Shepherd Center, Atlanta GA
The goal of this pilot study is to find out how four different types of transcranial electrical stimulation (tES) affect brain activity, the process of acquiring new skills (also called motor learning), and hand function after cervical spinal cord injury (cSCI). Participants will complete 5 study sessions: one sign-up session and four testing \& intervention sessions. Total participation will take about 18 hours. During the sign-up session, researchers will: discuss study details, review the participant's health history to make sure that it is safe for them to participate, perform tests to ensure that the participant meets the study criteria, and collect the participant's demographic information. During each testing \& intervention session, the participant will receive a different type of tES. Before and after getting tES, they will take part in tests that measure their brain activity and the strength, sensation, and function of their right hand.
Improved use of the upper extremities (UEs) is a paramount concern for most individuals with cervical spinal cord injury (cSCI). The majority of people with SCI have some remaining pathways connecting the cortical and spinal circuitry. Strengthening descending corticospinal circuits, which drive volitional control, has potential to have a significant impact on UE function. Therapeutic modalities that enhance descending drive via direct excitation of the cortical circuitry may be valuable adjuncts to neurorehabilitation training for people with SCI. Transcranial electrical stimulation (tES) mo…
Inclusion Criteria: * cervical spinal cord injury (neurological level C1-C8) that occurred at least one year ago * International Standards for Neurological Classification of SCI/ASIA Impairment Scale (ISNCSCI/AIS) severity classification C or D * self-reported limitations in right hand function * volitional muscle activity in the right hand, as determined by a score ≥ 2 in at least one intrinsic hand muscle group evaluated in the Graded Redefined Assessment of Strength Sensibility and Prehension version 2 (GRASSP v2) strength subtest * ability to follow instructions * ability to communicate p…
tDCS (waveform: monophasic and continuous) will be delivered for a duration of 20 minutes and intensity of 2 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with tDCS application and will consist primarily of task-oriented arm and hand activities.
tPCS (waveform: monophasic square waves with 500 ms pulse duration and 50 ms inter-pulse interval) will be delivered for a duration of 20 minutes and intensity of 2 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with tPCS application and will consist primarily of task-oriented arm and hand activities.
tRNS (waveform: 0-500 Hz random frequency and Gaussian white noise random intensity) will be delivered for a duration of 20 minutes and intensity range of +/-1 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with tRNS application and will consist primarily of task-oriented arm and hand activities.
Sham tES will be delivered for a duration of 20 minutes and intensity of 0 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with sham tESapplication and will consist primarily of task-oriented arm and hand activities.
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