Effect of Transcranial Magnetic Stimulation by Theta Burst Modality as a Priming Effect to Transcranial Direct Current Stimulation in Unilateral Spatial Neglect after Stroke: TITAN TRIAL

• Grant number: 23/08911-4
• Support Opportunities: Regular Research Grants
• Start date: April 01, 2025
• End date: March 31, 2027
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Rodrigo Bazan
• Grantee: Rodrigo Bazan
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
• City of the host institution: Botucatu
• Associated researchers: Fernanda Cristina Winckler

Abstract

About 38% of patients who survive a right hemisphere cerebrovascular accident (CVA) have a perception deficit, with unilateral special neglect syndrome (SUS), with a chance of having a poor functional prognosis. Transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) is used in patients with the aim of rebalancing hemispheric activity and in this project the objective is to evaluate the safety and potency of continuous transcranial magnetic theta burst stimulation in the left parietal cortex followed by anodic tDCS in the right parietal cortex associated with rehabilitation in the improvement of unilateral special neglect. This is a randomized, double-blind, multicenter clinical trial in adult patients with NEU after stroke who will be randomized into three groups: Priming Group (GP): 17 patients confirmed continuous theta burst EMT in the left parietal region followed of anodic tDCS in the right parietal lobe; Conventional Group (CG): 17 anodic tDCS patients in the right parietal region and Sham Group (GS): 17 TMS and sham tDCS patients in the right parietal region, in 15 sessions divided into 3 sessions per week lasting 30 minutes and all groups followed physiotherapy sessions, with estimates to be made at screening, after 8 sessions and at the end of treatment. Follow-up of these patients accepted at 3, 6 and 12 months after the last session. (AU)