Stimulation paradigms for recovery of movement after spinal cord injury

Despite advances in medical care and rehabilitation, the recovery of arm and hand function following a cervical spinal cord injury (cSCI) is often limited, and regaining upper limb function is consistently cited as the single most important factor that would improve the quality of life in individuals with tetra or quadriplegia After cervical spinal cord injury (cSCI) both the spinal cord and brain undergo anatomical and functional changes that limit recovery of hand function. Intense periods of rehabilitation provides a change in the environmental demands of the nervous system, and are associated with improvements in hand function. However, stimulation approaches, whether at the cortical (transcranial direct current stimulation; tDCS) or spinal cord (transcutaneous electrical stimulation) level that increase neural drive of efferent information down spared spinal pathways to the hands, when used either in isolation or combined with rehabilitation, have been under explored. The aim of this project will be to examine how stimulation paradigms and rehabilitation might be combined in an optimal manner to aid recovery of hand function after cSCI, and how type, severity and time since injury affects this functional recovery.