Effects of rTMS and tDCS on Motor Function in Stroke
Effects of rTMS and tDCS on Motor Function in Stroke
In this study the investigators aim to investigate the effects of two different types of
 non-invasive brain stimulation techniques -- repetitive transcranial magnetic stimulation
 (rTMS) and transcranial direct current stimulation (tDCS) on motor function in stroke. This
 is a cross-over study where subjects will receive 5 sessions of stimulation (each separated
 by 1 week) -- with either active tDCS and sham rTMS, sham tDCS and active rTMS or both sham
 tDCS and rTMS.
Inclusion criteria:

 (1) All subjects must be between the ages of 18-90.

 Exclusion criteria:

 1. History of Major depression, as defined by Beck Depression scale 30;

 2. Any substantial decrease in alertness, language comprehension, or attention that might
 interfere with understanding instructions for motor testing;

 3. Contraindications to TMS

 -  history of seizures

 -  unexplained loss of consciousness

 -  metal in the head

 -  frequent or severe headaches or neck pain

 -  implanted brain medical devices.

 4. Contraindications to tDCS

 -  metal in the head

 -  implanted brain medical devices

 5. Advanced liver, kidney, cardiac, or pulmonary disease;

 6. A terminal medical diagnosis consistent with survival < 1 year;

 7. Coexistent major neurological or psychiatric disease (to decrease number of
 confounders);

 8. A history of significant alcohol or drug abuse in the prior 6 months;

 9. Subjects may not be actively enrolled in a separate intervention study targeting
 stroke recovery and any other clinical trials;

 10. Subjects with global aphasia and deficits of comprehension

 11. Pregnancy. Female subjects of child bearing potential will be asked to take a
 pregnancy test. If the pregnancy test is positive, the subject may not enroll in the
 study.

 12. Use of neuropsychotropic medications [healthy subjects only]

 Additional inclusion criteria for stroke subjects:

 1. First-time clinical ischemic or hemorrhagic cerebrovascular events - evidenced by a
 radiological (or physician's) report

 2. Weakness, defined as score of less than 55 (out of 66) on arm motor Fugl-Meyer (FM)
 scale

 3. Stroke onset >6 months prior to study enrollment .

 Additional exclusion criteria for stroke subjects:

 1. Subjects may not have already received TMS and/or tDCS stimulation for stroke;

 2. History of epilepsy before stroke or episodes of seizures within the last six months;