Enhancing STDP After Spinal Cord Injury



Status:Recruiting
Conditions:Hospital, Orthopedic
Therapuetic Areas:Orthopedics / Podiatry, Other
Healthy:No
Age Range:18 - 85
Updated:1/27/2019
Start Date:December 15, 2017
End Date:January 1, 2021
Contact:Audrey Wilson, MEng
Email:audrey.wilson2@va.gov
Phone:(305) 575-3179

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Maximizing Spike - Timing Dependent Plasticity After Spinal Cord Injury

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.


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.
We found this trial at
1
site
Miami, Florida 33125
Principal Investigator: Martin Oudega, PhD
Phone: 305-575-3179
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Miami, FL
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