Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial
Abstract Introduction : Brain has a spontaneous recovery after stroke, reflecting the plasticity of the brain. Currently, TMS is used for studies of single-target brain region modulation, which lacks consideration of brain networks and functional connectivity. Cortico-cortical paired associative sti...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12883-023-03218-2 |
| _version_ | 1797836434297585664 |
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| author | Jun-Peng Zhang Xiang-Xin Xing Mou-Xiong Zheng Jia-Jia Wu Xin Xue Yu-Lin Li Xu-Yun Hua Shu-Jie Ma Jian-Guang Xu |
| author_facet | Jun-Peng Zhang Xiang-Xin Xing Mou-Xiong Zheng Jia-Jia Wu Xin Xue Yu-Lin Li Xu-Yun Hua Shu-Jie Ma Jian-Guang Xu |
| author_sort | Jun-Peng Zhang |
| collection | DOAJ |
| description | Abstract Introduction : Brain has a spontaneous recovery after stroke, reflecting the plasticity of the brain. Currently, TMS is used for studies of single-target brain region modulation, which lacks consideration of brain networks and functional connectivity. Cortico-cortical paired associative stimulation (ccPAS) promotes recovery of motor function. Multisensory effects in primary visual cortex(V1) directly influence behavior and perception, which facilitate motor functional recovery in stroke patients. Therefore, in this study, dual-targeted precise stimulation of V1 and primary motor cortex(M1) on the affected hemisphere of stroke patients will be used for cortical visuomotor multisensory integration to improve motor function. Method This study is a randomized, double-blind controlled clinical trial over a 14-week period. 69 stroke subjects will be enrolled and divided into sham stimulation group, ccPAS low frequency group, and ccPAS high frequency group. All groups will receive conventional rehabilitation. The intervention lasted for two weeks, five times a week. Assessments will be performed before the intervention, at the end of the intervention, and followed up at 6 and 14 weeks. The primary assessment indicator is the ‘Fugl-Meyer Assessment of the Upper Extremity ’, secondary outcomes were ‘The line bisection test’, ‘Modified Taylor Complex Figure’, ‘NIHSS’ and neuroimaging assessments. All adverse events will be recorded. Discussion Currently, ccPAS is used for the modulation of neural circuits. Based on spike-timing dependent plasticity theory, we can precisely intervene in the connections between different cortices to promote the recovery of functional connectivity on damaged brain networks after stroke. We hope to achieve the modulation of cortical visuomotor interaction by combining ccPAS with the concept of multisensory integration. We will further analyze the correlation between analyzing visual and motor circuits and explore the alteration of neuroplasticity by the interactions between different brain networks. This study will provide us with a new clinical treatment strategy to achieve precise rehabilitation for patient with motor dysfunction after stroke. Trial registration This trial was registered in the Chinese Clinical Trial Registry with code ChiCTR2300067422 and was approved on January 16, 2023. |
| first_indexed | 2024-04-09T15:08:51Z |
| format | Article |
| id | doaj.art-b4a40d02cd1e4eb3aae0f5f724e277a1 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-04-09T15:08:51Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-b4a40d02cd1e4eb3aae0f5f724e277a12023-04-30T11:19:27ZengBMCBMC Neurology1471-23772023-04-0123111010.1186/s12883-023-03218-2Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trialJun-Peng Zhang0Xiang-Xin Xing1Mou-Xiong Zheng2Jia-Jia Wu3Xin Xue4Yu-Lin Li5Xu-Yun Hua6Shu-Jie Ma7Jian-Guang Xu8School of Rehabilitation Science, Shanghai University of Traditional Chinese MedicineDepartment of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineDepartment of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineDepartment of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineSchool of Rehabilitation Science, Shanghai University of Traditional Chinese MedicineSchool of Rehabilitation Science, Shanghai University of Traditional Chinese MedicineDepartment of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineRehabilitation Department of Traditional Chinese Medicine, The Second Rehabilitation Hospital of ShanghaiSchool of Rehabilitation Science, Shanghai University of Traditional Chinese MedicineAbstract Introduction : Brain has a spontaneous recovery after stroke, reflecting the plasticity of the brain. Currently, TMS is used for studies of single-target brain region modulation, which lacks consideration of brain networks and functional connectivity. Cortico-cortical paired associative stimulation (ccPAS) promotes recovery of motor function. Multisensory effects in primary visual cortex(V1) directly influence behavior and perception, which facilitate motor functional recovery in stroke patients. Therefore, in this study, dual-targeted precise stimulation of V1 and primary motor cortex(M1) on the affected hemisphere of stroke patients will be used for cortical visuomotor multisensory integration to improve motor function. Method This study is a randomized, double-blind controlled clinical trial over a 14-week period. 69 stroke subjects will be enrolled and divided into sham stimulation group, ccPAS low frequency group, and ccPAS high frequency group. All groups will receive conventional rehabilitation. The intervention lasted for two weeks, five times a week. Assessments will be performed before the intervention, at the end of the intervention, and followed up at 6 and 14 weeks. The primary assessment indicator is the ‘Fugl-Meyer Assessment of the Upper Extremity ’, secondary outcomes were ‘The line bisection test’, ‘Modified Taylor Complex Figure’, ‘NIHSS’ and neuroimaging assessments. All adverse events will be recorded. Discussion Currently, ccPAS is used for the modulation of neural circuits. Based on spike-timing dependent plasticity theory, we can precisely intervene in the connections between different cortices to promote the recovery of functional connectivity on damaged brain networks after stroke. We hope to achieve the modulation of cortical visuomotor interaction by combining ccPAS with the concept of multisensory integration. We will further analyze the correlation between analyzing visual and motor circuits and explore the alteration of neuroplasticity by the interactions between different brain networks. This study will provide us with a new clinical treatment strategy to achieve precise rehabilitation for patient with motor dysfunction after stroke. Trial registration This trial was registered in the Chinese Clinical Trial Registry with code ChiCTR2300067422 and was approved on January 16, 2023.https://doi.org/10.1186/s12883-023-03218-2StrokeTranscranial magnetic stimulationSpike-timing dependent plasticityCortico-cortical paired-association stimulationPrimary visual cortexPrimary motor cortex |
| spellingShingle | Jun-Peng Zhang Xiang-Xin Xing Mou-Xiong Zheng Jia-Jia Wu Xin Xue Yu-Lin Li Xu-Yun Hua Shu-Jie Ma Jian-Guang Xu Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial BMC Neurology Stroke Transcranial magnetic stimulation Spike-timing dependent plasticity Cortico-cortical paired-association stimulation Primary visual cortex Primary motor cortex |
| title | Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial |
| title_full | Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial |
| title_fullStr | Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial |
| title_full_unstemmed | Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial |
| title_short | Effects of cortico-cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients: study protocol for a randomized doubled blind clinical trial |
| title_sort | effects of cortico cortical paired associative stimulation based on multisensory integration to brain network connectivity in stroke patients study protocol for a randomized doubled blind clinical trial |
| topic | Stroke Transcranial magnetic stimulation Spike-timing dependent plasticity Cortico-cortical paired-association stimulation Primary visual cortex Primary motor cortex |
| url | https://doi.org/10.1186/s12883-023-03218-2 |
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