Using Hebbian-Type Stimulation to Rescue Arm Function After Stroke: Study Protocol for a Randomized Clinical Trial.

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Upper-extremity hemiplegia post-stroke is a major clinical challenge.
• The supplementary motor area (SMA) is crucial for motor recovery.
• Reconstructing the SMA's descending motor tract is a potential therapeutic strategy.

Purpose of the Study:

• To assess the efficacy of cortico-peripheral Hebbian-type stimulation (HTS) for neural circuit reconstruction.
• To evaluate HTS's potential to restore arm motor function after stroke.
• To analyze the clinical effectiveness of a novel Hebbian theory-based neuromodulation strategy.

Main Methods:

• A 4-month, double-blind, randomized, sham-controlled trial.
• 90 participants with mild to moderate upper limb paralysis post-stroke.
• 5 weeks of HTS or sham stimulation, with assessments at baseline, post-treatment, and 3-month follow-up.

Main Results:

• Primary outcome: Wolf Motor Function Test (WMFT).
• Secondary outcomes: Fugl-Meyer Assessment (FMA-UE), Functional Independence Measure (FIM), and fNIRS parameters.
• Adverse events will be systematically recorded.

Conclusions:

• Neural circuit reconstruction is a promising approach for post-stroke upper-limb paralysis.
• The SMA plays a key role in compensating for motor deficits.
• This trial will provide insights into HTS for neurorehabilitation and promoting cortico-peripheral connections.