Behavioral and Neural Correlates of Post-Stroke Fatigue

中风后疲劳的行为和神经相关性

• 批准号: 10725951
• 负责人: Hui-Ting Goh
• 金额: $ 37.29万
• 依托单位: TEXAS WOMAN'S UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10725951
• 关键词: Adopted; Anodes; Behavior assessment; Behavioral; Brain; Brain imaging; Brain region; Clinical; Clinical Trials; Clinical assessments; Complex; Complication; Development; Education; Experimental Designs; Fatigue; Fostering; Functional Magnetic Resonance Imaging; Future; Goals; Imaging Techniques; Individual; Intervention; Investigation; Knowledge; Measures; Mediating; Motor; Motor Cortex; Neuromodulator; Outcome; Participant; Pathologic; Perception; Phase; Population; Proxy; Quality of life; Randomized; Recovery; Rehabilitation therapy; Reporting; Research; Research Personnel; Rest; Severities; Stroke; Students; TAP1 gene; Texas; Thalamic structure; Therapeutic Effect; Transcranial magnetic stimulation; Woman; Work; clinical efficacy; clinically significant; cohort; design; disabling symptom; efficacy evaluation; evidence base; experience; follow-up; innovation; insight; multimodality; negative affect; neural; neural correlate; neuromechanism; neurophysiology; noninvasive brain stimulation; novel; patient response; post intervention; post stroke; randomized, clinical trials; stroke survivor; theories; therapy development; transcranial direct current stimulation; university student

PROJECT SUMMARY Up to 85% stroke survivors experience post-stroke fatigue (PSF) defined as intensified perceived effort during activities. PSF is a significant barrier to full participation in rehabilitation and negatively affects quality of life after stroke. Despite its well-known impacts, there are very few targeted interventions for PSF largely due to unclear underlying mechanisms. A few brain stimulation studies have suggested a relationship between primary motor cortex (M1) excitability and PSF. Recent clinical trials using anodal transcranial direct current stimulation (tDCS) to modulate brain excitability reported mixed clinical efficacy in reducing PSF with unclear mechanisms of action. The proposed research will address the gaps in our knowledge by determining the behavioral and neural correlates of PSF using an experimental design and multimodal approach. Thirty-two individuals with significant fatigue due stroke will be randomly assigned to receive five consecutive sessions of anodal or sham tDCS. Before and after intervention, participants will complete clinical and behavioral assessments of PSF, brain excitability assessment using transcranial magnetic stimulation, and brain connectivity assessment using resting state functional MRI. In aim 1, we will determine if upregulating M1 excitability via tDCS will reduce PSF assessed by clinical and behavioral markers. Aim 2 will utilize brain stimulation and brain imaging techniques to probe the neurophysiological effect of tDCS on PSF. Aim 3 will explore the correlation between behavioral changes and neurophysiological changes to provide further insights into the neural correlates of PSF. Our long-term goal is to develop evidence based, theory-driven interventions to manage PSF. The proposed study is innovative in that it investigates a relative novel intervention to mitigate PSF and adopts a multimodal approach to examine the underlying mechanisms. The comprehensive research will guide the development of treatment targeted the underlying mechanisms of PSF. In addition to its scientific and clinical significances, the proposed research will achieve its educational goals by fostering a group of student researchers and promoting rigorous research cultures within our institute.

项目总结