Spinal Cord Injuries Clinical Trial
Official title:
Acute Interactions Between Electromagnetic Stimulation and Physical Exercise
- People with cervical spinal cord injury (SCI) and amyotrophic lateral sclerosis (ALS)
have reduced connections in the nerve circuits between the brain and the hands.
Activating spared nerve circuits is one potential way to improve recovery.
- The investigators are testing different combinations of physical wrist and hand
movements paired with magnetic brain stimulation and electrical spinal cord or nerve
stimulation to see the effects on nerve transmission to hand muscles.
- This is a preliminary study. This study is testing for temporary changes in nerve
transmission to hand muscles. There is no expectation of long-term benefit from this
study. If temporary changes are seen in this study, then future studies would focus on
how to prolong that effect.
Spinal cord injury (SCI) and amyotrophic lateral sclerosis (ALS) result in a mixture of
destroyed, damaged, and spared neural circuits. Activating spared nerve circuits augments
neural transmission.
With this goal in mind, the investigators recently developed a novel method of cervical
electrical stimulation (CES) to noninvasively activate arm and hand muscles. The
investigators are conducting a pilot clinical study (NCT02469675) to establish CES safety in
subjects with cervical SCI, ALS, and non-disabled volunteers. To date, 19 subjects have
undergone >120 CES sessions without major safety or tolerability issues.
The current study is designed to gain further mechanistic insight. In Aim 1, the
investigators will test in more detail how CES (traveling through spinal and peripheral
circuits) interacts with individual pulses of TMS (traveling through corticospinal circuits).
In Aim 2, the investigators will further test CES's therapeutic potential by combining
stimulation with simultaneous physical exercises. In Aim 3, the investigators will compare
the acute effects on synaptic transmission of passive stimulation to stimulation triggered by
the subject's own muscle activity.
Please note, this is a preliminary study. This study is testing for temporary changes in
nerve transmission to hand muscles. There is no expectation of long-term benefit from this
study. If the investigators see temporary changes in this study, then future studies would
focus on how to prolong that effect.
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