Transcranial direct current stimulation to enhance motor function in spinal cord injury: Pilot data

Several lines of evidence indicate that a non-invasive form of brain stimulation called transcranial direct current stimulation (tDCS) can facilitate motor recovery after stroke. However, there is no available data about how tDCS may enhance outcomes of intensive, task-oriented upper extremity (UE) motor training in people with spinal cord injury (SCI). Moreover, there is a lack of effective interventions to enhance recovery of UE motor function after SCI, especially in chronic cases. Thus, we are conducting a double-blind, randomized, controlled study of how tDCS paired with intensive task-oriented training affects UE motor function in subjects with motor incomplete cervical SCI. Our central hypothesis is that subjects who receive anodal tDCS paired with intensive task-oriented training 3 days a week for 8 weeks will have significantly more improved UE motor performance than controls receiving sham tDCS paired with identical training. Furthermore, motor improvement will correlate with corticospinal reorganization (motor maps) measured by transcranial magnetic stimulation (TMS). Outcome measures for motor performance include Spinal Cord Independence Measure-Ill, Canadian Occupational Performance Measure, and Medical Research Council scale administered at baseline, at midpoint, and immediately post-intervention. Here, we present our preliminary results (n=2) of this ongoing study.