Effects of rTMS and tDCS on Motor Function in Stroke

Inclusion criteria

(1) All subjects must be between the ages of 18-90.

Exclusion criteria

• History of Major depression, as defined by Beck Depression scale 30;
• Any substantial decrease in alertness, language comprehension, or attention that might interfere with understanding instructions for motor testing;
• Contraindications to TMS

• history of seizures
• unexplained loss of consciousness
• metal in the head
• frequent or severe headaches or neck pain
• implanted brain medical devices.
• Contraindications to tDCS

• metal in the head
• implanted brain medical devices
• Advanced liver, kidney, cardiac, or pulmonary disease;
• A terminal medical diagnosis consistent with survival < 1 year;
• Coexistent major neurological or psychiatric disease (to decrease number of confounders);
• A history of significant alcohol or drug abuse in the prior 6 months;
• Subjects may not be actively enrolled in a separate intervention study targeting stroke recovery and any other clinical trials;
• Subjects with global aphasia and deficits of comprehension
• Pregnancy. Female subjects of child bearing potential will be asked to take a pregnancy test. If the pregnancy test is positive, the subject may not enroll in the study.
• Use of neuropsychotropic medications [healthy subjects only]

Additional inclusion criteria for stroke subjects:

• First-time clinical ischemic or hemorrhagic cerebrovascular events - evidenced by a radiological (or physician's) report
• Weakness, defined as score of less than 55 (out of 66) on arm motor Fugl-Meyer (FM) scale
• Stroke onset >6 months prior to study enrollment .

Additional exclusion criteria for stroke subjects:

• Subjects may not have already received TMS and/or tDCS stimulation for stroke;
• History of epilepsy before stroke or episodes of seizures within the last six months;