Enhancing Motor Plasticity After Perinatal Stroke Using tDCS "tDCS"

Completed

Phase 2 Results N/A

Eligibility Criteria

Inclusion Criteria

1. Symptomatic hemiparetic CP (Pediatric Stroke Outcome Measure (PSOM) >0.5) AND Manual Abilities Classification System (MACS) grade I-IV AND child/parent perceived limitations
2. Clinical and MRI-confirmed perinatal stroke syndrome (NAIS, APPIS, PVI)
3. Active wrist extension >20 degrees, finger extension >10 degrees
4. Can lift the affected arm 15 cm above a table surface and grasp light objects
5. Term birth (>36 weeks) and current age 6 - 18 years
6. Informed consent

Exclusion Criteria

1. Other neurological disorder not related to perinatal stroke
2. Multifocal perinatal stroke
3. Severe hemiparesis (no voluntary contraction in paretic hand, MACS level V)
4. Severe spasticity in the affected limb (Modified Ashworth Scale >3)
5. Severe developmental delay or other inability to comply with study protocol
6. Unstable epilepsy (>1 seizure/month or >2 medication changes last 6 months)
7. Any TMS or MRI contraindication including implanted electronic devices
8. Botox, orthopedic surgery, or other invasive therapy in past 12 months
9. Constraint, brain stimulation or other modulatory therapy in past 6 months