Objectives {7}
stroke
STROKE
The BOSS‐STROKE trial is based on the hypothesis that the timing of individual stimuli of the rTMS protocol is critically important for the therapeutic efficacy of rTMS and, specifically, that high‐frequency rTMS needs to be applied during the brief states of high corticospinal excitability to effectively support functional reorganization of brain networks in the early neurorehabilitation phase following stroke. Therefore, the trial will address a critical question: to what extent the strong evidence in basic neuroscience and human neurophysiological experimentation supporting the principle of spike‐timing‐dependent plasticity can be translated into a relevant clinical benefit for the treatment of stroke patients. All trial‐participating patients will receive standard treatment care according to national stroke therapy guidelines. The trial‐specific treatment will be applied additionally. All participating patients in this randomized controlled trial will receive the additional treatment, with one‐third receiving brain-state-synchronized TMS therapy (experimental condition), one‐third receiving non‐synchronized TMS therapy (control condition I) and one‐third receiving sham TMS therapy (control condition II). Regarding diagnostic procedures, all participating patients will be submitted to standard diagnostic procedures in stroke care. Trial‐specific will be the additional performance of a diagnostic EEG (to achieve a higher level of patient safety) and an MRI (to achieve a higher level of diagnostic and treatment precision), which are optional procedures in standard stroke care.