Transspinal Stimulation Plus Lokomotorisk träning för SCI
27 juli 2026 uppdaterad av: Maria Knikou, PT, MBA, PhD, City University of New York
Priming med högfrekvent transspinal stimulering för att öka rörelsefördelar vid ryggmärgsskada
Rörelseträning används ofta i syfte att förbättra kortikospinalfunktion och gångförmåga hos personer med ryggmärgsskada.
Spännande nog kan fördelarna med rörelseträning förstärkas av icke-invasiv elektrisk stimulering av ryggmärgen och förbättra motorisk återhämtning vid SCI.
Denna studie kommer att jämföra effekterna av priming lokomotorisk träning med högfrekvent icke-invasiv toracolumbar spinal stimulering.
Hos personer med motorisk ofullständig SCI kommer en serie kliniska och elektriska tester av hjärn- och ryggmärgsfunktion att utföras före och efter 40 sessioner av rörelseträning där ryggradsstimulering ges omedelbart före antingen liggande eller stående.
Studieöversikt
Status
Avslutad
Detaljerad beskrivning
Ryggmärgsskada (SCI) försämrar kraftigt stå- och gångförmågan, vilket allvarligt äventyrar dagliga aktiviteter. Även om dessa brister delvis förbättras av rörelseträning, kvarstår fortfarande onormal muskelaktivitet och koordination även efter flera träningspass. Således kan enbart rörelseträning inte helt optimera den neuronala plasticitet som krävs för att stärka synapserna som förbinder hjärnan, ryggmärgen och lokala kretsar. Som sådan behövs behandlingsinterventioner som effektivt främjar neuromodulering av spinala rörelsenätverk och stärker neurala anslutningar hos den skadade mänskliga ryggmärgen i kombination med fysisk rehabilitering. Det föreslås att transkutan ryggmärgsstimulering (transspinal) är en metod för att synergistiskt "prima" nervsystemet för att bättre svara på rörelseträning. Transspinal stimulering förändrar motoneurons excitabilitet över flera ryggradssegment, en förutsättning för att fungera fallande och lokala ingångar. Viktigt, om samtidig behandling med transspinal stimulering och rörelseträning maximerar motorisk återhämtning efter SCI är okänt. Målet med denna kliniska prövning är att använda högfrekvent (30 Hz) transspinal stimulering för att primera rörelseträning och i slutändan förbättra stående, gå och övergripande funktion hos individer med kroniskt ofullständigt SCI (iSCI). Fyrtiofem individer med iSCI kommer att genomgå 40 sessioner med kroppsviktstödd stegträning förberedd med högfrekvent transspinal stimulering. Deltagarna kommer att randomiseras för att få transspinal stimulering när de står (riktiga eller skenbara) eller när de ligger på rygg (riktiga). Mål 1 utvärderar hur primerande rörelseträning med högfrekvent transspinal stimulering i SCI förändrar kortikomotoneuronal anslutningsstyrka, vilket indikeras av motoriska framkallade potentialer registrerade från benen.
Mål 2 utvärderar hur primerande rörelseträning med högfrekvent transspinal stimulering i iSCI påverkar omorganisation och lämpligt engagemang av spinala neuronala kretsar. Slutligen utvärderar Mål 3 aktivitetsbaserad motorisk funktion, förmåga att stå och gå samt livskvalitet. Dessa resultat kommer att stödja uppfattningen att tonisk högfrekvent transspinal stimulering stärker kortikomotoneuronal anslutning och förbättrar spinalkretsorganisationen genom ställningsberoende kortikospinal neuroplasticitet. Det förväntas att informationen från denna mekanistiska kliniska prövning i hög grad kommer att påverka klinisk praxis. Detta beror på att i verkliga kliniska miljöer kan icke-invasiv transspinal stimulering implementeras lättare och mer allmänt än invasiv epidural stimulering.
Studietyp
Interventionell
Inskrivning (Faktisk)
14
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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New York
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Staten Island, New York, Förenta staterna, 10314
- Department of Physical Therapy, Motor Control and NeuroRecovery Laboratory
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The Bronx, New York, Förenta staterna, 10468
- Veterans Affairs Medical Center
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
14 år till 66 år (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Beskrivning
Inklusionskriterier:
- Villighet att följa alla studieprocedurer och tillgänglighet under hela studietiden.
- Förmåga att förstå samtyckesformuläret och underteckna samtyckesformuläret.
- Man eller kvinna, ålder 18-70 år.
- Vid god allmän hälsa, vilket framgår av medicinsk historia.
- Diagnostiserats med motor ofullständig SCI (AIS C-D).
- Benmineraltäthet i höften (proximal femur) T-poäng
- Lesion över bröst (T) 10 för att säkerställa frånvarande nedre motoneuron lesion.
- Förekomst av senreflexer för att kunna framkalla soleus H-reflex.
- Frånvarande permanenta fotledskontrakturer som förhindrar passiv eller aktiv fotledsrörelse eftersom kortikospinal och spinal excitabilitet är baserad på fotledsvinkeln. Ankelbanden på Lokomat kräver också flexibla ankelleder.
- En diagnos av förstagångs-SCI på grund av trauma, vaskulär eller ortopedisk patologi.
- Tid efter SCI på mer än 6 månader.
- Stabilt medicinskt tillstånd utan hjärt- och lungsjukdom eller kognitiv funktionsnedsättning.
Exklusions kriterier:
- Supraspinal lesioner.
- Betydande neuropatier i det perifera nervsystemet.
- Betydande degenerativa neurologiska störningar i ryggraden eller ryggmärgen.
- AIS A eller B.
- Förekomst av trycksår.
- Avancerad urinvägsinfektion.
- Neoplastiska eller vaskulära störningar i ryggraden eller ryggmärgen.
- Deltagande i en pågående forskningsstudie eller nytt rehabiliteringsprogram.
- Gravida kvinnor eller kvinnor som misstänker att de kan vara eller kan bli gravida kommer att uteslutas från deltagande eftersom riskerna för torakolumbar stimulering av fostret är okända.
- Personer med cochleaimplantat, pacemaker, implanterad infusionsanordning och/eller implanterade stimulatorer av något slag och syfte kommer att uteslutas för att undvika funktionsfel på grund av stimulering.
- Människor med anfallshistoria.
- Medicinska tillstånd som ökar risken för anfall.
- Läkemedel som kan ändra kramptröskeln.
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Verklig transspinal stimulering levererad under stående följt av rörelseträning
Transspinal tonisk stimulering av thoracolumbar-regionen kommer att levereras med en frekvens på 30 Hz under stående med vid behov kroppsviktsstöd (BWS) i en stående ram eller i Lokomat för att garantera säkerheten.
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Femton personer med ryggmärgsskada kommer att få 40 dagliga sessioner med 30 minuters icke-invasiv högfrekvent (t.ex. 30 Hz) transkutan transspinal stimulering under stående följt av 30 minuters assisterad stegrad robotgångsträning.
Före och efter träning kommer standardiserade kliniska och neurofysiologiska tester att användas för att bedöma återhämtning av sensorimotorisk funktion.
Andra namn:
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Experimentell: Verklig transspinal stimulering levererad liggandes följt av rörelseträning
Transspinal tonisk stimulering kommer att levereras med en frekvens på 30 Hz när du ligger på ryggen.
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Femton personer med ryggmärgsskada kommer att få 40 dagliga sessioner om 30 minuter av icke-invasiv högfrekvent (t.ex. 30 Hz) transkutan transspinal stimulering medan de ligger liggande på ett terapibord följt av 30 minuters assisterad stegande robotgångsträning.
Före och efter träning kommer standardiserade kliniska och neurofysiologiska tester att användas för att bedöma återhämtning av sensorimotorisk funktion.
Andra namn:
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Sham Comparator: Sham transspinal stimulering levererad under stående följt av rörelseträning
En skengrupp kommer att få transspinal stimulering under stående med en intensitet där känseln saknas.
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Femton personer med ryggmärgsskada kommer att få 40 dagliga sessioner med 30 minuters simulerad transspinal stimulering under stående med en intensitet där känseln saknas följt av 30 minuters robotgångsträning.
Före och efter träning kommer standardiserade kliniska och neurofysiologiska tester att användas för att bedöma återhämtning av sensorimotorisk funktion.
Andra namn:
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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Plasticity of Spinal Neuronal Networks - Homosynaptic Depression
Tidsram: 4-6 months
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Soleus H-reflexes following posterior tibial nerve stimulation with a 1-ms monophasic pulse were recorded with subjects seated and stimuli delivered every 1 s (1.0 Hz), 3 s (0.33 Hz), 5 s (0.2 Hz), 8 s (0.125 Hz), and 10s (0.1 Hz).
Results for each interval vs 0.1 Hz shown.
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4-6 months
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Plasticity of Spinal Neuronal Networks - Presynaptic Inhibition
Tidsram: 4-6 months
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Presynaptic inhibition was assessed with a conditioning pulse train of 4 pulses with 9 ms duration, delivered to the CPN at the C-T intervals of 20, 60, or 100 ms. These C-T intervals were selected because the reflex inhibition produced at the intermediate C-T intervals is predominantly presynaptic. The stimulus to the CPN was delivered at 1.27 ± 0.12 (21.8 ± 10.1 mA) and 1.4 ± 0.28 (21.8 ± 10.1 mA) TA motor threshold before and after treatment, respectively. Control and conditioned soleus H-reflexes were randomly recorded across the C-T intervals tested, and 15 H-reflexes were recorded at each C-T interval. For each participant at each timepoint, amplitudes across the 15 H-reflexes per C-T interval were averaged. Results are listed for each C-T interval, pre- and post-intervention. |
4-6 months
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Plasticity of Spinal Neuronal Networks - Reciprocal Inhigition
Tidsram: 4-6 months
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To assess restoration of reciprocal Ia inhibition, soleus H-reflexes were recorded following common peroneal nerve (CPN) stimulation at short conditioning-test (C-T) intervals of 0, 1, 2, 3, and 4 ms. The stimulus to the CPN was delivered at 1.27 ± 0.12 (21.8 ± 10.1 mA) and 1.4 ± 0.28 (21.8 ± 10.1 mA) TA motor threshold before and after treatment, respectively. Control and conditioned soleus H-reflexes were randomly recorded across the C-T intervals tested, and 15 H-reflexes were recorded at each C-T interval. For each participant at each timepoint, amplitudes across the 15 H-reflexes per C-T interval were averaged. Results are listed for each C-T interval, pre- and post-intervention. |
4-6 months
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Plasticity of Corticospinal Networks
Tidsram: 4-6 months
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Neurophysiological measurements assessing changes in corticospinal excitability from the interventions by recording responses to single-pulse transcranial magnetic stimulation (TMS) at rest and during robotic-assisted stepping. The tibialis anterior resting motor threshold (RMT) was established and corresponded to the lowest TMS maximal stimulator output that induced reproducible evoked potentials of at least ~50 µV in 4 out of 5 consecutive single TMS pulses. RMTs (percentage of maximal stimulator output) are shown pre- and post-intervention. |
4-6 months
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
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Ambulatory Function
Tidsram: 4-6 months
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Change in 10-meter timed test (seconds required to complete 10-meter walk) between baseline and post-intervention.
Fewer seconds means faster (better) gait.
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4-6 months
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Balance
Tidsram: 4-6 months
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Changes in Berg Balance Scale score between baseline and post-intervention.
Scale scores between 0 and 56.
Higher scores mean better balance.
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4-6 months
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Autonomic Function
Tidsram: 4-6 months
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SCIM III Bladder and Bowel management subscores Bladder subscore rated 0-15 (higher means better bladder function).
Bowel subscore rated 0-10 (higher means better bowel function).
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4-6 months
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Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Sponsor
Samarbetspartners
Utredare
- Huvudutredare: Noam Y. Harel, MD, PhD, Bronx Veterans Medical Research Foundation
- Huvudutredare: Maria Knikou, PT, PhD, Research Foundation of the City University of New York
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna publikationer
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- Learmonth YC, Paul L, McFadyen AK, Mattison P, Miller L. Reliability and clinical significance of mobility and balance assessments in multiple sclerosis. Int J Rehabil Res. 2012 Mar;35(1):69-74. doi: 10.1097/MRR.0b013e328350b65f.
- Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992 Jul-Aug;83 Suppl 2:S7-11.
- Angeli CA, Boakye M, Morton RA, Vogt J, Benton K, Chen Y, Ferreira CK, Harkema SJ. Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury. N Engl J Med. 2018 Sep 27;379(13):1244-1250. doi: 10.1056/NEJMoa1803588. Epub 2018 Sep 24.
- Wagner FB, Mignardot JB, Le Goff-Mignardot CG, Demesmaeker R, Komi S, Capogrosso M, Rowald A, Seanez I, Caban M, Pirondini E, Vat M, McCracken LA, Heimgartner R, Fodor I, Watrin A, Seguin P, Paoles E, Van Den Keybus K, Eberle G, Schurch B, Pralong E, Becce F, Prior J, Buse N, Buschman R, Neufeld E, Kuster N, Carda S, von Zitzewitz J, Delattre V, Denison T, Lambert H, Minassian K, Bloch J, Courtine G. Targeted neurotechnology restores walking in humans with spinal cord injury. Nature. 2018 Nov;563(7729):65-71. doi: 10.1038/s41586-018-0649-2. Epub 2018 Oct 31.
- Gerasimenko Y, Gorodnichev R, Moshonkina T, Sayenko D, Gad P, Reggie Edgerton V. Transcutaneous electrical spinal-cord stimulation in humans. Ann Phys Rehabil Med. 2015 Sep;58(4):225-231. doi: 10.1016/j.rehab.2015.05.003. Epub 2015 Jul 20.
- Knikou M, Murray LM. Repeated transspinal stimulation decreases soleus H-reflex excitability and restores spinal inhibition in human spinal cord injury. PLoS One. 2019 Sep 26;14(9):e0223135. doi: 10.1371/journal.pone.0223135. eCollection 2019.
- Sayenko DG, Rath M, Ferguson AR, Burdick JW, Havton LA, Edgerton VR, Gerasimenko YP. Self-Assisted Standing Enabled by Non-Invasive Spinal Stimulation after Spinal Cord Injury. J Neurotrauma. 2019 May 1;36(9):1435-1450. doi: 10.1089/neu.2018.5956. Epub 2018 Dec 15.
- Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol. 2003 Mar;2(3):145-56. doi: 10.1016/s1474-4422(03)00321-1.
- Courtine G, Gerasimenko Y, van den Brand R, Yew A, Musienko P, Zhong H, Song B, Ao Y, Ichiyama RM, Lavrov I, Roy RR, Sofroniew MV, Edgerton VR. Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Nat Neurosci. 2009 Oct;12(10):1333-42. doi: 10.1038/nn.2401. Epub 2009 Sep 20.
- Dixon L, Ibrahim MM, Santora D, Knikou M. Paired associative transspinal and transcortical stimulation produces plasticity in human cortical and spinal neuronal circuits. J Neurophysiol. 2016 Aug 1;116(2):904-16. doi: 10.1152/jn.00259.2016. Epub 2016 Jun 8.
- Knikou M. Functional reorganization of soleus H-reflex modulation during stepping after robotic-assisted step training in people with complete and incomplete spinal cord injury. Exp Brain Res. 2013 Jul;228(3):279-96. doi: 10.1007/s00221-013-3560-y. Epub 2013 May 25.
- Smith AC, Mummidisetty CK, Rymer WZ, Knikou M. Locomotor training alters the behavior of flexor reflexes during walking in human spinal cord injury. J Neurophysiol. 2014 Nov 1;112(9):2164-75. doi: 10.1152/jn.00308.2014. Epub 2014 Aug 13.
- Smith AC, Rymer WZ, Knikou M. Locomotor training modifies soleus monosynaptic motoneuron responses in human spinal cord injury. Exp Brain Res. 2015 Jan;233(1):89-103. doi: 10.1007/s00221-014-4094-7. Epub 2014 Sep 10.
- Thomas SL, Gorassini MA. Increases in corticospinal tract function by treadmill training after incomplete spinal cord injury. J Neurophysiol. 2005 Oct;94(4):2844-55. doi: 10.1152/jn.00532.2005. Epub 2005 Jul 6.
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- Harkema S, Gerasimenko Y, Hodes J, Burdick J, Angeli C, Chen Y, Ferreira C, Willhite A, Rejc E, Grossman RG, Edgerton VR. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Lancet. 2011 Jun 4;377(9781):1938-47. doi: 10.1016/S0140-6736(11)60547-3. Epub 2011 May 19.
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- Cote MP, Murray LM, Knikou M. Spinal Control of Locomotion: Individual Neurons, Their Circuits and Functions. Front Physiol. 2018 Jun 25;9:784. doi: 10.3389/fphys.2018.00784. eCollection 2018.
- Ellaway PH, Catley M, Davey NJ, Kuppuswamy A, Strutton P, Frankel HL, Jamous A, Savic G. Review of physiological motor outcome measures in spinal cord injury using transcranial magnetic stimulation and spinal reflexes. J Rehabil Res Dev. 2007;44(1):69-76. doi: 10.1682/jrrd.2005.08.0140.
- Wirth B, van Hedel HJ, Curt A. Ankle paresis in incomplete spinal cord injury: relation to corticospinal conductivity and ambulatory capacity. J Clin Neurophysiol. 2008 Aug;25(4):210-7. doi: 10.1097/WNP.0b013e318183f4e3.
- Cirillo J, Calabro FJ, Perez MA. Impaired Organization of Paired-Pulse TMS-Induced I-Waves After Human Spinal Cord Injury. Cereb Cortex. 2016 May;26(5):2167-77. doi: 10.1093/cercor/bhv048. Epub 2015 Mar 25.
- Arvanian VL, Schnell L, Lou L, Golshani R, Hunanyan A, Ghosh A, Pearse DD, Robinson JK, Schwab ME, Fawcett JW, Mendell LM. Chronic spinal hemisection in rats induces a progressive decline in transmission in uninjured fibers to motoneurons. Exp Neurol. 2009 Apr;216(2):471-80. doi: 10.1016/j.expneurol.2009.01.004.
- Nielsen JB, Crone C, Hultborn H. The spinal pathophysiology of spasticity--from a basic science point of view. Acta Physiol (Oxf). 2007 Feb;189(2):171-80. doi: 10.1111/j.1748-1716.2006.01652.x.
- Knikou M. Plantar cutaneous input modulates differently spinal reflexes in subjects with intact and injured spinal cord. Spinal Cord. 2007 Jan;45(1):69-77. doi: 10.1038/sj.sc.3101917. Epub 2006 Mar 14.
- Knikou M, Angeli CA, Ferreira CK, Harkema SJ. Soleus H-reflex gain, threshold, and amplitude as function of body posture and load in spinal cord intact and injured subjects. Int J Neurosci. 2009;119(11):2056-73. doi: 10.1080/00207450903139747.
- Knikou M, Angeli CA, Ferreira CK, Harkema SJ. Soleus H-reflex modulation during body weight support treadmill walking in spinal cord intact and injured subjects. Exp Brain Res. 2009 Mar;193(3):397-407. doi: 10.1007/s00221-008-1636-x. Epub 2008 Nov 15.
- Barthelemy D, Willerslev-Olsen M, Lundell H, Biering-Sorensen F, Nielsen JB. Assessment of transmission in specific descending pathways in relation to gait and balance following spinal cord injury. Prog Brain Res. 2015;218:79-101. doi: 10.1016/bs.pbr.2014.12.012. Epub 2015 Mar 29.
- Barthelemy D, Willerslev-Olsen M, Lundell H, Conway BA, Knudsen H, Biering-Sorensen F, Nielsen JB. Impaired transmission in the corticospinal tract and gait disability in spinal cord injured persons. J Neurophysiol. 2010 Aug;104(2):1167-76. doi: 10.1152/jn.00382.2010. Epub 2010 Jun 16.
- James ND, McMahon SB, Field-Fote EC, Bradbury EJ. Neuromodulation in the restoration of function after spinal cord injury. Lancet Neurol. 2018 Oct;17(10):905-917. doi: 10.1016/S1474-4422(18)30287-4. Epub 2018 Sep 18.
- Tansey KE, McKay WB, Kakulas BA. Restorative neurology: consideration of the new anatomy and physiology of the injured nervous system. Clin Neurol Neurosurg. 2012 Jun;114(5):436-40. doi: 10.1016/j.clineuro.2012.01.010. Epub 2012 Feb 1.
- Martinez SA, Nguyen ND, Bailey E, Doyle-Green D, Hauser HA, Handrakis JP, Knezevic S, Marett C, Weinman J, Romero AF, Santiago TM, Yang AH, Yung L, Asselin PK, Weir JP, Kornfeld SD, Bauman WA, Spungen AM, Harel NY. Multimodal cortical and subcortical exercise compared with treadmill training for spinal cord injury. PLoS One. 2018 Aug 9;13(8):e0202130. doi: 10.1371/journal.pone.0202130. eCollection 2018.
- Dobkin BH. Spinal and supraspinal plasticity after incomplete spinal cord injury: correlations between functional magnetic resonance imaging and engaged locomotor networks. Prog Brain Res. 2000;128:99-111. doi: 10.1016/S0079-6123(00)28010-2. No abstract available.
- Knikou M, Mummidisetty CK. Locomotor training improves premotoneuronal control after chronic spinal cord injury. J Neurophysiol. 2014 Jun 1;111(11):2264-75. doi: 10.1152/jn.00871.2013. Epub 2014 Mar 5.
- Knikou M, Smith AC, Mummidisetty CK. Locomotor training improves reciprocal and nonreciprocal inhibitory control of soleus motoneurons in human spinal cord injury. J Neurophysiol. 2015 Apr 1;113(7):2447-60. doi: 10.1152/jn.00872.2014. Epub 2015 Jan 21.
- Ramer LM, Ramer MS, Bradbury EJ. Restoring function after spinal cord injury: towards clinical translation of experimental strategies. Lancet Neurol. 2014 Dec;13(12):1241-56. doi: 10.1016/S1474-4422(14)70144-9. Epub 2014 Nov 10.
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- Rejc E, Angeli C, Harkema S. Effects of Lumbosacral Spinal Cord Epidural Stimulation for Standing after Chronic Complete Paralysis in Humans. PLoS One. 2015 Jul 24;10(7):e0133998. doi: 10.1371/journal.pone.0133998. eCollection 2015.
- Rejc E, Angeli CA, Bryant N, Harkema SJ. Effects of Stand and Step Training with Epidural Stimulation on Motor Function for Standing in Chronic Complete Paraplegics. J Neurotrauma. 2017 May 1;34(9):1787-1802. doi: 10.1089/neu.2016.4516. Epub 2016 Oct 5.
- Hofstoetter US, Knikou M, Guertin PA, Minassian K. Probing the Human Spinal Locomotor Circuits by Phasic Step-Induced Feedback and by Tonic Electrical and Pharmacological Neuromodulation. Curr Pharm Des. 2017;23(12):1805-1820. doi: 10.2174/1381612822666161214144655.
- Pulverenti TS, Islam MA, Alsalman O, Murray LM, Harel NY, Knikou M. Transspinal stimulation decreases corticospinal excitability and alters the function of spinal locomotor networks. J Neurophysiol. 2019 Dec 1;122(6):2331-2343. doi: 10.1152/jn.00554.2019. Epub 2019 Oct 2.
- Donovan J, Kirshblum S. Clinical Trials in Traumatic Spinal Cord Injury. Neurotherapeutics. 2018 Jul;15(3):654-668. doi: 10.1007/s13311-018-0632-5.
- James ND, Bartus K, Grist J, Bennett DL, McMahon SB, Bradbury EJ. Conduction failure following spinal cord injury: functional and anatomical changes from acute to chronic stages. J Neurosci. 2011 Dec 14;31(50):18543-55. doi: 10.1523/JNEUROSCI.4306-11.2011.
- Murray LM, Knikou M. Repeated cathodal transspinal pulse and direct current stimulation modulate cortical and corticospinal excitability differently in healthy humans. Exp Brain Res. 2019 Jul;237(7):1841-1852. doi: 10.1007/s00221-019-05559-2. Epub 2019 May 11.
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27 juli 2026
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1 juli 2026
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- R01HD100544 (U.S.S. NIH-anslag/kontrakt)
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Nej
Studerar en amerikansk FDA-reglerad produktprodukt
Ja
produkt tillverkad i och exporterad från U.S.A.
Nej
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