Clinical Research Directory

Inclusion Criteria: SCI Patients: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Male or female, aged between 18 and 75 years old * Have physician diagnosed cervical incomplete spinal cord injury or lesion (iSCI) * Classified by the American Spinal Cord Association (AIS) impairment scale as AIS C or D * iSCI occurred at least 18 months ago * Level of injury or lesion is between C2 and T1 * Bicep strength must be classified as ≥ 3 muscle grade as defined by the medical research council scale * Tricep strength must be at least an MRC grade of 2 and bet at least 1 muscle grade lower than the bicep * Both the biceps and triceps will be required to elicit an active motor evoked potential \>200 uV with transcranial magnetic stimulation * Must maintain current medication regime * Must present with a weaker side of the body, as indicated by a Upper extremity motor score difference between the left and right side * UEMS \< 40 (50 max score) * Must be able to perform reaching movement training task Healthy Controls: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Male or female, aged between 18 and 75 years old * Must be right-handed * Must be able to perform hand exercises Exclusion Criteria: SCI Patients: * Pacemaker or another implanted device * Metal in the skull * History of seizures * Pregnancy * First-degree relative with medication-resistant epilepsy * Current participation in upper limb rehabilitation therapies * Current use of illicit drugs, abusing alcohol, or have withdrawn from alcohol in the last 6 months * Other neurological impairment or condition * Pressure ulcers * Significant lower motor neuron loss at C7 as noted by a nerve conduction velocity \<50 m/s * History of traumatic brain injury as documented by Rancho Scale Impairment of \<5 * History of brain MRI documented focal cerebral cortex infarct (e.g. hydrocephalus) * Contractures at the elbow * Severe spasticity as noted by a modified ashworth scale (MAS) \> 4 * Documented, non-sedated post-traumatic amnesia lasting more than 48 hours * Pregnancy * Allergic to lidocaine * A neuroactive medication that has the potential to lower the seizure threshold * Based on documented publications in stroke, this will include bupropion (wellbutrin), psychostimulants and neuroleptics * All medications will be reviewed with physician, Dr. Amol Utturkar (DHR) Healthy Controls: * Pacemaker or other implanted device * Metal in the skull * History of seizures * First-degree relative with medication-resistant epilepsy * Current use of illicit drugs (including heroin, crack/cocaine, marijuana), abusing alcohol or having withdrawn from alcohol in the last 6 months * Allergy to lidocaine * Other neurological impairment or condition * Pregnancy * A neuroactive medication that has the potential to lower the seizure threshold * Based on documented publications on stroke, this will include bupropion (wellbutrin), psychostimulants and neuroleptics