This study will help the investigators better understand the changes in short-term excitability and long-term plasticity of corticospinal, reticulospinal and spinal neural circuits and how the changes impact the improvements of spinal cord stimulation (SCS) mediated motor function.
The goal of this project is to determine the changes in short-term excitability and long-term plasticity of corticospinal, reticulospinal, and spinal neural circuits that are involved in SCS-mediated motor function improvements in individuals with spinal cord injury (SCI). The study will: (1) Determine the short-term effects in neural excitability induced by SCS and activity-based training. (2) Determine the effect of motor training on short-term changes in neural excitability enabled by SCS. (3) Determine the long-term changes in motor control and neural plasticity induced by combined SCS and activity-based training in individuals with chronic SCI. Having a better understanding of the neural mechanisms that are enhanced by SCS can allow the development of therapies that directly target the excitability and plasticity states of these structures towards improved and accelerated recovery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
120
Kinematics and cortical spinal motor excitability
Kinematics and reticular spinal motor excitability
Kinematics and spinal motoneuron excitability
Washington University
St Louis, Missouri, United States
RECRUITINGMotor evoked potentials amplitude and latency
This primary outcome is a measure of changes in corticospinal tract excitability and plasticity as quantified by changes in the amplitude size and onset latency of motor evoked potentials elicited via transcranial magnetic stimulation.
Time frame: 30 minutes before and 30 minutes after intervention; 4 weeks
Reaction time to startle response
This primary outcome is a measure of changes in reticulospinal tract excitability after training as quantified by changes in reaction time after a startling auditory stimulus.
Time frame: 30 minutes before and 30 minutes after intervention; 4 weeks
F-wave response persistence
This primary outcome is a measure of changes in spinal motoneuron excitability as quantified by changes in the persistence of F-wave responses elicited via peripheral nerve stimulation.
Time frame: 30 minutes before and 30 minutes after intervention; 4 weeks
Changes in time to completion from baseline
Participants will perform cursor control as a computer game. This outcome measure is the time it takes participants to complete each task.
Time frame: Baseline, 30 minutes, and 4 weeks
Change in movement smoothness
This outcome is a measure of changes in movement smoothness when operating the computer cursor with the body.
Time frame: Baseline, 30 minutes, and 4 weeks
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Motor task
Non-invasive spinal cord stimulation