Non-invasive Brain and Spinal Cord Stimulation for Spinal Cord Injury

This trial explores a new treatment for individuals with chronic cervical spinal cord injury who struggle with arm and hand function. It combines two non-invasive techniques: cerebellar theta burst stimulation (a type of brain stimulation) and cervical transcutaneous spinal cord stimulation (a type of spinal cord stimulation). The researchers aim to determine if this combination can enhance the ability to perform tasks like pinching and grasping. Individuals with a stable cervical spinal cord injury for at least 12 months who face ongoing challenges with their upper limbs may be suitable candidates. Participants will receive one of three treatments over an 8-week period: both stimulations, only the spinal cord stimulation, or a sham (placebo) version. As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could lead to new treatment options for spinal cord injuries.

The trial requires that if you are taking anti-spasticity or pain medications, you must be on a stable dose for at least 4 weeks before starting the study. Other medications are not specifically mentioned, so it's best to discuss with the trial team.

Research has shown that cerebellar theta burst stimulation (TBS) is generally safe and well-tolerated. Several studies have found no serious side effects linked to cerebellar TBS. It works quickly, using shorter sessions to create lasting changes in brain activity. However, as a newer method, experts recommend cautious use.

For cervical transcutaneous spinal cord stimulation (tSCS), research indicates it is safe and effective, particularly for adults with long-term spinal cord injuries. Studies have not reported any serious issues like permanent nerve damage or infections. Some mild or temporary side effects might occur, but they are not serious.

Researchers are excited about non-invasive brain and spinal cord stimulation for spinal cord injury because it offers a unique approach compared to traditional treatments like surgery, physical therapy, and medications. Unlike these standard methods, cerebellar theta burst stimulation (TBS) and cervical transcutaneous spinal cord stimulation (tSCS) aim to enhance neural plasticity and improve motor function by directly stimulating the nervous system without the need for invasive procedures. This technique could potentially accelerate recovery and improve outcomes for individuals with spinal cord injuries by harnessing the brain and spinal cord’s natural ability to adapt and reorganize. Additionally, the use of sham stimulation in the trial helps to rigorously assess the effectiveness of these methods, which increases confidence in the results.

This trial will evaluate the effects of cerebellar theta burst stimulation (TBS) and cervical transcutaneous spinal cord stimulation (tSCS) on spinal cord injury recovery. Research has shown that cerebellar TBS can aid in the recovery of motor skills, such as walking, after a stroke. Meanwhile, tSCS shows promise for enhancing movement in individuals with spinal cord injuries, with studies finding that it can quickly improve hand movement and muscle activity. In this trial, some participants will receive both cerebellar TBS and cervical tSCS, while others will receive only cervical tSCS. Both treatments aim to improve communication between the brain and spinal cord, which is crucial for regaining control of movement. Together, they might offer a new way to enhance arm and hand function in people with spinal cord injuries.²³⁶⁷⁸