Protocol Number: 04-N-0150

Title:

Role of Ventral Premotor Cortex in Recovery of Motor Function in Chronic Stroke

Number:

04-N-0150

Summary:

This study will examine how the brain works to recover motor function after stroke. Specific areas of the brain control different movements, such as hand movements. When someone has a stroke, causing oxygen deprivation to area of the brain that controls hand movements, the hand becomes weak. Patients often recover from this weakness, perhaps because another area of the brain assumes control of hand function. Knowledge of how new brain areas take control to help patients recover from stroke could help researchers develop new treatment strategies for such patients.

Healthy volunteers and patients who have had a thromboembolic stroke (stroke due to blood vessel blockage) resulting in paralysis on only one side of the body may be eligible for this study. Candidates must be between 18 and 90 years of age and have no prior history of neurological or psychiatric illness. They will be screened with clinical and neurological examinations if such examinations have not been done within a year, and stroke patients will undergo magnetic resonance imaging (MRI) to identify the brain areas affected by the stroke. MRI is a diagnostic and research tool that uses a strong magnetic field and radio waves to obtain images of body organs and tissues, including the brain. For this procedure, the subject lies in a cylindrical machine for up to 90 minutes.

Participants come to the NIH Clinical Center for four separate sessions, each on a different day. In the first two sessions, they learn about the manual tasks they will perform in the experiments to be conducted in sessions three and four, become familiar with the machines to be used in the experiments, and receive training in the tasks.

In the third session, participants undergo functional MRI, in which MRI is done while the subject performs certain manual tasks, in order to observe changes in brain regions associated with performance of the tasks. Subjects in this study perform the following two tasks:

- Reactive grip force: Wearing a blindfold, the subject holds a small box between the thumb and index finger. Without warning, a small additional weight is dropped into the box, testing the subject's reactive grip force.

- Visuo-motor tracking test: In this computer task, the subject uses a computer mouse to move the cursor, trying to track a moving square in a maze.

In the last session, participants undergo repetitive transcranial magnetic stimulation (rTMS). For this procedure, a wire coil is held on the subject's scalp. A brief electrical current is passed through the coil, creating a magnetic pulse that stimulates the brain. The subject hears a click and feels a pulling sensation on the skin under the coil. There may also be a twitch in the muscles of the arm or leg. During the TMS, subjects are asked to tense certain muscles slightly or perform other simple actions to position the coil properly. Then, they perform the reactive grip force and visuo-motor tracking tasks. rTMS is applied at various times during the performance of the tasks. During the stimulation, subjects may again be asked to tense muscles slightly or perform other simple actions.

Sponsoring Institute:

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Completed Study; data analyses ongoing

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria: This study is not currently recruiting new subjects. If you have questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.

Special Instructions:

Currently Not Provided

Keyword(s):

Premotor Cortex

Chronic Stroke

Recovery

fMRI

TMS

Recruitment Keyword(s):

Stroke

Healthy Volunteer

HV

Condition(s):

Stroke

Investigational Drug(s):

None

Investigational Device(s):

rTMS

Interventions:

None

Supporting Site:

National Institute of Neurological Disorders and Stroke

Contact(s):

This study is not currently recruiting new subjects. If you have questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.

Citation(s):

Calautti C, Baron JC. Functional neuroimaging studies of motor recovery after stroke in adults: a review. Stroke. 2003 Jun;34(6):1553-66. Epub 2003 May 08.

Dum RP, Strick PL. Motor areas in the frontal lobe of the primate. Physiol Behav. 2002 Dec;77(4-5):677-82.

Dum RP, Strick PL. The origin of corticospinal projections from the premotor areas in the frontal lobe. J Neurosci. 1991 Mar;11(3):667-89.

• Questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.
• Technical questions regarding the Clinical Center web site, please contact the Department of Networks and Applications, CC.

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