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: 23/15550-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2024
• End date: October 31, 2025
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Rodrigo Bazan
• Grantee: Ricardo Silva Carvalho
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Approximately 38% of patients who survive right hemisphere stroke present perception deficits, characterized by the syndrome of unilateral spatial neglect, with a likelihood of poor functional prognosis. Transcranial magnetic stimulation, or transcranial direct current stimulation, is employed in these patients to rebalance hemispheric activity. The aim of this project is to assess the safety and efficacy of continuous theta burst transcranial magnetic stimulation in the left parietal cortex followed by anodic transcranial direct current stimulation in the right parietal cortex associated with rehabilitation to improve unilateral spatial neglect. This is a randomized, double-blind, multicenter clinical trial involving adult patients with unilateral spatial neglect following stroke, who will be randomized into three groups: Priming Group - 17 patients will receive continuous theta burst transcranial magnetic stimulation in the left parietal region followed by anodic transcranial direct current stimulation in the right parietal lobe; Conventional Group - 17 patients will receive anodic transcranial direct current stimulation in the right parietal region, and Sham Group - 17 patients will receive transcranial magnetic stimulation and sham transcranial direct current stimulation in the right parietal region, across 15 sessions distributed over 3 sessions per week lasting 30 minutes each. All groups will undergo physical therapy sessions, with assessments conducted at screening, after 8 sessions, and at the end of treatment. Follow-up of these patients will occur at 3, 6, and 12 months after the last session.