Status:

COMPLETED

Interhemispheric Connectivity and Compensation

Lead Sponsor:

Washington University School of Medicine

Collaborating Sponsors:

National Institute of Neurological Disorders and Stroke (NINDS)

Conditions:

Peripheral Nerve Injury Upper Limb

Healthy

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

The goal of this study is to determine which parts of the brain make it possible for some people to move skillfully with their left non-dominant hand.

Detailed Description

This is a one-visit study, in which right-handed participants (individuals with unilateral peripheral nerve injury to the right upper limb, and healthy controls) will complete surveys and perform move...

Eligibility Criteria

Inclusion

  • This study contains two groups: typical controls and patients. Participants will be matched by age and sex between the two groups. No randomization will occur.
  • A. Inclusion criteria (all participants):
  • Age ≥ 18
  • English speaking and reading
  • Able to fit in Prisma scanner bore (60 cm diameter)
  • Right hand dominant (self report, and Edinburgh handedness ≥ +40)
  • B. Inclusion criteria (patients only):
  • Chronic unilateral upper extremity peripheral nerve injury to the right side
  • "Chronic" defined as ≥ 6 months since injury
  • "Upper extremity" defined as hand, arm, or shoulder (including e.g. brachial plexus)
  • "Injury" defined as localized cause (e.g. mechanical/tumor, not distributed pathology), including compression
  • Some impairment to writing, requiring both of:
  • Difficulty writing, as determined by score 2+ (Mild+) on "How much difficulty have you had in the last week with writing?" (From Disabilities of the Arm, Shoulder, and Hand survey question #2)
  • Box and Blocks motor performance ≥1 standard deviation below the mean of age-matched healthy adults (Mathiowetz et al. 1985, AJOT).
  • C. Exclusion criteria (all participants)
  • Currently intoxicated or otherwise non-compliant
  • Chronic pain diagnosis unrelated to the nerve injury
  • Uncorrected visual impairment that interferes with ability to see drawings in MRI
  • Motor function diagnoses that affect function of the left hand, now or in past 2 years
  • Motor function diagnoses currently affecting the right hand, unrelated to the nerve injury
  • This is not meant to exclude a single event with complex consequences (e.g. nerve and tendon)
  • This is not meant to exclude multiple nerve injuries in the same arm, if each one is eligible (II.B.1)
  • This is meant to exclude e.g. injury and unrelated musculoskeletal disorder in same arm
  • Upper extremity surgery, including peripheral nerve surgery, within last 2 months
  • Contraindication for MRI
  • Contraindication for transcranial magnetic stimulation (TMS)
  • May exclude from TMS only (since not all participants undergo TMS), or exclude from full study
  • Amputation affecting any part of thumb, index, or middle fingers (including higher level, e.g. whole hand)
  • History of chronic cocaine use (based on medical record or volunteered; will not actively inquire)
  • Diagnosis of schizophrenia or other rare psychiatric disorder
  • This is not meant to exclude depression or anxiety
  • History of major neurological diagnosis, e.g. stroke, traumatic brain injury, Alzheimer's, Parkinson's
  • This is not meant to exclude concussion UNLESS \< 6 months ago, or post-concussion syndrome (diagnosed or self-report)
  • D. Exclusion criteria (controls only)
  • 1\. Motor function diagnoses that affect function of either hand, now or in past 2 years

Exclusion

    Key Trial Info

    Start Date :

    December 9 2021

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    August 1 2025

    Estimated Enrollment :

    120 Patients enrolled

    Trial Details

    Trial ID

    NCT05207878

    Start Date

    December 9 2021

    End Date

    August 1 2025

    Last Update

    October 9 2025

    Active Locations (1)

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    Washington University School of Medicine

    St Louis, Missouri, United States, 63108