NCT05670873

Brief Summary

This study is aimed at evaluating the potential of transcranial magnetic stimulation in patients with acute severe ischemic stroke with DoC while assessing patients with a hybrid neural network evaluation model. This model may be the basis for initiating individualized closed-loop neuromodulation treatment in patients with DoC.

Trial Health

65
Monitor

Trial Health Score

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

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable

Timeline
1mo left

Started Mar 2023

Longer than P75 for not_applicable

Status
not yet recruiting

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 Progress98%
Mar 2023Jun 2026

First Submitted

Initial submission to the registry

January 2, 2023

Completed
2 days until next milestone

First Posted

Study publicly available on registry

January 4, 2023

Completed
2 months until next milestone

Study Start

First participant enrolled

March 1, 2023

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2026

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2026

Expected
Last Updated

January 4, 2023

Status Verified

January 1, 2023

Enrollment Period

2.8 years

First QC Date

January 2, 2023

Last Update Submit

January 2, 2023

Conditions

Keywords

Ischemic StrokeConsciousness DisorderTranscranial Magnetic StimulationHybrid Neural Network Evaluation Model

Outcome Measures

Primary Outcomes (2)

  • Coma Recovery Scale Revised (CRS-R)

    The Coma Recovery Scale Revised (CRS-R) is a standard clinical protocol specifically developed to assess a patient's level of consciousness, and does so by evaluating a patient's level of responsiveness to sensory stimulation, their ability to understand language, and to communicate. This procedure is typically administered at bedside. The protocol is divided into 6 sub-scales, each assessing a different area (e.g., visual function, auditory function, communication, arousal), and the final score is calculating by adding all sub-scales.The total score of this scale goes from its minimum, 0, which implied a state of coma, to 23, which implies emergence from a Minimally Conscious State (i.e., eMCS). Higher values thus map onto better outcomes.

    Change in maximum CRS-R score from baseline to 1 month

  • Number of Participants With (Severe) Adverse Events

    Number of AEs and SAEs occurring throughout the paradigm.

    day 20 (+/-3)

Secondary Outcomes (2)

  • Hybrid Neural Network Evaluation

    Change from baseline to day 20 (+/-3)

  • Number of voxels in which the Functional Magnetic Resonance Imaging (fMRI) signal is significantly associated to TMS across the whole group

    Change from baseline to 1 month

Study Arms (2)

rTMS treatment

EXPERIMENTAL

20 days of repetitive transcranial magnetic stimulation: stimulation site is the left dorsolateral prefrontal cortex, stimulation intensity at 90% RMT, stimulation frequency is 10Hz. A total of 1000 pulses, 10s 10Hz train stimulation, repeated 10 times, each interval 60s, a total of 11 minutes and 40 seconds, 1 treatment per day, a total of 20 days.

Device: Transcranial magnetic stimulation

iTBS treatment

EXPERIMENTAL

20 days of intermittent theta-burst stimulation: stimulation site is the left dorsolateral prefrontal cortex, stimulation intensity at 90% RMT, stimulation frequency is 50Hz. A total of 600 pulses, 3 pulses each time, with an interval of 200 ms, for a total of 2 seconds (10 groups), and then repeat the above process after an interval of 10 seconds, a total of 190 seconds, 1 treatment per day, a total of 20 days.

Device: Transcranial magnetic stimulation

Interventions

Transcranial magnetic stimulation given to the left dorsolateral prefrontal cortex

iTBS treatmentrTMS treatment

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • days after ischemic stroke
  • behavioral profile consistent with a UWS or MCS as assessed with the Coma Recovery Scale Revise
  • prestroke Modified Ranking Scale(mRS) ≤2

You may not qualify if:

  • history of vascular malformation or aneurysmal SAH or untreated aneurysm prior to stroke
  • disorder of consciousness prior to stroke
  • impairment of hearing
  • metal implants, e.g. stenting, pacemaker, etc.
  • contraindications to MRI, such as claustrophobia
  • history of epilepsy or epileptic episodes
  • suffering from serious diseases such as malignant tumors, etc., with expected survival time \<1 year
  • patient is currently involved with other trials

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Ischemic StrokeConsciousness Disorders

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

StrokeCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular DiseasesNeurobehavioral ManifestationsNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsNeurocognitive DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Magnetic Field TherapyTherapeutics

Study Officials

  • Liping Liu

    Beijing Tiantan Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

January 2, 2023

First Posted

January 4, 2023

Study Start

March 1, 2023

Primary Completion

January 1, 2026

Study Completion (Estimated)

June 1, 2026

Last Updated

January 4, 2023

Record last verified: 2023-01

Data Sharing

IPD Sharing
Will not share