Comparison between mechanisms underlying effects of repetitive peripheral nerve stimulation on upper limb motor performance in the subacute and chronic phases after stroke

• Grant number: 18/03737-8
• Support Opportunities: Regular Research Grants
• Duration: December 01, 2018 - November 30, 2022
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Adriana Bastos Conforto
• Grantee: Adriana Bastos Conforto
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil
• Associated researchers: Benjamim Wolf Handfas ; Edson Amaro Junior ; Gisele Sampaio Silva ; Suzete Nascimento Farias da Guarda
• Associated grant(s): 19/00956-3 - Neuroprotective effects of neuromodulation in acute stroke, AP.R SPRINT
• Associated scholarship(s): 21/05874-5 - Comparison between mechanisms underlying effects of repetitive peripheral nerve stimulation on upper limb motor performance in the subacute and chronic phases after stroke, BP.TT; 21/06704-6 - Comparison between mechanisms underlying effects of repetitive peripheral nerve stimulation on upper limb motor performance in the subacute and chronic phases after stroke, BP.TT; 19/27859-8 - Comparison between mechanisms underlying effects of repetitive peripheral nerve stimulation on upper limb motor performance in the subacute and chronic phases after stroke, BP.TT; 19/05183-2 - Comparison between mechanisms underlying effects of repetitive peripheral nerve stimulation on upper limb motor performance in the subacute and chronic phases after stroke, BP.TT; 19/07743-5 - Comparison between mechanisms underlying effects of repetitive peripheral nerve stimulation on upper limb motor performance in the subacute and chronic phases after stroke, BP.TT

Abstract

Upper limb paresis is the most common type of post-stroke neurological impairment and a major cause of functional disability. Repetitive peripheral electrical stimulation (RPES) is a novel strategy to improve upper limb motor performance in the post-stroke chronic phase but its effects in the subacute phase are still poorly understood. Processes of plasticity and responses to neuromodulation interventions are different in these two phases. The objectives of this study are to compare the effects of RPES on motor performance of the upper limb in the subacute and chronic phases of stroke, and to identify the mechanisms underlying this intervention. Adults within the first 3 months post-stroke (subacute phase, n = 36) and after 6 months (chronic phase, n = 36) will be randomized to treatment with active RPE or placebo followed by motor training. The Jebsen Taylor (JTT) test and lateral pinch strength tests will be evaluated before, after RPES and after motor training. All results will be blindly evaluated. Both groups will undergo magnetic resonance perfusion and gamma-aminobutyric acid spectroscopy to investigate mechanisms underlying effects of RPES. This study will fill a gap in the understanding of similarities and differences between the effects of RPES in different post-stroke phases, allowing the design of clinical trials according to neurobiological effects and markers of favorable response to this intervention. (AU)