Recruiting

Brain Stimulation

Sponsor:

University of North Carolina, Chapel Hill

Code:

NCT07121582

Conditions

Stroke

Eligibility Criteria

Sex: All

Age: 45 - 70+

Healthy Volunteers: Not accepted

Interventions

Motor Brain Stimulation

Visual Brain Stimulation

Study Details

Brief summary:

The goal of this research study is to examine communication between brain and muscle in individuals with stroke and determine if applying non-invasive brain stimulation to different parts of the brain improves this communication and performance on a hand squeezing task.

The investigators will fit participants with an electroencephalography (EEG) cap and place electromyography (EMG) stickers on participants hand and arm muscles to record brain and muscle activity, respectively.

Participants will complete a single research visit lasting approximately 3 hours. During this visit, participants will receive two different types of non-invasive brain stimulation: \[1\] stimulation to the motor part of the brain and \[2\] stimulation to the visual part of the brain. Participants will be randomized so that half will receive stimulation to the motor part of the brain first followed by stimulation to the visual part of the brain second and vice versa. Participants will complete three blocks of hand squeezing trials using the stroke-affected (weak) hand. During the first block of squeezing trials, no brain stimulation will occur. During the second and third blocks, participants will receive stimulation just before each hand squeezing trial. The investigators will record participants' brain and muscle activity during these blocks of hand squeezing trials. Additionally, participants will also complete screening tests and exams looking at mood, motor function, and cognition.

Conditions

Stroke

Study ID

NCT07121582

Start date

Dec 1, 2025

Status verified date

Feb, 2026

Completion date

Jan, 2027

Anticipated

Primary completion date

Jan, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 45 - 70+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Chronic (≥ 6 months) unilateral cortical/subcortical ischemic or hemorrhagic stroke as confirmed by medical records
  • Upper extremity weakness (hemiparesis) contralateral to the stroke
  • Sufficient cognitive capacity (Montreal Cognitive Assessment ≥ 21 points), communication function, and English proficiency to understand and safely comply with all study procedures
  • Ipsilesional motor-evoked potential response
  • Able to perform isometric grip task by making a fist with their stroke-affected hand (hand contralateral to the stroke)

Exclusion Criteria:

  • Contraindications to TMS (seizure activity within past 2 years, pregnancy, indwelling metal)
  • Cognitive deficits (Montreal Cognitive Assessment < 21 points)
  • Concurrent physical/occupational therapy and/or clinical trial participation related to stroke
  • Injury or conditions that impact affected extremity-use beyond stroke (e.g., arthritis)
  • Impaired vision despite use of aid (e.g. glasses, contacts, etc.)
  • Cerebellar stroke
  • Major medical/neurological/psychiatric condition impacting physical function in the opinion of the physician co-investigator
  • Absent ipsilesional motor-evoked potential response

Study Design

Enrollment

20 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Other

Interventions and Outcome Measures

Arms

experimental: Motor then Visual Brain Stimulation

Following the first block of 20 grip/squeeze trials completed without brain stimulation, participants will complete a second and third set of blocks where non-invasive brain stimulation just before each grip trial will occur. Participants randomized to the "motor then visual brain stimulation" arm will receive stimulation to the motor part of their brain first followed by non-invasive brain stimulation to the visual (occipital) part of the brain. A 10-15 min participant break will separate the delivery of motor and visual brain stimulation (i.e., second and third blocks).

experimental: Visual then Motor Brain Stimulation

Following the first block of 20 grip/squeeze trials completed without brain stimulation, participants will complete a second and third set of blocks where non-invasive brain stimulation just before each grip trial will occur. Participants randomized to the "visual then motor brain stimulation" arm will receive stimulation to the visual part of their brain first followed by non-invasive brain stimulation to the motor part of the brain. A 10-15 min participant break will separate the delivery of visual and motor brain stimulation (i.e., second and third blocks).

Interventions

Motor Brain Stimulation

For each grip trial (20 grip trials per block), participants will receive visual cues that signify the onset and offset of squeezing. Just prior to the start of the visual cue representing the onset of squeezing, participants will receive a burst of repetitive transcranial magnetic stimulation (rTMS) to their primary motor hotspot region. Motor brain stimulation will involve 3 bursts of 5 pulses/burst with a 20 Hz inter-pulse interval delivered at 90% of their resting or active motor threshold.

Visual Brain Stimulation

For each grip trial (20 grip trials per block), participants will receive visual cues that signify the onset and offset of squeezing. Just prior to the start of the visual cue representing the onset of squeezing, participants will receive a burst of repetitive transcranial magnetic stimulation (rTMS) to their ipsilesional occipital cortex region. Visual brain stimulation will involve 3 burst of 5 pulses/burst with a 20 Hz inter-pulse interval delivered at 90% of their resting or active motor threshold.

Primary outcome measure

  • Corticomuscular Coherence Change [ Time Frame: Immediately (within 5 minutes) before and after (within 5 minutes) each stimulation block. ]
  • Grip Precision [ Time Frame: Immediately (within 5 minutes) before and after (within 5 minutes) each stimulation block. ]
  • Reaction Time [ Time Frame: Immediately (within 5 minutes) before and after (within 5 minutes) each stimulation block. ]

Central Contacts and Locations

Central contacts

Jessica M Cassidy, DPT, PT, PhD

919-966-8404CassidyLab@unc.edu

Locations

Bondurant Hall

Recruiting

Chapel Hill, North Carolina, United States, 27514

Contacts

Jessica M Cassidy, PT, DPT, PhD

919-843-5774jcassidy@med.unc.edu

More Information

Sponsor

University of North Carolina, Chapel Hill

Last update posted

Apr 27, 2026

Last verified

Feb, 2026

Keywords

  • stroke
  • neurostimulation
  • brain
  • motor
  • hand
  • electroencephalography

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by University of North Carolina, Chapel Hill on 2026-04-27.