Neuroregeneration Enhanced by Transcranial Direct Current Stimulation (TDCS) in Stroke (NETS)
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Purpose
Testing the hypothesis that non-invasive brain stimulation by transcranial direct current stimulation (tDCS) combined with functional training in the subacute phase of first-ever stroke will enhance functional regeneration compared with a Placebo intervention.
| Condition | Intervention |
|---|---|
|
Subacute Stroke |
Device: DC-Stimulator to apply tDCS or Sham tDCS |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Neuroregeneration Enhanced by TDCS in Stroke |
- Upper Extremity Fugl-Meyer-Assessment (UEFMA) [ Time Frame: 12 months after the intervention ] [ Designated as safety issue: No ]
- Jebsen-Taylor Test (JTT), Action Research Arm Test (ARAT), Nine Hole Peg Test (NHPT), Stroke Impact Scale (SIS), UEFMA [ Time Frame: 12 months after the intervention (day11, 40, 100, 190 after intervention) ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 250 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: tDCS
tDCS + Training
|
Device: DC-Stimulator to apply tDCS or Sham tDCS
Anodal tDCS (20 minutes) or Sham stimulation will be applied once a day in combination with standardized upper extremity rehabilitative training
|
|
Sham Comparator: Sham tDCS
Placebo + Training
|
Device: DC-Stimulator to apply tDCS or Sham tDCS
Anodal tDCS (20 minutes) or Sham stimulation will be applied once a day in combination with standardized upper extremity rehabilitative training
|
Detailed Description:
Stroke is the leading cause of long-term disability, which significantly impairs the economic and social life of patients and society. Every year 200 000 to 250 000 patients suffer a stroke in Germany. Only a small number of the stroke survivors recover to a degree that allows them to return into their professional and private life. Despite significant efforts to develop novel and efficient treatment strategies the level of functional regeneration is still not satisfying. Thus, the development of innovative and effective treatment strategies will have a major impact for the patients' life, the society and the public health system.
Within the proposed project an innovative, non-invasive and cost effective interventional strategy, based on the combination of a specific rehabilitative training and brain stimulation by transcranial direct current stimulation (tDCS), will be used to enhance functional regeneration in stroke patients. The intervention will be applied in an early stage in which plasticity, cortical reorganization and functional improvement is most pronounced. We hypothesize that the combination of anodal tDCS delivered to the motor cortex of the affected hemisphere combined with training over a period of two weeks in the subacute stage after stroke will significantly enhance cortical plasticity, functional regeneration and long-term outcome determined by clinical and functional outcome measures compared with Placebo stimulation.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Subacute stroke patients (5-21 days after stroke, age>18 years) with thromboembolic non-hemorrhagic subcortical or cortical first-ever strokes will be included. Moderate to moderately severe upper-extremity hemiparesis, defined as an Upper Extremity Fugl-Meyer score (UEFMA) between 28 and 50 (inclusive).
Exclusion Criteria:
- more than one stroke
- progressive stroke
- completely lesioned hand knob area of M1affected or cerebellar lesions
- history of severe alcohol or drug abuse, psychiatric illnesses like severe depression, poor motivational capacity, or severe language disturbances, or with serious cognitive deficits
- severe uncontrolled medical problems
- rheumatological or traumatic diseases affecting the upper extremities
- other neurological diseases
- severe microangiopathy, polyneuropathy, ischemic peripheral disease
- pregnancy
- contraindication for MRI or TMS
Contacts and Locations| Contact: Friedhelm Hummel, Dr. | +49(0)40 741053772 | f.hummel@uke.uni-hamburg.de |
| Contact: Christian Gerloff, Prof. Dr. | +49(0)40 741053772 | gerloff@uke.uni-hamburg.de |
| Austria | |
| Universitätsklinik für Neurologie Wien | Not yet recruiting |
| Wien, Austria | |
| Contact: Seidel, MD | |
| France | |
| Service de Médecine Physique et Réadaptation, Hôpital Bellevue | Not yet recruiting |
| CHU de Saint-Etienne, France | |
| Contact: P. Giraux, MD | |
| Service de Médecine Physique et Réadaptation, Hôpital Pitié-Salpétrière | Not yet recruiting |
| Pitié-Salpétrière, France | |
| Contact: D. Mazevet, MD | |
| Médecine Physique et de Réadaptation, Pôle Locomoteur Hôpital Rangueil | Not yet recruiting |
| Toulouse, France | |
| Contact: P. Marqué, MD | |
| Germany | |
| Neurologische Klinik Bad Aibling | Recruiting |
| Bad Aibling, Germany | |
| Contact: E. Koenig, MD | |
| Contact: Dressnandt, MD | |
| Moritz-Klinik Bad Klosterlausnitz | Not yet recruiting |
| Bad Klosterlausnitz, Germany, 07639 | |
| Contact: Farsin Hamzei, MD | |
| Neurologisches Zentrum Segeberger Kliniken | Recruiting |
| Bad Segeberg, Germany | |
| Contact: Valdueza, MD | |
| Contact: B. Hauptmann, MD | |
| Department of Neurology, University of Berlin | Not yet recruiting |
| Berlin, Germany | |
| Contact: A Floel, MD | |
| Department of Neurology, University of Freiburg | Not yet recruiting |
| Freiburg, Germany | |
| Contact: Janine Reis, MD | |
| Contact: Hamzei, MD | |
| Department of Neurology | Recruiting |
| Hamburg, Germany, 20246 | |
| Contact: Friedhelm Hummel, Dr. +49 (0)40 7410 53772 f.hummel@uke.uni-hamburg.de | |
| Neurologische Fachklinik Kipfenberg | Recruiting |
| Kipfenberg, Germany, 85110 | |
| Contact: Dennis Nowak, MD | |
| St. Mauritius Therapieklinik Meerbusch | Recruiting |
| Meerbusch, Germany | |
| Contact: Hömberg, MD | |
| Contact: Stephan, MD | |
| Switzerland | |
| Department of Neurology, University Zürich | Not yet recruiting |
| Zürich, Switzerland | |
| Contact: M. Weller, MD | |
| Contact: Luft, MD | |
| Principal Investigator: | Christian Gerloff, Prof. Dr. | Department of Neurology, University Medical Center Hamburg-Eppendorf |
| Principal Investigator: | Friedhelm C Hummel, MD | Department of Neurology, University Medical Center Hamburg-Eppendorf |
More Information
Publications:
| Responsible Party: | Universitätsklinikum Hamburg-Eppendorf |
| ClinicalTrials.gov Identifier: | NCT00909714 History of Changes |
| Other Study ID Numbers: | NETS Trial |
| Study First Received: | May 12, 2009 |
| Last Updated: | November 2, 2012 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by Universitätsklinikum Hamburg-Eppendorf:
|
Subacute Stroke non-invasive cortical stimulation motor recovery cortical plasticity TDCS |
Additional relevant MeSH terms:
|
Stroke Cerebral Infarction Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases |
Nervous System Diseases Vascular Diseases Cardiovascular Diseases Brain Infarction Brain Ischemia |
ClinicalTrials.gov processed this record on May 23, 2013