Combined Brain and Peripheral Nerve Stimulation for Stroke

Recruiting

Phase N/A Results N/A

Eligibility Criteria

Inclusion Criteria

- Age, 18 years or older;
- First-ever, ischemic or hemorrhagic stroke at least six months before, confirmed by computed tomography or magnetic resonance imaging;
- Moderate to severe motor impairment of an upper limb, defined as a score between 7 and 50 on the Fugl-Meyer Assessment of Sensorimotor Recovery after stroke, a scale with scores for upperlimb ranging from 0 (no function) to 66 (normal function;
- Ability to provide written Informed Consent (patient or legal representative);
- Ability to comply with the schedule of interventions and evaluations in the protocol.

Exclusion Criteria

- Lack of ability to voluntarily activate any active range of wrist extension;
- Anesthesia of the paretic hand;
- Stroke lesions affecting entirely the hand knob area of the motor cortex120;
- Stroke lesions affecting the cerebellum or the brain stem;
- Severe spasticity at the paretic elbow, wrist, or fingers, defined as a score of >3 on the Modified Ashworth Spasticity Scale;
- Active joint deformity;
- Uncontrolled medical problems such as end-stage cancer or renal disease;
- Pregnancy;
- Seizures;
- Pacemakers;
- Other neurological disorders such as Parkinson's disease;
- Psychiatric illness including severe depression;
- Aphasia or serious cognitive deficits that preclude comprehension of the experimental protocol or ability to provide consent. A score in the Minimental State Examination lower than 23/30 points will be used for patients with higher than 1 year of education, and a score lower than 19/30 will be used for patients with 1 year of education or less.