Each subject will undergo five different 20-minute interventions. Twenty participants (10 able bodied and 10 SCI subjects) will be recruited. Whether this approach can work non-invasively in humans remains unknown. However, these studies used invasive direct spinal cord stimulation in rodent models. Results showed that EMG-triggered stimulation plus physical retraining led to greater motor recovery than non-triggered stimulation or physical training alone. In a demonstration of closed-loop stimulation in SCI rats, target muscle electromyography (EMG) signals were used to trigger spinal cord electrical stimulation while performing physical retraining. In both animal models and humans with spinal cord injury (SCI), synaptic efficacy between corticospinal axons and spinal motor neurons has improved temporarily after a short period of paired stimulation between motor cortex and spinal or peripheral sites. Condition or diseaseĭevice: hand movements (signals from thumb muscle) triggered PNS and TMS This pilot study will be a foundation for future studies combining EMG-triggered stimulation with long-term physical exercise training. We will test different combinations of triggered and non-triggered electrical and magnetic stimulation, and record the short-term effects on nerve transmission and skilled function of hand muscles. This proposed study is a proof-of-principle to demonstrate the potential of non-invasive closed-loop stimulation in humans with incomplete cervical SCI. However, whether EMG-triggered closed loop stimulation has the same amount of effect when applied non-invasively in humans is still unknown. This might be an optimal method to coordinate brain and nerve activity, especially with the clinical advantage of being possible to combine with physical exercise training. Using the body's own signals to trigger nerve stimulation is called 'closed-loop stimulation'. In animal models of SCI, scientists have successfully used target muscle EMG to trigger spinal cord electrical stimulation pulses while the animals perform physical exercises. The brain's intention to move a muscle can be read by recording surface electrical activity over target muscles (electromyography or EMG). Past studies by other groups have shown that synapse strength can be improved temporarily after a short period of paired stimulation between the brain (motor cortex) and the peripheral nerves serving target muscles - in other words, 'Fire Together, Wire Together'. To do this, the investigators are attempting to pair electrical and magnetic stimulation with physical training targeted toward the connections between nerve circuits. The investigators aim to strengthen those circuits to improve motor recovery after injury.

Most individuals with spinal cord injury (SCI) have residual nerve circuits. Why Should I Register and Submit Results?.

Emg spine