduct physical tests to measure arm movement, muscle stiffness, and grip strength.

Inclusion Criteria:

1. Age 21-80 years old;
2. First ever stroke, at least 9 months after stroke onset;
3. Evidence of corticomotor excitability as manifested by a recordable Motor Evoked Potential from the ipsilesional Motor Cortex (M1) by TMS measurement.
4. Objectively documented motor weakness of the upper extremity as manifested by an Upper Extremity-Fugl-Meyer Assessment score <=55

Exclusion Criteria:

1. Patients with implants: cardiac, neural or medication implants; any electrically, magnetically or mechanically activated implant; brain medical devices; vascular clips or any other electrically sensitive support system in the brain; other metal implants inside the body that are contraindications of MRI scan;
2. Pregnancy;
3. Patients with a history of seizures; Patients with unexplained episodes of loss of consciousness, since such condition could be related with brain alterations or epilepsy;
4. Patients with serious brain injury;
5. Patients showing damage of skin at sites of stimulation;
6. Patients with unstable or non-controlled neuropsychiatric illness;
7. Patients suffering from severe or frequent headaches;
8. Patients with any serious life-threatening disease such as congestive heart failure, pulmonary obstructive chronic disease or active neoplasia;
9. Sensorimotor disturbance due to other causes other than stroke;