Paired Non-invasive Stimulation of Hand Motor Cortex and Median Nerve to Induce Plasticity in the Cervical Spinal Cord
Columbia University
Summary
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.
Description
Associative plasticity has been used to promote functional recovery in patient populations, such as adults with spinal cord injuries (SCI). Using non-invasive neuromodulation approaches, pairing of motor cortical stimulation and peripheral nerve stimulation has been shown to augment motor responses and promote plasticity, primarily through the convergence of sensory afferent stimuli and descending cortical stimuli in the motor cortex. However, prior work from the Carmel laboratory has shown that paired associative stimulation timed to converge in the cervical spinal cord induces significantly…
Eligibility
- Age range
- 18–80 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Willingness to participate in up to 4 sessions * Maintenance of caffeine and exercise levels at time of sessions * Ability to provide informed consent * No known central or peripheral neurological disease or injury * No known musculoskeletal injury of the tested arm or hand Exclusion Criteria: * Personal or family history of seizures * Use of medications that lower seizure threshold * History of implanted equipment including stimulators/pacemakers
Interventions
- OtherSCAP
This utilizes pairing of repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation (rPNS) timed to converge in the cervical spinal cord.
- DeviceMagPro X100
This stimulator will be use to provide repetitive transcranial magnetic stimulation (rTMS).
- DeviceDigitimer DS8R
This stimulator will be used to provide repetitive peripheral nerve stimulation (rPNS).
- OtherPaired non-associative stimulation
This utilizes pairing of repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation (rPNS) timed to arrive at a pairing interval of 40 msec.
Location
- Columbia University Irving Medical CenterNew York, New York