Neuromodulation to Improve Grasping Function After SCI

About this trial

This trial is enrolling 54 participants with chronic cervical spinal cord injury to evaluate the combination of two types of noninvasive brain stimulation on hand function. The study will pair intermittent theta burst stimulation (iTBS) with corticospinal motoneuronal stimulation (PCMS), with and without hand exercise training. iTBS is a form of non-invasive brain stimulation that delivers rapid bursts of magnetic pulses to brain regions involved in movement, altering their activity. PCMS is a technique that combines stimulation of the brain (using magnetic pulses) and a peripheral nerve (using electrical stimulation), timed to strengthen remaining nerve connections. If included, participants will first complete a session of active iTBS + active PCMS, and a session of sham iTBS + sham PCMS in random order. Participants will then be randomly assigned to perform hand exercises with either active iTBS + active PCMS, or sham iTBS + sham PCMS, delivered over multiple sessions. Final testing of hand function will be performed after 4 weeks.