Training to boost brain-to-spine signals for better wrist and hand control

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Participants with chronic cervical spinal cord injury will complete a 10-week operant up-conditioning protocol targeting the wrist extensor motor evoked potential (MEP) using non-invasive transcranial magnetic stimulation and real-time feedback. Investigators will measure changes in corticospinal excitability by tracking MEP size and voluntary muscle activation, and will test arm and hand motor function before and after the intervention. Brain and spine MRI will be acquired pre- and post-training to relate structural and functional imaging measures to motor status and responsiveness to the protocol. The study focuses on people at least six months post-injury with some residual wrist extensor activity and uses a single-site outpatient program at an academic center.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Adult (≥18 yrs old)
* A history of injury to spinal cord at or above C6
* \>6 months post SCI
* Weak wrist extension at least unilaterally
* Expectation that current medication will be maintained without change for at least 3 months. Stable use of anti-spasticity medication (e.g., baclofen, diazepam, tizanidine) is accepted.

Exclusion Criteria:

* Motoneuron injury
* Medically unstable condition
* Cognitive impairment
* A history of epileptic seizures
* Metal implants in the cranium
* Implanted biomedical device in or above the chest (e.g., a cardiac pacemaker, cochlear implant)
* Extensive use of functional electrical stimulation to the arm on a daily basis
* Pregnancy (due to changes in posture and potential medical instability)
* Contraindications to MRI
* No measurable MEP elicited in the ECR
* Unable to produce any voluntary ECR EMG activity

Where it's running

• Medical University of South Carolina
  Charleston, South Carolina, United States Recruiting

Study contacts

• Principal investigator: Allison Lewis, DPT, PhD — Medical University of South Carolina
• Study coordinator: Recruitment Contact
• Email: stecb@musc.edu
• Phone: 843-792-6313

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Implanted Brain-Computer Interface to Help People with Severe Arm Impairment

  We’re testing the N1 System, a fully implanted brain interface in the motor cortex with a robot, to see if it can help adults with spinal cord injury, ALS, or chronic stroke use a computer or keyboard more easily.

  Recruiting Neuralink Corp · Miami, Florida · NCT07929792

• Robotically implanted Neuralink N1 brain-computer interface to control external devices

  This study will test whether a robotically implanted Neuralink N1 brain-computer interface can safely help people with high spinal cord injuries or ALS control computers and other external devices.

  Recruiting at 2 sites Neuralink Corp · London, Greater London and 1 other locations · NCT07127172

• Robotically implanted brain chip to help control external devices

  This tests a wireless, rechargeable brain implant (Neuralink N1) and a robot surgical system (R1) to help people with severe arm and hand paralysis control external devices.

  Recruiting Neuralink Corp · Abu Dhabi · NCT06992596

• Robotically implanted brain-computer interface for controlling devices

  This study is testing a new brain implant and robot to see if they can help people with severe movement limitations control devices more easily.

  Recruiting Neuralink Corp · Toronto, Ontario · NCT06700304

• Remote training program for manual wheelchair skills

  This study tests whether a remote training program with peer coaching can help people improve their manual wheelchair skills and mobility.

  Recruiting University of Pittsburgh · Pittsburgh, Pennsylvania · NCT06295146

• tSCS with rehabilitation for improving movement after spinal cord injury

  This study tests whether adding rehabilitation training to transcutaneous spinal cord stimulation helps paraplegic patients regain voluntary movement after spinal cord injury.

  Recruiting Beijing Tsinghua Chang Gung Hospital · Beijing · NCT07907952

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.