MEP Up-conditioning to Target Corticospinal Plasticity
Trial Parameters
Brief Summary
Individuals with chronic cervical spinal cord injury will complete a 10-week training protocol where participants receive non-invasive brain stimulation and feedback on the size of the corresponding muscle response (wrist extensor). Investigators will assess the impact of the brain stimulation training on 1) the brain-to-spinal cord-to-muscle connection and 2) motor functions of the arm and hand. Also, brain and spine magnetic resonance imaging will be collected before and after the training. The imaging measurements will tell investigators about how spinal damage, brain function, and brain structure relate to motor presentation and the response to the training.
Eligibility Criteria
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