Multilevel Multimodal Neurophysiological Integration for Investigating the Network Modulatory Mechanisms of Epidural Spinal Cord Stimulation

Buddhist Tzu Chi General Hospital30 enrolled

Overview

This study will examine how the brain, spinal cord, and muscles communicate in people with spinal cord injury. Researchers will use noninvasive brain and muscle recordings together with spinal electrical recordings to better understand how epidural spinal cord stimulation (EES) affects nerve function. The results may help develop more effective and personalized rehabilitation treatments for people with spinal cord injury.

This study aims to investigate the neural activity of individuals with SCI by simultaneously recording spinal electrograms (SEG), electroencephalography (EEG), and electromyography (EMG). Multimodal neurophysiological recordings will be used to evaluate communication between the brain, spinal cord, and muscles before and after EES. Clinical assessments of neurological function, upper extremity motor performance, and functional independence will also be performed to examine the relationship between electrophysiological changes and functional recovery.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Spinal Cord Injury(SCI)

Interventions

participants will be divided into two disease cohorts: the spinal cord injury (SCI) group and the non-spinal cord injury (non-SCI) group.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: A. Non-Spinal Cord Injury (Non-SCI) Group * Individuals without spinal cord injury. * Patients diagnosed with chronic neuropathic pain who meet the criteria for routine temporary epidural spinal cord stimulation (EES) implantation therapy. * Patients who have undergone temporary epidural spinal cord stimulation (EES) implantation. * Ability to understand and follow motor instructions. * Age between 20 and 70 years. B. Spinal Cord Injury (SCI) Group * Patients with chronic spinal cord injury. * Patients who have undergone temporary epidural spinal cord stimulation (EES) implantation. * American Spinal Injury Association Impairment Scale (AIS) grades A-D. * Spinal cord injury levels between C3 and L1. * Ability to understand and follow motor instructions. * Age between 20 and 70 years. Exclusion Criteria: * Individuals with severe psychiatric disorders or cognitive impairments, including major depressive disorder, schizophrenia, or dementia, that may affect their ability to understand the study procedures or comply with study instructions. * Individuals who are unable to maintain consciousness, follow instructions, or complete study tasks, including motor tasks, isometric contractions, or resting-state tasks. * Individuals with severe medical conditions and unstable clinical status, such as uncontrolled cardiovascular disease, severe infection, respiratory failure, or other conditions deemed unsuitable for study participation by the attending physician. * Individuals with abnormal positioning, inadequate fixation, or complications related to temporary epidural spinal cord stimulation (EES) leads, including infection, significant pain, or neurological deterioration, as determined by clinical evaluation to be unsuitable for study recordings. * Individuals currently using medications that may significantly affect neurophysiological signals, such as high-dose sedatives, anesthetic agents, or other medications considered by the research team to interfere with data interpretation.

Outcomes

Primary Outcomes

Peak-to-peak amplitude of spinal evoked responses

Peak-to-peak amplitude of spinal evoked responses will be measured in microvolts (µV) to quantify the magnitude of neural activation under different stimulation conditions.

Time frame: baseline; at 7、20 days after the implantation

Latency of spinal evoked responses

Response latency of spinal evoked responses will be measured in milliseconds (ms) from stimulus onset to the onset or peak of the response to evaluate neural conduction characteristics.

Time frame: baseline; at 7、20 days after the implantation

Area under the curve (AUC) of spinal evoked responses

The area under the evoked response waveform will be calculated in µV、RMT(%)) to quantify the overall neural response elicited by stimulation.

Time frame: Baseline; at 7、20 days after the implantation

Recruitment curve of spinal evoked responses

Recruitment curves will be constructed by plotting peak-to-peak amplitude (µV) to characterize spinal neural excitability and recruitment properties.

Time frame: baseline; at 7、20 days after the implantation

EEG spectral power

EEG spectral power will be calculated using Morlet wavelet transform and expressed in decibels (dB) for the theta (θ), alpha (α), beta (β), and gamma (γ) frequency bands to quantify changes in neural oscillatory activity.

Time frame: baseline; 7、20 days after the implantation

SEG spectral power

SEG spectral power will be calculated using Morlet wavelet transform and expressed in decibels (dB) for the theta (θ), alpha (α), beta (β), and gamma (γ) frequency bands to quantify changes in spinal neural oscillatory activity.

Time frame: baseline; 7、20 days after the implantation

Multilevel Multimodal Neurophysiological Integration for Investigating the Network Modulatory Mechanisms of Epidural Spinal Cord Stimulation

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Central Contacts