Mapping the Causal Roles of Non-Primary Motor Areas in Human Reach Planning and Execution.
Golnaz Haddadshargh, Roberto M de Freitas, Jennifer Mak...
https://pubmed.ncbi.nlm.nih.gov/41641924/Actively Recruiting
Led by VA Office of Research and Development · Updated on 2026-06-02
76
Participants Needed
1
Research Sites
39 weeks
Total Duration
Researchers are investigating how different areas of the brain control arm movement before and after stroke, using Transcranial Magnetic Stimulation TMS during reaching movements performed with a robotic arm device. The study focuses on reorganization of brain network interactions after a common type of subcortical stroke, aiming to understand how connectivity between premotor and primary motor areas changes and influences motor performance. This knowledge may help develop targeted brain stimulation treatments to improve arm function after stroke. Participants will receive paired pulse TMS while performing reaching tasks with an advanced exoskeleton robotic system. The main study period involves using TMS synchronized with the reaching movements to examine how brain areas contribute to motor control. This approach is designed to collect detailed data on brain connectivity and motor output during the task. During the study, participants will be evaluated with measures such as path length, movement times, velocities, accuracy, and muscle activity EMG immediately following stimulation. The study includes behavioral testing and neurophysiology assessments to understand brain and motor function. Participants medical stability and ability to engage in tasks will be monitored, with total involvement lasting as long as the testing and training sessions require.
CONDITIONS
Brain Connections for Arm Movement After Stroke
A
Amy Boos
G
George F Wittenberg, MD PhD
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VA Office of Research and Development
Lead Sponsor
VA Pittsburgh Healthcare System
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Paired-Pulse TMS and Arm Task (Trial Intervention) | Task-Oriented Arm Rehabilitation (Context Comparator) |
|---|---|---|
| What it is | A research-based procedure using paired-pulse transcranial magnetic stimulation (TMS) targeted to the brain's motor regions, combined with reaching and movement tasks, in people with chronic arm weakness following stroke. | Usual post-stroke rehabilitation practice consisting of individualized, task-oriented upper limb therapy aimed at improving movement and function through repetitive, structured activities led by rehabilitation therapists. |
| Role in trial | Primary investigational intervention; all trial participants undergo TMS with concurrent motor tasks for research purposes. | Represents the current care approach outside experimental settings for eligible patients with similar stroke history and arm dysfunction. |
| Primary use | Exploring how TMS can assess and potentially influence brain connectivity and arm movement ability after chronic stroke. | Designed to improve real-world use and function of the affected upper limb after stroke through repetitive activity-focused therapy. |
| How it is given or performed | Participants receive paired pulses of magnetic stimulation to brain regions while performing reaching or motor tasks, under carefully controlled and monitored conditions. | Therapy sessions are delivered by rehabilitation professionals, typically several times per week, emphasizing repetitive, meaningful arm movements tailored to individual needs and therapy goals. |
| Evidence status | Currently under research; no published outcome results for this specific protocol are available yet. | Extensive clinical guideline and research support exists for improved arm function with consistent task-oriented rehabilitation in chronic stroke. |
| Important limitations | Long-term clinical benefit, safety, and functional impact of paired TMS on arm recovery in stroke survivors are not yet established, and participation is limited to eligible research volunteers. | Functional improvements with standard upper limb rehabilitation may plateau over time, and individual response can vary, especially in chronic stroke with persistent deficits. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Duration of active participation in the trial until completion
Participants receive transcranial magnetic stimulation while performing reaching movements using a robotic system to study brain connectivity and improve arm movement after stroke.
Multiple visits during treatment sessions as scheduled by the study team
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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https://pubmed.ncbi.nlm.nih.gov/12376621/VA Office of Research and Development
Lead Sponsor
VA Pittsburgh Healthcare System
Collaborating Sponsor