Role of Ipsilateral Motor Cortex in Executing Movements With Increasing Demand on Precision

It is well known that the motor area of one hemisphere of the brain (motor cortex) controls the movement of the opposite of the body. However, it is not clear whether as the movement becomes more complicated, the motor cortex of both hemispheres of the brain are involved. Currently the role of the motor cortex on the same side of the body (referred to as ipsilateral motor cortex) in hand performance remains controversial. The investigators demonstrated previously in healthy subjects that transiently lowering the activity of ipsilateral motor cortex improved the performance of the opposite hand. What is not know are the mechanisms involved in these changes of behavior. Transcranial magnetic stimulation (TMS) is a device that allows the non- invasive stimulation of the brain. When brain is stimulated repetitively at a very low rate and low intensity for about 15 minutes, the stimulated brain area becomes less active. This effect lasts 10 minutes and is called a "transient artificial lesion" as it mimicks the effects of transiently interfering with the function of the stimulated brain area. In the present study the investigators will conduct experiments using repetitive TMS to downregulate the activity of the motor area as in previous experiments and measures its effect on activity of motor cortex of both hemispheres. The investigators will study healthy subjects. It would be important to understand the effects in more detail for the design of treatment strategies in patients after stroke, which will be a topic of future studies.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Vascular Diseases

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Emory University School of Medicine

Atlanta, Georgia, 30322, United States

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for Stroke Patients:

Age 18-80
Single cerebral ischemic infarction one month prior to entering study
Affecting only one hemisphere as defined by MRI of the brain
At the time of cerebral infarct a motor deficit of hand of Medical Research Council Scale for Muscle Strength (MRC) of < 4- of wrist and finger extension/flexion movement
Fugl Meyer score > 27/66 (motor domain, upper extremity)
Ability to operate joystick at largest target level
No other neurological disorder
No intake of Central Nervous System (CNS) active drugs
Ability to give informed consent
Ability to meet criteria of inclusion experiment
No major cognitive impairment

Inclusion criteria

for Healthy Subjects:

Age 55-80 years with no neurological or psychiatric diseases
Normal neurological examination
Normal MRI of the brain
Normal neuropsychological testing
No intake of CNS active drugs that interfere with data collection
No contraindication to TMS
Ability to give informed consent

Treatment and study plan

Primary outcomes

Define key parameters that contribute to contralesional M1 reorganization following stroke

Time frame: Up to six months post-stroke

Sponsors and collaborators

Lead sponsor

Cathrin Buetefisch

Other

Collaborators

National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health (NIH)

Registry information

Official study title

Enhancing Stroke Recovery Through Cortical Stimulation: The Role of the Ipsilateral Motor Cortex in Executing Movements With Increasing Demand on Precision

Acronym: RIMC

Important dates

Study start: 2011
Primary completion: 2015
Study completion: 2015
First posted: Nov 14, 2012
Registry last updated: Oct 15, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

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