Neuromodulation to Improve Grasping Function After SCI
Neuromodulation to Improve Grasping Function After Spinal Cord Injury
State University of New York at Buffalo
54 participants
Apr 1, 2026
INTERVENTIONAL
Conditions
Summary
The goal of this study is to restore the activities of late descending signals with a noninvasive stimulation approach in combination with hand motor training to improve hand function in persons with cervical SCI. The main question it aims to answer is if the inputs to late descending signals above the level of injury and the output of residual late descending signals below the level of injury could be increased. Specifically, in the first part of the study, 30 participants will complete 2 randomized sessions to compare the effect of intermittent theta burst stimulation combined with paired corticospinal motoneuronal stimulation. In the second part of the study, 24 participants will complete either combined stimulation protocol or sham stimulation protocol with exercise training.
Eligibility
Inclusion Criteria5
- For individuals with SCI:
- Ages 18-75 years
- Chronic SCI (≥1 year of injury)
- Cervical injury at C8 or above
- Individuals who have MEP responses in at least one FDI muscle
Exclusion Criteria8
- Uncontrolled medical problems including pulmonary or cardiovascular disease
- Premorbid, ongoing major depression or psychosis, altered cognitive status
- History of head injury or stroke
- Metal plate in skull
- History of seizures
- Receiving drugs acting primarily on the central nervous system, which lower the seizure threshold such as antipsychotic drugs
- Pregnant females
- Individuals who suffer from a spinal cord disease such as spinal stenosis, spinal bifida or herniated cervical
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Interventions
Intermittent theta burst stimulation (iTBS) will be utilized since they have been reported to have a cortical neuromodulatory effect. The iTBS protocol will be applied over primary motor cortex to investigate its effect on corticospinal excitability and functional outcome. Theta burst stimulation (TBS) consists of bursts of pulses containing 3 pulses at 50 Hz (3 pulses per second) repeated at 200 ms intervals (5 Hz). During iTBS, a 2 second train of TBS is repeated every 10 seconds (600 pulses in 190 seconds).
Sham iTBS protocols will be applied with the same parameters as in iTBS protocol. However, sham coil will be used.
During PCMS, paired stimulation of the primary motor cortex by transcranial magnetic stimulation to elicit late corticospinal descending volleys and the peripheral nerve by electrical stimulation will be used to improve corticospinal transmission.
During PCMS, the same parameters will be used as in real PCMS but sham TMS coil will be used with minimum PNS intensity.
The motor training will be focused on participant's hand motor function such as grasping function.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07433959