Observational Learning in Stroke Patients

NCT00083642 | Completed

• 2 other identifiers: 04020304-N-0203
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study will determine how people who have had a stroke learn to perform a movement by observation, as compared with people who have not had a stroke. Normally, a person learns a new hand movement automatically by observing the movement performed by others. Improvement with practice also relies on visual feedback. This "observational training" - i.e., the repeated observation of a movement - is sufficient for normal individuals to learn a movement. This study will examine brain activity related to motor learning in stroke patients and in healthy control subjects to see whether stroke patients process visual-motor information the same way normal subjects do. Normal volunteers and stroke patients between 18 and 75 years of age may be eligible for this study. Patients must have had paralysis on one side of the body due to a stroke that occurred at least 3 months before entering the study. Candidates who have not had a recent health screening will have a clinical and neurological examination. Participants undergo the following procedures:

• Brain magnetic resonance imaging (MRI), if one has not been done recently. This test uses a strong magnetic field and radio waves to obtain images of body organs and tissues. The subject lies on a table that can slide in and out of the cylindrical scanner and wears earplugs to muffle loud noises caused by switching of magnetic fields. Scanning time varies from 20 minutes to 3 hours, with most sessions lasting 45 to 90 minutes.
• Task training. The subject practices the task to be performed during functional MRI (see below). The subject makes finger tapping movements, then watches finger movements on a video screen for several minutes, during which time the movie stops from time to time without warning. When the movie stops, the subject must reproduce the last finger movement that appeared on the screen. During this session, the electrical signals of the subject's forearm muscles are recorded at the skin surface. This session lasts up to 3 hours.
• Functional MRI. The subject undergoes MRI scanning while performing the same tasks done in the training session. This session lasts about 3 hours.

Conditions

Stroke

Keywords

Brain Plasticity; Functional MRI; Finger Movement; Rehabilitation; Improvement; Stroke; Motor Recovery; Observation; fMRI; Healthy Volunteer; HV

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• We will include PATIENTS:
• Who are aged 18 to 75,
• With a single thromboembolic non-hemorrhagic hemispheric lesions,
• With at least a 3 months period since the stroke,
• Who initially had a severe motor paresis (below MRC grade 2),
• Who subsequently recovered to the point that they can perform the motor tasks of this study,
• With no history of other neurological and psychiatric illness,
• Who are right-handed (before the stroke history).
• As a control group, we will include NORMAL VOLUNTEERS,
• Who are age- and gender matched to stroke PATIENTS,
• Who can perform the motor tasks of this study,
• With no history of other neurological and psychiatric illness,
• Who are right-handed.

You may not qualify if:

• PATIENTS with more than one stroke in the medial cerebral artery territory.
• PATIENTS with bilateral motor impairment.
• PATIENTS with cerebellar or brainstem lesions.
• PATIENTS and NORMAL VOLUNTEERS unable to perform the task.
• PATIENTS and NORMAL VOLUNTEERS with history of severe alcohol or drug abuse, psychiatric illness like severe depression, poor motivational capacity, or severe language disturbances, particularly of receptive nature or with serious cognitive deficits (defined as equivalent to a mini-mental state exam score of 23 or less).
• PATIENTS and NORMAL VOLUNTEERS with severe uncontrolled medical problems (e.g. cardiovascular disease, severe rheumatoid arthritis, active joint deformity of arthritic origin, active cancer or renal disease, any kind of end-stage pulmonary or cardiovascular disease, or a deteriorated condition due to age, uncontrolled epilepsy or others).
• PATIENTS and NORMAL VOLUNTEERS with increased intracranial pressure (as evaluated by clinical examination).
• PATIENTS and NORMAL VOLUNTEERS with unstable cardiac arrhythmia.
• PATIENTS and NORMAL VOLUNTEERS with h/o hyperthyroidism or individuals receiving drugs acting primarily on the central nervous system.
• PATIENTS and NORMAL VOLUNTEERS with more than moderate to severe microangiopathy (as assessed by multiple peri-ventricular T2 hyperintensity on the pre-experimental anatomical MRI), polyneuropathy (as assessed by clinical examination), diabetes mellitus (medical record), or ischemic peripheral disease (as assessed by clinical examination).
• PATIENTS and NORMAL VOLUNTEERS who are or who have been good skilled piano or string instruments players.
• PATIENTS and NORMAL VOLUNTEERS who is on medication with the potential to influence nervous system function, who has a history of surgery with metallic implants or a known history of metallic particles in the eye, a cardiac pacemaker, intracardiac lines, neural stimulators, cochlear implants.
• PATIENTS and NORMAL VOLUNTEERS who are pregnant.
• PATIENTS and NORMAL VOLUNTEERS with significant visual loss/deficits.
• PATIENTS and NORMAL VOLUNTEERS with MRI contraindications.

Sponsors & Collaborators

• National Institute of Neurological Disorders and Stroke (NINDS): lead

Study Sites (1)

National Institutes of Health Clinical Center, 9000 Rockville Pike

Bethesda, Maryland, 20892, United States

Location

Related Publications (1)

• Byrne RW, Russon AE. Learning by imitation: a hierarchical approach. Behav Brain Sci. 1998 Oct;21(5):667-84; discussion 684-721. doi: 10.1017/s0140525x98001745.

  PMID: 10097023 BACKGROUND

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: observational
• Sponsor Type: NIH

Study Record Dates

• First Submitted: May 27, 2004
• First Posted: May 27, 2004
• Study Start: May 25, 2004
• Study Completion: June 13, 2008
• Last Updated: July 2, 2017

Record last verified: 2008-06-13

Locations

US (1)