Cervical Spinal Cord Associative Plasticity

Conditions

• Cervical Spinal Cord Plasticity

Eligibility Criteria

Sex

ALL

Age

18 Years - 80 Years

Healthy Volunteers

Accepted

Interventions

• SCAP — OTHER
  This utilizes pairing of repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation (rPNS) timed to converge in the cervical spinal cord.
• MagPro X100 — DEVICE
  This stimulator will be use to provide repetitive transcranial magnetic stimulation (rTMS).
• Digitimer DS8R — DEVICE
  This stimulator will be used to provide repetitive peripheral nerve stimulation (rPNS).
• Paired non-associative stimulation — OTHER
  This utilizes pairing of repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation (rPNS) timed to arrive at a pairing interval of 40 msec.

Study Details

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.

Key Dates

Start date

May 9, 2026

Status verified

May 2026

Primary completion

Dec 31, 2028

Completion

Jun 30, 2029

Study Design

Enrollment

20 participants (estimated)

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

BASIC_SCIENCE

Arms

• Experimental: SCAP
  With this session, participants will receive 90 trials of 0.1hz paired motor cortical stimulation and median nerve stimulation for 15 minutes at sub-threshold intensities, timed to converge in the cervical spinal cord simultaneously.
• Active Comparator: Cortical stimulation only
  With this session, participants will receive 90 trials of 0.1hz motor cortical stimulation for 15 minutes at sub-threshold intensities.
• Active Comparator: Median nerve stimulation only
  With this session, participants will receive 90 trials of 0.1hz median nerve stimulation for 15 minutes at sub-threshold intensities.
• Active Comparator: Paired non-associative stimulation
  With this session, participants will receive 90 trials of 0.1hz paired motor cortical stimulation and median nerve stimulation for 15 minutes at sub-threshold intensities, timed to be 40 milliseconds apart in the cervical spinal cord.

Primary Outcome Measure

Size of muscle response to brain stimulation after SCAP (percentage) [ Time Frame: 30 minutes after SCAP ]

Central Contacts

• Shaker Dukkipati, MD, PhD
  2123046501
  [email protected]
• Jason Carmel, MD, PhD
  [email protected]

Locations (1)

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