经颅磁刺激调控触觉输入改善脑卒中患者上肢运动功能的作用及机制研究

注册号:

Registration number:

ChiCTR2300068830 

最近更新日期:

Date of Last Refreshed on:

2023-03-01 14:15:09 

注册时间:

Date of Registration:

2023-03-01 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

经颅磁刺激调控触觉输入改善脑卒中患者上肢运动功能的作用及机制研究

Public title:

Effects and Mechanisms of Repetitive Transcranial Magnetic Stimulation in Modulating Tactile Input to Improve Motor Function of the Upper Limb in Stroke Patients

注册题目简写:

English Acronym:

研究课题的正式科学名称:

重复经颅磁刺激调控触觉输入改善脑卒中患者上肢运动功能的作用及机制研究

Scientific title:

Effects and Mechanisms of Repetitive Transcranial Magnetic Stimulation in Modulating Tactile Input to Improve Motor Function of the Upper Limb in Stroke Patients

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

厉坤鹏 

研究负责人:

马洁 

Applicant:

Kun-peng Li 

Study leader:

Jie Ma 

申请注册联系人电话:

Applicant telephone:

13817889456

研究负责人电话:

Study leader's
telephone:

19921145567

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

xyfyli@163.com

研究负责人电子邮件:

Study leader's E-mail:

312523418@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市蔡伦路1200号

研究负责人通讯地址:

上海市甘河路110号

Applicant address:

No.1200 Cailun Road,Shanghai

Study leader's address:

No.110 Ganhe Road,Shanghai

申请注册联系人邮政编码:

Applicant postcode:

201203

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

上海中医药大学附属岳阳中西医结合医院

Applicant's institution:

Yueyang Hospital of Integrative Medicine affiliated to Shanghai University of Traditional Chinese Medicine

研究负责人所在单位:

上海中医药大学附属岳阳中西医结合医院

Affiliation of the Leader:

Yueyang Hospital of Integrative Medicine affiliated to Shanghai University of Traditional Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2023-019

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

上海中医药大学附属岳阳中西医结合医院伦理委员会

Name of the ethic committee:

Ethics Committee of Yueyang Hospital of Integrative Medicine affiliated to Shanghai University of Traditional Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2023-01-16 00:00:00

伦理委员会联系人:

殷从全

Contact Name of the ethic committee:

Cong-quan Yin

伦理委员会联系地址:

上海市甘河路110号

Contact Address of the ethic committee:

No.110 Ganhe Road,Shanghai

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 65161782 8122

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

上海中医药大学附属岳阳中西医结合医院

Primary sponsor:

Yueyang Hospital of Integrative Medicine affiliated to Shanghai University of Traditional Chinese Medicine

研究实施负责(组长)单位地址:

上海市甘河路110号

Primary sponsor's address:

No.110 Ganhe Road,Shanghai

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海中医药大学附属岳阳中西医结合医院

具体地址:

上海市甘河路110号

Institution
hospital:

Yueyang Hospital of Integrative Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Address:

No.110 Ganhe Road,Shanghai

经费或物资来源:

自筹经费

Source(s) of funding:

Self-funding

研究疾病:

脑卒中  

Target disease:

stroke

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

治疗新技术临床试验 

Study phase:

New Treatment Measure Clinical Study

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

1、通过刺激皮质下核团在皮质的映射点,达到间接刺激皮质下核团的目的,从而构建整合外周感觉刺激和中枢干预的方案,从触觉输入的角度调控大脑皮质的运动输出。 2、通过对比皮质-皮质关联刺激方案(cortico-cortical paired associative stimulation, ccPAS)和常规重复经颅磁刺激方案(repetitive transcranial magnetic stimulation, rTMS),明确本方案对健康成人上肢运动功能的作用,为脑卒中患者的康复提供新方法。 3、通过分析患者ccPAS干预前后上肢运动功能指标、触觉指标、电生理指标及磁共振数据的变化,阐明触觉输入促进脑卒中后上肢运动功能的作用和可能的机制。  

Objectives of Study:

1. By stimulating the subcortical clusters at their mapping points in the cortex, the subcortical clusters are indirectly stimulated, thus building a protocol that integrates peripheral sensory stimulation and central intervention to modulate the motor output of the cerebral cortex from the perspective of tactile input. 2. By comparing the cortico-cortical paired associative stimulation (ccPAS) and the conventional repetitive transcranial magnetic stimulation (rTMS), in order to clarify the effect of this protocol on the motor function of cortical stimulation in healthy adults, and to provide a new approach to the rehabilitation of stroke patients. 3. To elucidate the effects and possible mechanisms of tactile input in promoting upper limb motor function after stroke by analyzing the changes in upper limb motor function indexes, tactile indexes, electrophysiological indexes and magnetic resonance data before and after the ccPAS intervention in patients.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

健康成人排除标准:
①任何经颅磁刺激的禁忌证,如体内有金属植入物、起搏器等异物;
②脑卒中、糖尿病周围神经病变、末梢神经炎等神经疾病或精神疾病引起的肢体感觉障碍;
③药物或烟酒等成瘾性物质成瘾史等相关的医学问题;
④妊娠期或哺乳期女性等。
脑卒中患者排除标准:
①短暂性脑缺血发作、复发性脑卒中、原发性或继发性脑内血肿,或蛛网膜下腔出血,或硬膜下/硬膜外血肿;
②病灶累及刺激靶点(M1手、S2和丘脑VPL)。
③任何经颅磁刺激的禁忌证,如体内有金属植入物、心脏起搏器等异物;严重意识障碍与交流障碍(视力、听力、言语及认知有严重障碍者);
④既往精神病史、癫痫病史或正在进行抗癫痫治疗等;
⑤严重肝、肺、心、肾等内脏疾病。
⑥药物或烟酒等其他成瘾性物质成瘾史等相关的医学问题;
⑦患有帕金森病、周围神经病变、脑肿瘤、脓肿或脊髓疾病等其他可导致运动功能障碍的疾病。

Exclusion criteria:

Exclusion criteria for healthy adults.
① Contraindications to any transcranial magnetic stimulation, such as the presence of foreign bodies such as metal implants, pacemakers, etc. in the body.
② limb sensory dysfunction caused by neurological diseases such as stroke, diabetic peripheral neuropathy, peripheral neuritis or psychiatric disorders.
③ Medical problems related to a history of addiction to drugs or addictive substances such as alcohol or tobacco.
④ Pregnant or lactating women, etc.
Exclusion criteria for stroke patients.
① transient ischemic attack, recurrent stroke, primary or secondary intracerebral hematoma, or subarachnoid hemorrhage, or subdural/epidural hematoma.
② lesions involving the stimulation target (M1 hand, S2 and thalamic VPL).
③ Contraindications to any transcranial magnetic stimulation, such as the presence of foreign bodies such as metallic implants, pacemakers, etc.; severe impairment of consciousness and communication (those with severe impairment of vision, hearing, speech and cognition).
④ Previous history of psychiatric disorders, epilepsy or ongoing antiepileptic treatment, etc.
⑤ Severe internal organ diseases such as liver, lung, heart, kidney, etc.
⑥ Medical problems related to a history of addiction to drugs or other addictive substances such as alcohol or tobacco
⑦ Suffering from other diseases that can cause motor dysfunction such as Parkinson's disease, peripheral neuropathy, brain tumor, abscess or spinal cord disease.

研究实施时间:

Study execute time:

From 2023-03-01 00:00:00 To 2024-03-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2023-03-01 00:00:00 To 2024-03-31 00:00:00

干预措施:

Interventions:

组别:

rTMS组

样本量:

20

Group:

rTMS group

Sample size:

干预措施:

重复经颅磁刺激

干预措施代码:

Intervention:

transcranial magnetic stimulation

Intervention code:

组别:

假rTMS组

样本量:

20

Group:

sham rTMS group

Sample size:

干预措施:

假重复经颅磁刺激

干预措施代码:

Intervention:

sham transcranial magnetic stimulation

Intervention code:

组别:

ccPAS组

样本量:

19

Group:

ccPAS group

Sample size:

干预措施:

皮质-皮质配对关联刺激

干预措施代码:

Intervention:

Cortico-cortical paired association stimulation

Intervention code:

组别:

假ccPAS组

样本量:

19

Group:

sham ccPAS group

Sample size:

干预措施:

皮质-皮质配对关联刺激

干预措施代码:

Intervention:

Cortico-cortical paired association stimulation

Intervention code:

组别:

ccPAS卒中组

样本量:

20

Group:

ccPAS stroke group

Sample size:

干预措施:

皮质-皮质配对关联刺激

干预措施代码:

Intervention:

Cortico-cortical paired association stimulation

Intervention code:

组别:

假ccPAS卒中组

样本量:

20

Group:

sham ccPAS group

Sample size:

干预措施:

假皮质-皮质配对关联刺激

干预措施代码:

Intervention:

sham Cortico-cortical paired association stimulation

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海中医药大学附属岳阳中西医结合医院 

单位级别:

三级甲等 

Institution
hospital:

Yueyang Hospital of Integrative Medicine affiliated to Shanghai University of Traditional Chinese Medicine

Level of the institution:

grade 3A

测量指标:

Outcomes:

指标中文名:

运动诱发电位

指标类型:

主要指标

Outcome:

motor evoked potential

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

触觉评定单丝皮肤压力测试

指标类型:

次要指标

Outcome:

Semmes-Weinstein monofilament cutaneous sensibility threshold test

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

两点辨别觉

指标类型:

次要指标

Outcome:

Two-point Discrimination

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

手指敲击试验

指标类型:

次要指标

Outcome:

Finger tapping test

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肌电图

指标类型:

次要指标

Outcome:

Electromyography

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

磁共振数据

指标类型:

次要指标

Outcome:

Magnetic Resonance Data

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

Fugl-Meyer运动功能量表上肢部分

指标类型:

主要指标

Outcome:

Fugl-Meyer Assessment Upper Extremity Scale

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

Brunnstrom分期

指标类型:

次要指标

Outcome:

Brunnstrom stage

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

国立卫生研究院卒中量表

指标类型:

次要指标

Outcome:

national institutes of health stroke scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

Wolf上肢运动功能测试量表

指标类型:

次要指标

Outcome:

Wolf motor function test

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

上肢肌力

指标类型:

次要指标

Outcome:

Muscle strength of upper limb

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

上肢关节活动度

指标类型:

次要指标

Outcome:

Range of motion of upper limb

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

改良Barthel指数

指标类型:

次要指标

Outcome:

modified Barthel index

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

卒中专门生存质量量表

指标类型:

次要指标

Outcome:

Stroke-specific quality of life scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由不参与研究实施的人员,通过 SPSS 26.0 产生随机序列。

Randomization Procedure (please state who generates the random number sequence and by what method):

The random sequence was generated by the personnel who did not participate in the study implementation through SPSS 26.0.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

评估者和受试者不知晓随机分配方案。

Blinding:

Assessors and subjects were unaware of the random assignment protocol.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

无,根据投稿的期刊要求,提供给投稿期刊。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None, provided to the submitting journal according to the requirements of the submitting journal.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2023-03-01 14:14:49