Lumy Sawaki, University of Kentucky, Physical Medicine and Rehabilitation, Lexington, United States

Improving hand recovery with neuromodulation in tetraplegia (IGNITE trial)

Funded in: 2019, 2020, 2021


Back to overview

Problem: Loss of arm and hand function after cervical spinal cord injury affects meaningful and independent engagement in multiple life domains and no effective treatments are available especially in chronic spinal cord injury

Target: Improving function in chronic spinal cord injury

Goal: Understand the effect of non-invasive brain stimulation for improvement of motor function as well as the markers of neuroplasticity and the impact in quality of life

 

Every year, there are more than 250,000 new cases worldwide. Less than 1% of the people with spinal cord injury (SCI) completely recover. Almost two-thirds of these cases are at the cervical (neck) level. The loss of arm function after cervical SCI can affect meaningful and independent engagement in multiple life domains. However, there are no effective treatments to improve arm and hand function especially in chronic SCI.

Recently, this group demonstrated that a form of non-invasive brain stimulation coupled with motor training can improve function in chronic SCI. However, very little is known about the capacity of the brain and spinal cord to rewire (neuroplasticity) after such interventions. Additionally, there is no information if this type of intervention can improve quality of life in chronic SCI.

Therefore, the scientists are proposing to collect further data in a larger number of people with SCI to better understand the effect of this brain stimulation for improvement of motor function as well as the markers of neuroplasticity and the impact in quality of life. They want to recruit 36 participants with a chronic (more than 12 months after SCI), incomplete cervical SCI and classified as B, C and D by the American Spinal Injury Association Impairment Scale. 

Participants will receive active or inactive brain stimulation coupled with motor training. The scientists will collect measures of motor function, measures to evaluate markers of neuroplasticity and conduct interviews. They will collect this information before starting the 24 days of intervention, after completing the intervention period, as well as at 1-month and 4-month follow ups.
Achieving their goals will be fundamental to advance interventions to promote improvement of arm and hand function after SCI and is particularly important considering the lack of effective interventions available during the long-term stages of recovery.