NCT03268070

Brief Summary

The goal of the study is to determine the effect of repetitive transcranial magnetic stimulation (rTMS) over the premotor cortex on training-related improvements in motor performance and associated neural plasticity.

Trial Health

45
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Timeline
7mo left

Started Mar 2025

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress67%
Mar 2025Feb 2027

First Submitted

Initial submission to the registry

August 29, 2017

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 31, 2017

Completed
7.5 years until next milestone

Study Start

First participant enrolled

March 1, 2025

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2027

Last Updated

August 28, 2025

Status Verified

August 1, 2025

Enrollment Period

1.9 years

First QC Date

August 29, 2017

Last Update Submit

August 21, 2025

Conditions

Keywords

Transcranial Magnetic StimulationNeurophysiologyNeuroscienceStroke Rehabilitation

Outcome Measures

Primary Outcomes (2)

  • Change in wrist velocity

    The subjects will be asked to perform 7 isometric wrist extensions before and after motor training. Wrist velocity will be measured by a gyroscope taped to the dorsum of the wrist that was used during motor training. An increase in the maximum velocity that persists at least an hour after training is indicative of motor learning.

    Before, 0 mins after, 30 mins after, and 60 mins after motor training.

  • Change in Stimulus Response Curve parameters

    To measure organization of a motor region in the primary motor cortex supporting wrist movement, a Stimulus Response Curve (SRC) will be collected before and after motor training. SRC is a set of motor evoked potentials (MEP) that characterizes input-output parameters of the primary motor cortex and associated corticospinal tract. A change in the SRC parameters after training will reflect a change in the organization of the primary motor cortex.

    Before, 0 mins after, 30 mins after and 60 mins after motor training.

Secondary Outcomes (5)

  • Change in wrist force

    Before, 0 mins after, 30 mins after, and 60 mins after motor training.

  • Change in reaction time

    Before, 0 mins after, 30 mins after and 60 mins after motor training.

  • Change in task accuracy

    During motor training (will compare first block to last block).

  • Change in Short interval intracortical inhibition (SICI) of the primary motor cortex

    Before, 0 mins after, 30 mins after, and 60 mins after motor training.

  • Change in Resting Motor Threshold

    Before, 0 mins after, 30 mins after, and 60 mins after motor training.

Study Arms (5)

Repetitive TMS over contralateral premotor cortex

EXPERIMENTAL

Location of repetitive Transcranial Magnetic Stimulation (rTMS): contralateral premotor cortex.

Device: Repetitive TMS over contralateral premotor cortex.

Repetitive TMS over ipsilateral premotor cortex

EXPERIMENTAL

Location of repetitive Transcranial Magnetic Stimulation (rTMS): ipsilateral premotor cortex.

Device: Repetitive TMS over ipsilateral premotor cortex.

Repetitive TMS over contralateral primary motor cortex

EXPERIMENTAL

Location of repetitive Transcranial Magnetic Stimulation (rTMS): contralateral primary motor cortex.

Device: Repetitive TMS over contralateral primary motor cortex.

Sham repetitive TMS over contralateral premotor cortex

SHAM COMPARATOR

Location of Sham repetitive Transcranial Magnetic Stimulation (rTMS): contralateral premotor cortex.

Device: Sham Repetitive TMS over contralateral premotor cortex.

Single TMS over extensor carpi ulnaris spot of motor cortex

EXPERIMENTAL

Location of single-pulse Transcranial Magnetic Stimulation (sTMS): extensor carpi ulnaris (ECU) hotspot of primary motor cortex (M1).

Device: Single TMS over extensor carpi ulnaris spot of motor cortex

Interventions

Repetitive Transcranial magnetic stimulation (rTMS) will be applied over contralateral premotor cortex during motor training. TMS uses magnetism to excite neurons near the surface of the brain. Frequency of rTMS: 0.1 Hz; time of rTMS: 50 milliseconds before the onset of movement-related electromyography (EMG); device: Super Rapid 2 Transcranial Magnetic Stimulator.

Repetitive TMS over contralateral premotor cortex

Repetitive Transcranial magnetic stimulation (rTMS) will be applied over ipsilateral premotor cortex during motor training. TMS uses magnetism to excite neurons near the surface of the brain. Frequency of rTMS: 0.1 Hz; time of rTMS: 50 milliseconds before the onset of movement-related electromyography (EMG); device: Super Rapid 2 Transcranial Magnetic Stimulator.

Repetitive TMS over ipsilateral premotor cortex

Repetitive Transcranial magnetic stimulation (rTMS) will be applied over contralateral primary motor cortex during motor training. TMS uses magnetism to excite neurons near the surface of the brain.Frequency of rTMS: 0.1 Hz; time of rTMS: 50 milliseconds before the onset of movement-related electromyography (EMG); device: Super Rapid 2 Transcranial Magnetic Stimulator.

Repetitive TMS over contralateral primary motor cortex

Sham rTMS will be applied over contralateral premotor cortex. TMS uses magnetism to excite neurons near the surface of the brain. Frequency of rTMS: 0.1 Hz; time of rTMS: 50 milliseconds before the onset of movement-related electromyography (EMG); device: Super Rapid 2 Transcranial Magnetic Stimulator.

Sham repetitive TMS over contralateral premotor cortex

Single-pulse TMS will be applied over the extensor carpi ulnaris (ECU) hotspot of primary motor cortex (M1) during motor training.TMS uses magnetism to excite neurons near the surface of the brain. TMS pulses will be applied at different strengths (30%-80% maximum stimulator output) and record subsequent activity of the ECU muscle using electromyography (EMG).

Single TMS over extensor carpi ulnaris spot of motor cortex

Eligibility Criteria

Age30 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Have the ability to give informed, written consent
  • Be aged 30-80 years old
  • Have a single ischemic infarction affecting the primary motor system
  • Have intact cognitive abilities
  • No current depression
  • No neurological disease
  • No contradictions to TMS
  • No history of seizures or epilepsy
  • No implanted medical device
  • No metal in neck or head
  • No history of migraine headaches
  • No intake of medication that lowers seizure threshold

You may not qualify if:

  • none

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Study Officials

  • Cathrin Buetefisch, MD

    Emory University

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Masking Details
Subjects will be blinded to the type of TMS that they receive on each day.
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

August 29, 2017

First Posted

August 31, 2017

Study Start

March 1, 2025

Primary Completion (Estimated)

February 1, 2027

Study Completion (Estimated)

February 1, 2027

Last Updated

August 28, 2025

Record last verified: 2025-08

Data Sharing

IPD Sharing
Will share

De-identified individual participant data will be made available for sharing with other researchers. Data will be shared with the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Stroke Recovery group. The researchers plan to share the entire data set including clinical, behavioral, anatomical MRI data, with the ENIGMA Stroke Recovery group.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
Individual participant data will be available for sharing following publication of primary results from this study, with no end date for sharing.
Access Criteria
The format of the shared data will be compatible with the ENIGMA data base. Outside researchers interested in using this data can contact Dr. Buetefisch at cathrin.buetefisch@emory.edu.