Combined nerve and brain stimulation for ischemic stroke recovery
Tests two electrical stimulation treatments together in adults with ischemic stroke.
Plain-language title generated from the registry record
Registry title: Combined taVNS and tDCS in Subacute Stroke Patients
Key facts
- Where
- Tainan, TaiwanSee the site
Where in Taiwan
- National Cheng Kung University HospitalTainan, TaiwanTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- National Cheng-Kung University Hospital
- Trial code
- NCT06244914
- Record updated
- 20 March 2024
- Original description
Ischemic stroke, the most prevalent neurological disorder, is treated with medication and thrombectomy but with limited success, especially in chronic stages where traditional rehabilitation is the primary option. Stroke often leads to post-stroke autonomic imbalance, deteriorating functional outcomes and increasing recurrence risk. Emerging non-pharmacological treatments like Transcutaneous Auricular Vagus Nerve Stimulation (VNS) and Focused Transcranial Direct Current Stimulation (tDCS) offer new possibilities. VNS targets post-stroke tissue injury and promotes healing and neurogenesis, while tDCS aims to enhance motor learning by rebalancing brain activity. Both therapies seek to improve outcomes in both acute and chronic stroke stages.Read full original descriptionShow less
Combining Closed-loop Transcutaneous Auricular Vagus Nerve Stimulation and Focal Transcranial Direct Current Stimulation as an Adjuvant Treatment for Acute and Subacute Strokes
Ischemic stroke, the most prevalent neurological disorder, is treated with medication and thrombectomy but with limited success, especially in chronic stages where traditional rehabilitation is the primary option. Stroke often leads to post-stroke autonomic imbalance, deteriorating functional outcomes and increasing recurrence risk. Emerging non-pharmacological treatments like Transcutaneous Auricular Vagus Nerve Stimulation (VNS) and Focused Transcranial Direct Current Stimulation (tDCS) offer new possibilities. VNS targets post-stroke tissue injury and promotes healing and neurogenesis, while tDCS aims to enhance motor learning by rebalancing brain activity. Both therapies seek to improve outcomes in both acute and chronic stroke stages.
Inclusion: Age ≥ 18 years old; Subacute ischemic stroke patients within 7-30 days after stroke symptoms is stabilized; Stroke will be documented by DWI-MRI; Lesion locations at least involve supratentorial area; Patients have unilateral weakness documented with manual muscle testing scales less than 4; Stable vital signs and stable neurological signs; Able to receive regular rehabilitation programs, and 8) modified Rankin Scales (mRS) less than 5.
Exclusion: Patients with radiographic evidence or suspicion of chronic conditions that may predispose them to intracranial hemorrhage including brain arteriovenous malformations, cerebral cavernous malformations, cerebral telangiectasia, multiple previous intracerebral hemorrhages (amyloid angiopathy); Concomitant experimental therapy; A National Institute of Health Stroke Scale (NIHSS) score > 25 at study entry; Unstable clinical condition; Marked arrhythmia or cardiovascular complications; Patients suspected of having infective endocarditis and ischemic stroke related to septic emboli; Signs or symptoms of acute myocardial infarction, including EKG findings; Suspected cranial dural arteriovenous fistula, and evidence of dissection in the intracranial cerebral arteries; Cerebral venous thrombosis and significant mass effect with midline shift; History of left atrial myxoma; Presence of contraindication for VNS (TENS) and tDCS: (A) Intracranial space occupied lesion, (B) Presence of a pacemaker, (C) History of brain neurosurgery, (D) Active CNS or systemic infection, (E) Presence of a metallic foreign body implant, (F) Skin abnormalities, (G) History of alcohol/drug abuse, (H) Epilepsy/History of epilepsy at family (I) Hyperacusis, (J) Cognitive/Consciousness disturbance, (K) Pregnancy or nursing females, (L) Use of neuropsycoactive drugs, (M) Psychiatric/ Neurologic disease; Not suitable for equipping ECG recorders: (A) Chronic disease, and allergic to polyester, (B) Acute and severe patients; Pre-existing coagulopathy, consist of platelet count of ≤100, INR≥ 3, PTT≥ 90; The presence of hemineglect; Moderate-to-severe pain in any limb; Recurrent strokes or brainstem strokes; Bradycardia (HR≤50 bpm) or low blood pressure (SBP≤100 mmHg or DBP≤60mmHg) at admission; Suspected cerebral vasculitis based on medical history and CTA/Magnetic Resonance Angiogram (MRA).