Status:

COMPLETED

TMS and Exercise for Post-stroke Pain

Lead Sponsor:

VA Office of Research and Development

Conditions:

Chronic Post-stroke Headache

Eligibility:

All Genders

19+ years

Phase:

PHASE1

Brief Summary

There are over 7 million people living with stroke in the United States. Per year, approximately 17,000 Veterans are admitted to the VA for acute stroke. Chronic pain after stroke can occur between 10...

Eligibility Criteria

Inclusion

  • Male or female Veteran of US military 19 years of age
  • Signed informed consent
  • Minimum of 3-months since time of stroke and medically stable
  • Headache has persisted for \>3 months after stabilization of the stroke
  • Ability to walk or tolerate recumbent cycle ergometry for 10 mins without assistance
  • Stable pain medication regimen for 1 month prior to study
  • Females of child-bearing potential (i.e. not postmenopausal or surgically sterile) must be using a medically acceptable method of birth control and should not be pregnant nor have plans for pregnancy or breastfeeding during the study
  • Completed diagnostic, maximal graded exercise test including 12-lead ECG and indirect calorimetry (i.e. oxygen uptake, minute ventilation, respiratory exchange ratio, etc.)
  • Minimum pain intensity of 30 on the Mechanical Visual Analogue Scale on average with pain symptoms.

Exclusion

  • Moderate to severe cognitive impairment (Montreal Cognitive Assessment score \<16/30)
  • Pre-stroke modified Rankin \>2
  • History of seizures
  • Presence of any standard TMS or MRI contraindications (see human subjects)
  • Current diagnosis of DSM-5-defined bipolar disorder I, schizophrenia, schizoaffective disorder, or obsessive-compulsive disorder
  • Diagnosis of moderate or severe substance use disorder (except for caffeine and nicotine) during the preceding 3 months (Participants must agree to abstain from illicit drugs during the study)
  • Increased risk of suicide that necessitates inpatient treatment or warrants additional therapy excluded by the protocol; and/or intensity of suicidal ideation (Type 4 or Type 5) or any suicidal behavior in the past 3 months on Columbia Suicide Severity Rating Scale (C-SSRS)
  • Litigating for compensation for a psychiatric disorder
  • Veterans who are in the process of applying for or receiving VA service-connected disability are eligible
  • Current enrollment in another intervention trial for pain or stroke
  • Persons imprisoned, of minor age, diagnosed with terminal illness, or require surrogate for consent
  • Fails baseline exercise screening activities
  • Persistent post-stroke headaches not better accounted for by another diagnosis
  • Is unable to reliably attend intervention sessions i.e. planning to move, transportation issues
  • Neurological disorder pre- or post- stroke affecting subject's ability to follow study directions

Key Trial Info

Start Date :

January 14 2022

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 30 2024

Estimated Enrollment :

9 Patients enrolled

Trial Details

Trial ID

NCT04672044

Start Date

January 14 2022

End Date

December 30 2024

Last Update

June 15 2025

Active Locations (1)

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Page 1 of 1 (1 locations)

1

Birmingham VA Medical Center, Birmingham, AL

Birmingham, Alabama, United States, 35233-1927