An interventional study of Corticoreticular excitability and co-contraction measurement in Spinal Cord Injury and Spasticity, sponsored by Taipei Veterans General Hospital, Taiwan. Enrolling by invitation at 1 site in Taiwan. Open to participants aged 20 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-10-14.
Sponsored by Taipei Veterans General Hospital, Taiwan · Not applicable, Interventional, and Basic science
This study is to elucidate whether hyperexcitability of the cortico-reticulospinal tract leads to abnormal co-contraction and spasticity of elbow flexors in persons with cervical cervical spinal cord injury. By measuring the supplementary motor area (SMA) regulation of the StartReact response, it is possible to quantify whether the cortico-reticular pathway is excessively active or weakened in these persons.
Participants will
Background: Abnormal muscle co-contraction, which refers to maladaptive activation of both synergist and antagonist muscles at the same time, is one of the major causes of the loss of smoothness and accuracy in movement following spinal cord injury. Previous studies have indicated a correlation between the excitability of the cortico-reticulospinal pathway and abnormal muscle tone. This trial will modulate the StartReact response in persons with SCI in order to elucidate the neurological basis of this motor impairment. The investigators hypothesize that hyperexcitability of the cortico-reticulospinal tract leads to abnormal co-contraction and spasticity. By measuring the SMA regulation of the StartReact response, it is possible to quantify whether the cortico-reticular pathway is excessively active or weakened in these persons.
Methods: This cross-sectional study will recruit 20 individuals with chronic cervical SCI (C3-C8, ASIA Impairment Scale C or D). This study will investigate the relationship between two primary measures: corticoreticular excitability and co-contraction index. Corticoreticular excitability will be assessed using a conditioning-test paradigm that combines the StartReact response with non-invasive TMS over the SMA. The co-contraction index will be calculated from the electromyography (EMG) of the biceps and triceps brachii during a sustained isometric elbow extension task. As a related measure, reticulospinal excitability will be evaluated using the standard StartReact response, which measures reaction times to visual stimuli with and without startling auditory stimuli. Secondary outcomes will include corticospinal excitability, as measured by motor evoked potential (MEP) amplitude; muscle strength; and clinical assessments of upper limb function.
Anticipated Outcomes and Significance: The investigators hypothesize that (1) individuals with SCI will exhibit greater corticoreticular excitability than healthy individuals, and (2) a positive correlation will exist between the degree of corticoreticular excitability and the co-contraction index. The findings of this study are expected to elucidate the neural basis of abnormal co-contraction following SCI. This could provide valuable insights for the development of more targeted and effective rehabilitation strategies, ultimately aiming to improve motor function and quality of life in individuals with SCI.
1,988 studies on the registry are indexed under Spinal Cord Injuries; 516 are open to participants now.
This study's planned enrollment of 20 is below the median of 24 across 1,594 interventional studies indexed under Spinal Cord Injuries.
Browse Spinal Cord Injuries studies →Taipei Veterans General Hospital, Taiwan is the lead sponsor of 338 studies on the registry; 74 are open to participants now.
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Exclusion Criteria:
All participants will be tested for corticoreticular excitability of the elbow flexors of the determined side, and co-contraction of the elbow flexors and extensors of the same side.
Other: Corticoreticular excitability and co-contraction measurement
The more spastic side will be chosen as the tested side graded by the modified Ashworth Scale. Corticoreticular excitability will be assessed using a conditioning-test paradigm that combines the StartReact response with non-invasive transcranial magnetic stimulation over the supplementary motor area. The co-contraction index will be calculated from the electromyography of the biceps and triceps brachii during sustained isometric elbow flexion and extension tasks.
corticoreticular excitability
Corticoreticular excitability will be assessed using a conditioning-test paradigm that combines the StartReact response with non-invasive transcranial magnetic stimulation over the supplementary motor area.
Time frame: Day 1
Co-contraction index
The extension and flexion co-contraction index will be calculated from the electromyography (EMG) of the biceps and triceps brachii during a sustained isometric elbow extension task and during a sustained isometric flexion task.
Time frame: Day 1
Spasticity of tested elbow flexors
spasticity of the elbow flexors measured by modified Ashworth scale
Time frame: Day 1
The maximal isometric strength of tested elbow flexors and extensors
The maximal isometric strength of the elbow flexors (biceps brachii) and extensors (triceps brachii) will be measured using a Hand-Held Dynamometer (HHD) with a pull sensor
Time frame: Day 1
The upper limb function
Clinical assessment of upper limb function will be measured by related items of the Functional Independence Measure (FIM) and the Spinal Cord Injury Measure III (SCIM III)
Time frame: Day 1
Plan to share: No — This is a preliminary investigation of the relationship between corticoreticular excitability and co-contraction in persons with spinal cord injury. To our knowledge, there are no other similar ongoing studies, and thus we do not have a plan to share the IPD from this study.
Started Jul 2026 (actual). Primary completion is estimated for Jun 2027, 11 months after the start.
Of 766 non-industry interventional studies with no phase under Spinal Cord Injuries, half reached primary completion within 36 months of starting (the median), counting those still running; a quarter within 18 and three quarters within 65. This study's planned 11 months is below that.
Counting every sponsor, half of 816 studies reached it within 35 months; a quarter within 16 and three quarters within 65.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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Taipei Veterans General Hospital, Taiwan →