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RECRUITING
NCT06104735
NA

Finding the Best Combination of Brain and Spinal Cord Stimulation With Hand Training After Spinal Cord Injury

Sponsor: Bronx VA Medical Center

View on ClinicalTrials.gov

Summary

While physical exercise remains the foundation for any rehabilitation therapy, the team seeks to improve the benefits of exercise by combining it with the concept of "Fire Together, Wire Together" - when brain stimulation is synchronized with spinal cord stimulation, nerve circuits in the spinal cord strengthen - a phenomenon termed "Spinal Cord Associative Plasticity", or SCAP. This project will build on the team's promising preliminary findings. When one pulse of brain stimulation is synchronized with one pulse of cervical spinal stimulation, hand muscle responses are larger than with brain stimulation alone or unsynchronized stimulation. However, the team does not know the best ways to apply SCAP repetitively, especially in conjunction with exercise, to increase and extend improvements in clinical function. Do ideal intervention parameters vary across individuals, or do they need to be customized? The team will take a systematic approach with people who have chronic cervical SCI to determine each person's best combination of SCAP with task-oriented hand exercise. Participants will undergo up to 53 intervention, verification, and follow-up sessions over a period of 6 to 10 months each. The team will measure clinical and physiological responses of hand and arm muscles to each intervention. Regaining control over hand function represents the top priority for individuals with cervical SCI. Furthermore, this approach could be compatible with other future interventions, including medications and cell-based treatments.

Official title: Optimizing Spinal Cord Associative Plasticity to Enhance Response to Hand Training in Cervical Spinal Cord Injury

Key Details

Gender

All

Age Range

18 Years - 85 Years

Study Type

INTERVENTIONAL

Enrollment

12

Start Date

2024-05-24

Completion Date

2026-12-31

Last Updated

2025-10-22

Healthy Volunteers

No

Interventions

PROCEDURE

Synaptic Pairing Interval

Optimize interstimulus pairing between brain and spinal cord stimulation.

PROCEDURE

Frequency

Compare 2 Hz continuous to intermittent theta burst frequency

PROCEDURE

Bouts

Compare effects of 1, 2, or 4 bouts of SCAP

PROCEDURE

Spacing

Compare 6 versus 12 minutes of rest in between bouts of SCAP

PROCEDURE

Exercise

Task-oriented hand exercises

PROCEDURE

SCAP plus Exercise

Compare interleaved versus serial bouts of SCAP and exercise.

Locations (1)

James J. Peters VA Medical Center, Bronx, NY

The Bronx, New York, United States