P 168. TMS neurophysiology and interventional rTMS in children with perinatal stroke: Safety and tolerability in the PLASTIC CHAMPS trial

Introduction/Question: Perinatal stroke causes hemiplegic cerebral palsy and lifelong disability. TMS can define neurophysiology and central therapeutic targets while rTMS carries therapeutic potential in adult stroke but have not been applied to the more plastic developing brain. Ipsilateral projections from the unlesioned hemisphere to the affected hand are prominent in this population and the effects of non-lesioned inhibitory rTMS are unknown.Methods: PLASTIC CHAMPS is a randomized, blinded, factorial clinical trial of rTMS and constraint therapy (CIMT) to enhance upper extremity function in children (6–18years) with perinatal stroke hemiparesis. Thirty-five children (mean age 11.25y, 20 males) attended a 2-week intensive motor learning camp, randomized 1:1 to daily non-lesioned M1 inhibitory (1Hz, 1200 stimulations) rTMS or sham. TMS neurophysiology mapping lasting 90–120min (baseline and 1week post-camp) included RMT, AMT, stimulus response curves, iSP, SICI, ICF, and IHI. Primary safety outcomes were decreased function in: (1) affected hand in children with ipsilateral projections (Assisting Hand Assessment (AHA), Melbourne Assessment (MA)) and (2) unaffected hand in all children (grip strength [GS], pinch strength [PS]). The Pediatric TMS Tolerability Evaluation was administered at 4 timepoints: 2 TMS neurophysiology sessions (pre and post camp) and 2 rTMS treatments (days 1 and 10). This measure characterizes any adverse events and subjectively ranks TMS against ...
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Tags: Society Proceedings Source Type: research