Enhancing STDP After Spinal Cord Injury

• Status: Not yet recruiting
• Trial end date: 0000-00-00
• Target enrollment: 500
• Participant gender: Both

Summary

The overall goal is to develop new clinical approaches to restore upper-limb function after incomplete cervical spinal cord injury (SCI). Corticospinal tract (CST) axons are involved in controlling upper-limb function. Paired pulse induced spike-timing dependent plasticity (STDP) enhances synaptic strength between residual CST axons and spinal motoneurons (SMNs) resulting in temporary improvements in upper-limb function in humans with incomplete cervical SCI. Motor training will be combined with paired-pulse STDP stimulation to further enhance plasticity and behavioral recovery.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: VA Office of Research and Development
• Collaborator: University of Miami
• Treatments: Cycloserine; Dextromethorphan
• Last Updated: 2016-11-10

Criteria

Inclusion Criteria:

Participants who are unimpaired healthy controls:

• Male and females between ages 18-85 years

• Right handed

• Able to complete precision grips with both hands

• Able to complete full wrist flexion-extension bilaterally

• Able to walk unassisted

• Able to complete full ankle flexion-extension bilaterally

Participants who have had a spinal cord injury:

• Male and females between ages 18-85 years

• SCI ( 2 months of injury)

• Spinal Cord injury at or above L5

• The ability to produce a visible precision grip force with one hand

• Able to perform some small wrist flexion and extension

• The ability to perform a small visible contraction with dorsiflexion and hip flexor muscles

• No subjects will be excluded based on their race, religion, ethnicity, gender or HIV status.

• ASIA A,B,C, or D

Exclusion Criteria:

Exclusion criteria for enrollment For SCI and Healthy Control Subjects (4-8 exclusion for non-invasive brain stimulation only):

• Uncontrolled medical problems including pulmonary, cardiovascular or orthopedic disease

• Any debilitating disease prior to the SCI that caused exercise intolerance

• 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 (see appendix 2)

• Pregnant females

• Ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinal cord disease such as spinal stenosis, spina bifida, MS, or herniated disk

• Individuals with scalp shrapnel, cochlear implants, or aneurysm clips.