Spinal Cord Injury
Conditions
Keywords
SCI
Brief summary
The investigator's overall goal is to develop new strategies to test optimization of Spike-timing-dependent plasticity (STDP) doses to maximize strategy to restore upper and lower-limb motor function in individuals with spinal cord injury (SCI). The investigator proposes to use modern electrophysiological methods to enhance the efficacy of residual corticospinal connections. Defining the neural basis by which corticospinal volleys generate muscle responses will provide crucial information required to maximize residual motor output. The investigator's specific goals are to: 1) determine the temporal and spatial organization of corticospinal volleys and motor cortical representations of upper-limb muscles after incomplete cervical SCI and 2) develop methodologies to promote recovery of function. The investigator's focus on reach and grasp movements because of their importance in daily life activities.
Detailed description
This study will determine the temporal organization of corticospinal volleys during reach and grasp movements. Multiple descending volleys in the corticospinal tract generate multiple peaks in muscle responses (indirect (I)-waves). I-waves are a mechanism by which corticospinal neurons are transynaptically activated at periodic intervals of \ 1.5 ms. This periodic activation contributes to the recruitment of spinal motoneurons and generation of movement. we will use paired-TMS to examine I-waves in surface EMG recordings from upper-limb muscles during reach and grasp movements. We will also identify motor cortical maps of upper-limb muscles involved in reach and grasp movements. We will use TMS guided by a frameless neuronavigation system to define the size and location of motor cortical maps of upper-limb muscles during reach and grasp movements. We will be able to determine overlaps and functional interactions between distal and proximal arm motor cortical representations. Our preliminary data shows that finger and biceps cortical maps largely overlap during reach and grasp movements in controls but considerable less in patients
Interventions
OTHERElectrophysiology Assessment of Time Domain
Kinematics, Spinal Cord Excitability and Cortical Spinal Motor Excitability.
OTHERElectrophysiology Assessment of Location
Kinematics, Spinal Cord Excitability and Cortical Spinal Motor Excitability
motor task combined with real or sham stimulation
Sponsors
Shirley Ryan AbilityLab
National Institute of Neurological Disorders and Stroke (NINDS)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
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
*
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Upper-limb motor function | 5 months | measured by functional tests of hand/arm motor function |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cortical Neurophysiological Outcome | 5 months | measured by the maps area and overlap in millimeters |
| Change in Sensorimotor Function | 5 months | measured by upper-limb movements scale from 1(dependent) to 7 (independent). |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORMonica Perez, PT PhD
Shirley Ryan AbilityLab
Outcome results
None listed