We plan to improve learning of motor skills by pharmacolocical means (dopamine), and by noninvasive brain stimlulation. We will study both healthy subjects and chronic stroke patients. In addition, we want to study the mechanisms of enhanced learning, on the molecular and the systems level.

Condition	Intervention	Phase
Stroke Aging	Drug: dopamine	Phase IV

Further Study Details: 

Primary Outcomes: Procedural motor learning (decrease in reaction time in ms)after the respective intervention (dopamine, transcranial direct current stimulation), compared to placebo.
Expected Total Enrollment:  40

Adaptive behavior requires procedural motor learning, i.e. the acquisition of motor skills. Procedural learning is particularly critical in the rehabilitation of chronic motor deficits after stroke. A potent modulator of motor function and learning is found in the endogenous dopaminergic system. My own work could demonstrate that formation of an elementary motor memory, which constitutes the first step in acquiring more complex motor skills, can be enhanced in both healthy subjects and chronic stroke patients by pre-medication with levodopa. The aim of the present proposal is to: (a) expand these exciting findings to procedural motor learning; (b) explore the interaction with age, brain lesions, add-on interventions such as transcranial direct current stimulation (tDCS); and (c) illuminate the underlying mechanisms. The effect of levodopa +/- tDCS on procedural motor learning and cortical excitability will be studied in healthy volunteers and stroke patients. Then I plan to delineate the underlying mechanisms of this effect by exploring NMDA receptor-dependency of levodopa-enhanced learning and changes in activation and connectivity (using functional magnetic resonance imaging) in the respective neural networks resulting from the interaction of learning and dopaminergic neuromodulation.

Ages Eligible for Study:  18 Years   -   80 Years,  Genders Eligible for Study:  Both

Accepts Healthy Volunteers

Criteria

Inclusion Criteria:

• 1) Healthy volunteers. normal neurological examination. Mini-Mental-State Examination of > 27 . Right handedness

2) Stroke patients: Cortical or subcortical stroke with an initial severe hemiparesis MRC scale < 2 that has recovered to a degree that they are able to perform the proposed task (in general > MRC 4.5, with low spasticity, work in progress on motor learning in stroke patients). At least 1 year post-stroke. Mini-Mental-State Examination of > 27 . Right-handedness.

Exclusion Criteria:

• 1) Healthy volunteers: No antipsychotic, antidepressant drugs, and drugs affecting the dopaminergic system.

2) Stroke patients: No antipsychotic, antidepressant drugs, and drugs affecting the dopaminergic system.

Please refer to this study by ClinicalTrials.gov identifier  NCT00126087

Agnes Flöel, MD      +49 251 83  Ext. 49970    floeel@uni-muenster.de
Caterina Breitenstein, PhD      +49 251 83  Ext. 49969    breitens@uni-muenster.de

Germany, Nordrhein-Westfalen
      University of Münster, Department of Neurology, MÜNSTER,  Nordrhein-Westfalen,  48129,  Germany; Recruiting

Study chairs or principal investigators

Agnes Flöel, MD,  Principal Investigator,  University of Münster, Department of Neurology, Germany   

Study ID Numbers:  Motor-Neuromod_01
Last Updated:  August 1, 2005
Record first received:  August 1, 2005
ClinicalTrials.gov Identifier:  NCT00126087
Health Authority: Germany: Federal Institute for Drugs and Medicinal Devices
ClinicalTrials.gov processed this record on 2005-08-02