Improving motor function after spinal cord injury

Corticospinal Function After Spinal Cord Injury

This study is testing new ways to improve movement in people with spinal cord injuries by using special techniques to help their brain and muscles work better together.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 300 (estimated)
• Ages: 18 Years to 85 Years
• Sex: All
• Sponsor: Shirley Ryan AbilityLab (other)
• Locations: 1 site (Chicago, Illinois)
• Trial ID: NCT02451683 on ClinicalTrials.gov

What this trial studies

This study aims to develop new strategies to enhance motor function in individuals with spinal cord injury (SCI) by optimizing Spike-timing-dependent plasticity (STDP) doses. Using advanced electrophysiological techniques, the researchers will investigate the organization of corticospinal volleys and motor cortical representations during reach and grasp movements. The study will involve assessing muscle responses through paired transcranial magnetic stimulation (TMS) and mapping motor cortical areas to understand their interactions. The ultimate goal is to promote recovery of upper and lower-limb function in patients with chronic cervical SCI.

Who should consider this trial

Good fit: Ideal candidates include males and females aged 18-85 with chronic cervical spinal cord injuries who can perform specific reach and grasp tasks.

Not a fit: Patients with uncontrolled medical problems or those who had debilitating diseases prior to their spinal cord injury may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved rehabilitation strategies that enhance motor function in individuals with spinal cord injuries.

How similar studies have performed: Other studies have shown promise in using electrophysiological methods to enhance motor function, making this approach both relevant and potentially impactful.

Eligibility criteria

Inclusion Criteria:

* Inclusion criteria for individuals with SCI:

  1. Male and females between 18-85 years,
  2. Chronic SCI (≥ 6 months post injury),
  3. Cervical injury at C8 or above,
  4. Intact or impaired but not absent innervations in dermatomes C6, C7, and C8 using the American Spinal Injury Association sensory scores, and
  5. Ability to reach and grasp a small object located at least 8 cm forward, above, and laterally without leaning forward with the trunk

Inclusion criteria for healthy controls:

1. Male and females between 18-85 years,
2. Right handed,
3. Ability to reach and grasp a small object located at least 8 cm forward, above, and laterally without leaning forward with the trunk

Exclusion Criteria:

* Exclusion criteria for individuals with SCI and Healthy Controls:

  1. Uncontrolled medical problems including pulmonary, cardiovascular or orthopedic disease
  2. Any debilitating disease prior to the SCI that caused exercise intolerance
  3. Premorbid, ongoing major depression or psychosis, altered cognitive status
  4. History of head injury or stroke
  5. Pacemaker
  6. Metal plate in skull
  7. History of seizures
  8. Receiving drugs acting primarily on the central nervous system, which lower the seizure threshold such as antipsychotic drugs (chlorpromazine, clozapine) or tricyclic antidepressants
  9. Pregnant females
  10. Ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinal cord disease such as spinal stenosis, spina bifida or herniated cervical disk.
  11. History of brain tumor and or brain infection

Where this trial is running

Chicago, Illinois

• Shirley Ryan AbilityLab — Chicago, Illinois, United States (RECRUITING)

Study contacts

• Principal investigator: Monica Perez, PT PhD — Shirley Ryan AbilityLab
• Study coordinator: Monica A Perez, PhD, PT

Conditions: Spinal Cord Injury, SCI