Repetitive Transcranial Magnetic Stimulation (rTMS) to Contralesional Hemisphere in Patients With Stroke for Upper Limb Recovery "ContraStim"


Phase 1/2 Results N/A

Eligibility Criteria

Inclusion Criteria

- ≥ 18 years of age
- An ischemic or hemorrhagic stroke suffered 3-9 months prior to the study
- no other known brain abnormalities by history or by structural MRI
- A one-sided stroke resulting in upper extremity paresis
- A Chedoke Arm and Hand Activity Inventory score of 3-6 for the affected limb

Exclusion Criteria

- Implanted metallic parts of implanted electronic devices, including pacemakers, defibrillators, or implant medication pump
- Pregnant or trying to become pregnant
- History of alcohol abuse, illicit drug use or drug abuse or significant mental illness
- any history of epilepsy
- Any condition that would prevent the subject from giving voluntary informed consent
- An implanted brain stimulator
- Aneurysm clip or other metal in body
- Enrolled or plans to enroll in an interventional trial during this study
- Scalp wounds or infections
- Claustrophobia precluding MRI
- A fixed contraction deformity in the affected limb
- Excessive spasticity as indicated by the Modified Ashworth Spasticity (MAS) Scale >2/4 in the affected limb
- previous stroke with residual deficits (TIAs not a reason for exclusion)
- premorbid (retrospective) modified Rankin Scale (mRS) score ≥2 of any aetiology
- a concurrent progressive neurologic disorder, acute coronary syndrome, severe heart disease (NYHA Classification > 3), or other major medical condition
- confirmed or suspected lower-limb fracture preventing mobilization
- patients requiring palliative care
- patients undergoing any other occupational therapy than what is provided in the study
- A recent injection of botulinum toxin to the affected upper limb in the last 3 months, or the need of an injection of botulinum toxin anytime during the study period and follow up
- Ataxia as measured by a score > 1 on item 7 (limb ataxia) of the NIH stroke scale
- Severe aphasia as measured by a score of > 2 on item 9 (best language) of the NIH stroke scale
- Severe neglect as measured by a score of 2 on item 11 (extinction and inattention) of the NIH stroke scale