Spinal Cord Injuries
Conditions
Keywords
spinal cord injury, spinal cord stimulation, rehabilitation
Brief summary
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.
Detailed description
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.
Interventions
Kinematics and cortical spinal motor excitability
Kinematics and reticular spinal motor excitability
OTHERElectrophysiology assessment - spinal motoneuron
Kinematics and spinal motoneuron excitability
OTHERActivity-based training
Motor task
OTHERTranscutaneous spinal cord stimulation
Non-invasive spinal cord stimulation
Sponsors
Washington University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Healthy Volunteers * Age between 16 and 65 years old * Healthy people with no major comorbidities of any organ system
Exclusion criteria
Healthy Volunteers * Subjects younger than 16 or older than 65 years old * Subjects not providing consent or not able to consent * Subjects with any acute or chronic pain condition * Subjects with any acute or chronic disease of a major organ system * Use of analgesics within 24 hours prior to study period * Use of caffeine with 3 hours of study appointment Inclusion criteria: Participants with spinal cord injury (SCI) * Age between 16-65 years old * Traumatic SCI C4-T9 level, incomplete (ASIA C or D) * at least 1 year post injury * Stable medical condition * difficulty independently performing leg movements in routine activities * able to follow simple commands * able to speak and respond to questions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Motor evoked potentials amplitude and latency | 30 minutes before and 30 minutes after intervention; 4 weeks | 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. |
| Reaction time to startle response | 30 minutes before and 30 minutes after intervention; 4 weeks | 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. |
| F-wave response persistence | 30 minutes before and 30 minutes after intervention; 4 weeks | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in time to completion from baseline | Baseline, 30 minutes, and 4 weeks | Participants will perform cursor control as a computer game. This outcome measure is the time it takes participants to complete each task. |
| Change in movement smoothness | Baseline, 30 minutes, and 4 weeks | This outcome is a measure of changes in movement smoothness when operating the computer cursor with the body. |
Countries
United States
Contacts
CONTACTIsmael Seanez, PHD
PRINCIPAL_INVESTIGATORIsmael Seanez, PhD
Washington University School of Medicine
Outcome results
None listed