Dystonia Synergistic Intervention
| Status: | Completed |
|---|---|
| Conditions: | Neurology, Orthopedic |
| Therapuetic Areas: | Neurology, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 3/1/2014 |
| Start Date: | November 2011 |
| End Date: | August 2013 |
| Contact: | Teresa J Kimberley, PhD, PT |
| Email: | tjk@umn.edu |
| Phone: | 612-626-4096 |
Determining the Efficacy of Synergistic Intervention With rTMS and Sensorimotor Retraining
This study is exploring a new experimental procedure in dystonia called repetitive
transcranial magnetic brain stimulation (TMS) combined with rehabilitation. The purpose of
the study is to determine whether repetitive TMS is effective as a treatment to reduce
symptoms in dystonia as demonstrated by improved motor performance.
transcranial magnetic brain stimulation (TMS) combined with rehabilitation. The purpose of
the study is to determine whether repetitive TMS is effective as a treatment to reduce
symptoms in dystonia as demonstrated by improved motor performance.
BACKGROUND: Though the etiology of focal hand dystonia (FHD) is uncertain, two primary
factors implicated in the development of dystonic symptoms are excessive cortical
excitability and impaired sensorimotor processing.
OBJECTIVE: The purpose of this study was to determine the functional efficacy and neural
effects of a Dual intervention of rTMS and sensorimotor retraining. Our working hypothesis
is: subjects receiving the combined intervention will (1) display significantly improved
handwriting measures; (2) report significant improvement in daily functional ability; (3)
display reduced hand cramping compared; and (4) demonstrate reduced corticospinal
excitability after the Dual intervention when compared to the rTMS+ stretching and massage
(Sham) intervention.
METHODS: A randomized, single-subject, multiple baseline design with crossover is used for
this study that will examine ten subjects with FHD with two interventions: five days of
low-frequency 1 Hz rTMS + sensorimotor retraining (Dual intervention) vs. rTMS + stretching
and massage (Sham). The rTMS is applied to the premotor cortex at 1 Hz at 90% resting motor
threshold for 1200 pulses. For sensorimotor retraining, a subset of the Learning-based
Sensorimotor Training program was followed.
factors implicated in the development of dystonic symptoms are excessive cortical
excitability and impaired sensorimotor processing.
OBJECTIVE: The purpose of this study was to determine the functional efficacy and neural
effects of a Dual intervention of rTMS and sensorimotor retraining. Our working hypothesis
is: subjects receiving the combined intervention will (1) display significantly improved
handwriting measures; (2) report significant improvement in daily functional ability; (3)
display reduced hand cramping compared; and (4) demonstrate reduced corticospinal
excitability after the Dual intervention when compared to the rTMS+ stretching and massage
(Sham) intervention.
METHODS: A randomized, single-subject, multiple baseline design with crossover is used for
this study that will examine ten subjects with FHD with two interventions: five days of
low-frequency 1 Hz rTMS + sensorimotor retraining (Dual intervention) vs. rTMS + stretching
and massage (Sham). The rTMS is applied to the premotor cortex at 1 Hz at 90% resting motor
threshold for 1200 pulses. For sensorimotor retraining, a subset of the Learning-based
Sensorimotor Training program was followed.
Inclusion Criteria:
- Greater than 18 years of age
- Symptoms of focal hand dystonia or writer's cramp
Exclusion Criteria:
- History of seizure or other neurologic disorder
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2
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