Cervical Spinal Cord Associative Plasticity

Associative plasticity has been used to promote functional recovery from conditions affecting movement. Prior work from the Carmel laboratory has shown that paired associative stimulation protocols timed to converge in the cervical spinal cord induce significantly larger upper limb motor responses than if timed to converge in the motor cortex. The goal of this prospective experimental study in typically developing adults is to test the effects of pairing sub-threshold hand motor cortical and median nerve stimulation targeted to induce plasticity in the cervical spinal cord, rather than in the motor cortex. Based on preliminary data, the investigators are performing a confirmatory study to test the physiological and behavioral effects of the paired brain and peripheral nerve protocol, called the SCAP-Nerve protocol. This study will first be conducted in typically developing adults to confirm the cervical spinal cord as the ideal target and verify the present stimulation parameters are sufficient to promote induction of associative plasticity of sensorimotor connections for manual dexterity. The outcomes from this study could then be translated to efficacy studies in people with spinal cord injury and cerebral palsy to promote clinically meaningful improvements in dexterity.