NCT06533176 · Sara Hussain
Real-time Personalized Brain State-dependent TMS After Stroke
What this study is about
Transcranial magnetic stimulation (TMS) interventions could feasibly strengthen residual corticospinal tract (CST) connections and enhance recovery of paretic upper extremity function after stroke.
View original scientific description
Transcranial magnetic stimulation (TMS) interventions could feasibly strengthen residual corticospinal tract (CST) connections and enhance recovery of paretic upper extremity function after stroke. This project will test whether personalized brain state-dependent TMS can activate the residual corticospinal tract better than standard TMS, and evaluate the relationship between this activation and upper extremity motor impairment.
Interventions
DEVICE
Personalized brain state-dependent single-pulse TMS
Single-pulse TMS will be applied to the lesioned hemisphere during brain activity patterns associated with strong residual corticospinal tract activation and random brain activity patterns.
Primary outcome measures
MEP amplitudes
Time frame: 1 week
Peak-to-peak MEP amplitudes elicited by single TMS pulses delivered during personalized brain activity patterns corresponding to strong corticospinal transmission and random brain activity patterns will be measured. At the individual participant level, all MEP amplitudes will be normalized to the mean MEP amplitude observed in that participant. Mean normalized MEP amplitudes will be used to calculate the percentage MEP amplitude difference between the two brain activity patterns (i.e., strong and random).
Upper Extremity Fugl-Meyer Assessment Scores
Time frame: 1 week
Scores obtained for each participant during the Upper Extremity Fugl-Meyer Assessment will be calculated. This will provide a single impairment score that will be correlated with the percentage MEP amplitude difference between brain activity patterns reflecting strong corticospinal transmission and random brain activity patterns.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- -Presence of residual upper extremity hemiparesis, defined as any of the following: Fugl Meyer Upper Extremity Score \<66, Wolf Motor Function Test Score \<70, Affected hand performance on the 9-Hole Peg Test \>= 10% worse than unaffected hand, Affected hand pinch, key, or power grip performance \>= 10% worse than unaffected hand,
- Occurrence of ischemic or hemorrhagic stroke \>= 6 months before participation
- Mini Mental State Exam score \> 24
- Willingness and ability to provide informed consent
- No history of neurological disease and/or neurological injury other than stroke
- No TMS contraindications, including but not limited to: Cardiac pacemaker, Cochlear implant, Cortical stimulator, Deep brain stimulator, Vagus nerve stimulator, Cervical spine epidural stimulation, Ventriculoperitoneal shunt, Ferromagnetic metallic implants above the level of the seventh cervical vertebra, Seizure in the last 12 months while taking anti-epilepsy medication, History of adverse reactions to TMS or peripheral nerve stimulation, Current, suspected, or planned pregnancy, Any recent changes (within the last month) to medication use \- Presence of residual corticospinal connections innervating an affected upper extremity muscle following stimulation of the lesioned hemisphere (i.e., MEP+), evaluated at rest
Where
- Iowa City, Iowa
Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Feb 3, 2026 · Source of record for eligibility and locations