Exercise and Brain Stimulation for Post-stroke Depression

Recruiting

Phase N/A Results N/A

Eligibility Criteria

Inclusion Criteria

- 1) age 50-70
- 2) stroke within the past 6 to 60 months,
- 3) major depressive disorder (PHQ-9 > 10) and diagnosed using the Structured Clinical Interview for Depression (SCID) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV),
- 4) residual paresis in the lower extremity (Fugl-Meyer LE motor score <34),
- 5) ability to walk without assistance and without an AFO on the treadmill ≥ 30 seconds at speeds ranging from 0.2-0.8 m/s,
- 6) no antidepressant medications or clinically able to discontinue medications,
- 7) HRSD question #9 regarding suicide <2,
- 8) provision of informed consent. In addition, all subjects who meet criteria for the training portion must complete an exercise tolerance test and be cleared for participation by the study cardiologist.

Exclusion Criteria

1. Unable to ambulate at least 150 feet prior to stroke, or experienced intermittent claudication while walking;
2. history of congestive heart failure, unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during ADL's;
3. History of oxygen dependence;
4. Preexisting neurological disorders, dementia or previous stroke;
5. History of major head trauma;
6. Legal blindness or severe visual impairment;
7. history of psychosis or other Axis I disorder that is primary;
8. Life expectancy <1 yr.;
9. Severe arthritis or other problems that limit passive range of motion;
10. History of DVT or pulmonary embolism within 6 months;
11. Uncontrolled diabetes with recent weight loss, diabetic coma, or frequent insulin reactions;
12. Severe hypertension with systolic >200 mmHg and diastolic >110 mmHg at rest;
13. attempt of suicide in the last 2 years or at suicidal risk assessed by SCID interview;
14. Previous or current enrollment in a clinical trial to enhance motor recovery; 15) currently exercising ≥ 2 times per week (≥20 minutes);
16) Presence of non-MR compatible implants, pregnancy or severe claustrophobia.