Non-invasive Brain Stimulation Using Paired Associative Stimulation to Improve Motor Recovery and Reduce Pain in Stroke and Phantom Limb Pain Patients

What this Trial Is About

Researchers are exploring new non-invasive brain stimulation techniques to help improve motor recovery and reduce pain in people with neurological conditions such as stroke and phantom limb pain. This study evaluates a standard paired associative stimulation PAS protocol and a novel cross-modal mirror-PAS protocol that targets a broader visuomotor brain network. The goal is to understand which method better promotes brain plasticity and sensory-motor function. Participants will undergo two separate sessions receiving either the standard PAS or the mirror-PAS. The standard PAS uses paired stimuli to the motor system, while the mirror-PAS pairs a visual hand movement stimulus with transcranial magnetic stimulation TMS to the motor cortex. The study includes two phases one with stroke patients experiencing upper-limb hemiparesis and another with patients suffering phantom limb pain after upper limb amputation. During the study, researchers will measure changes in motor-evoked potentials and brain mapping related to phantom limb areas before and after the PAS protocols. Participants will be monitored for neurophysiological and behavioral changes to assess the effects of each treatment. The study runs until September 2026 and involves regular assessments to track brain plasticity and functional improvements.

Novel Non-invasive Brain Stimulation Techniques in Neurological Rehabilitation