An interventional study of transcranial direct current stimulation (tDCS) + FTP and transcranial pulsed current stimulation (tPCS) + FTP in Spinal Cord Injury, sponsored by Shepherd Center, Atlanta GA. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-05.
Sponsored by Shepherd Center, Atlanta GA · Not applicable, Interventional, and Treatment
The goal of this pilot study is to find out how four different types of transcranial electrical stimulation (tES) affect brain activity, the process of acquiring new skills (also called motor learning), and hand function after cervical spinal cord injury (cSCI).
Participants will complete 5 study sessions: one sign-up session and four testing \& intervention sessions. Total participation will take about 18 hours. During the sign-up session, researchers will: discuss study details, review the participant's health history to make sure that it is safe for them to participate, perform tests to ensure that the participant meets the study criteria, and collect the participant's demographic information. During each testing \& intervention session, the participant will receive a different type of tES. Before and after getting tES, they will take part in tests that measure their brain activity and the strength, sensation, and function of their right hand.
Improved use of the upper extremities (UEs) is a paramount concern for most individuals with cervical spinal cord injury (cSCI). The majority of people with SCI have some remaining pathways connecting the cortical and spinal circuitry. Strengthening descending corticospinal circuits, which drive volitional control, has potential to have a significant impact on UE function. Therapeutic modalities that enhance descending drive via direct excitation of the cortical circuitry may be valuable adjuncts to neurorehabilitation training for people with SCI.
Transcranial electrical stimulation (tES) modulates cortical excitability via low intensity electrical stimulation applied to the scalp. It is an attractive candidate for use as an adjunct to standard neurorehabilitation training given its clinical accessibility; tES devices are cost effective, highly portable, require minimal training, and have short set-up times. Further, tES has been shown to improve implicit motor learning, a cornerstone of neurorehabilitation training. While the use of tES as a neuromodulatory intervention has been studied extensively in people with stroke, these modalities have received little attention in the realm of SCI neurorehabilitation research.
Multiple types of tES exist, including transcranial direct current stimulation (tDCS), transcranial pulsed current stimulation (tPCS), and transcranial random noise stimulation (tRNS). These modalities vary based on the applied waveform. Continuous, patterned, and variable waveforms are applied during tDCS, tPCS and tRNS, respectively. In addition to modulating cortical excitability, tDCS has been shown to improve implicit learning processes which are impaired after SCI. Preliminary evidence in neurologically intact individuals suggests that tPCS and tRNS may be more efficacious modulators of cortical excitability than tDCS. However, it is unknown whether these effects on cortical excitability carry over to improvements in implicit motor learning. Further, the type of tES that has the largest effect on motor learning and UE function in people with cSCI has yet to be determined. For this pilot project, the investigators will employ a sham-controlled, randomized crossover study designed to evaluate the comparative efficacy of four different types of tES (tDCS, tPCS, tRNS, and sham) in 12 participants with chronic cSCI via the following Specific Aims:
Aim 1. Quantify the effects of tDCS, tPCS, tRNS, and sham tES on implicit motor learning.
Aim 2. Quantify the effects of tDCS, tPCS, tRNS, and sham tES on UE function, strength and sensation.
2,025 studies on the registry are indexed under Spinal Cord Injuries; 537 are open to participants now.
This study's planned enrollment of 12 is below the median of 24 across 1,633 interventional studies indexed under Spinal Cord Injuries.
Browse Spinal Cord Injuries studies →Shepherd Center, Atlanta GA is the lead sponsor of 22 studies on the registry; 4 are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Hypersensitivity
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will participate in a single session of each of the three tES types being evaluated combined with upper extremity FTP.
Other: transcranial direct current stimulation (tDCS) + FTP · Other: transcranial pulsed current stimulation (tPCS) + FTP · Other: transcranial random noise stimulation (tRNS) + FTP
Participants will participate in a single session of sham tES combined with upper extremity FTP.
Other: sham transcranial electrical stimulation (tES) + FTP
tDCS (waveform: monophasic and continuous) will be delivered for a duration of 20 minutes and intensity of 2 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with tDCS application and will consist primarily of task-oriented arm and hand activities.
tPCS (waveform: monophasic square waves with 500 ms pulse duration and 50 ms inter-pulse interval) will be delivered for a duration of 20 minutes and intensity of 2 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with tPCS application and will consist primarily of task-oriented arm and hand activities.
tRNS (waveform: 0-500 Hz random frequency and Gaussian white noise random intensity) will be delivered for a duration of 20 minutes and intensity range of +/-1 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with tRNS application and will consist primarily of task-oriented arm and hand activities.
Sham tES will be delivered for a duration of 20 minutes and intensity of 0 mA using two saline-soaked reusable sponge electrodes (35 cm2 each). The active electrode will be placed over the hand representation of the motor cortex controlling the right upper extremity (C3, 10-20 EEG system) and the reference electrode will be placed over the contralateral supraorbital area (FP2, 10-20 EEG system). The FTP component of intervention will occur concurrently with sham tESapplication and will consist primarily of task-oriented arm and hand activities.
Change in brain activity
Electroencephalography (EEG) event-related potential (ERP) amplitude will be recorded in the left parietofrontal network during performance of a modified serial reaction time task (mSRTT).
Time frame: Twice during each of the four testing & intervention sessions through study completion, an average of two weeks.
Change in brain connectivity
Electroencephalography (EEG) alpha band parietofrontal connectivity will be recorded under two conditions: 1) resting state and 2) during performance of a modified serial reaction time task (mSRTT).
Time frame: Twice during each of the four testing & intervention sessions through study completion, an average of two weeks.
Change in upper extremity (UE) function
Function will be measured in the right UE using the Graded Redefined Assessment of Strength Sensibility and Prehension version 2 (GRASSP v2) quantitative prehension subtest. Participants will complete four tasks: pouring water from a bottle to a cup, moving nine pegs from one side of a board to the other, inserting a key into a lock and rotating, and fastening four nuts onto screws. Each task will be scored on a 0-5 scale (0: task cannot be conducted at all - 5: task conducted without difficulty using the expected grasp pattern) and timed (maximum of 75 seconds will be allowed per task). The number of drops during each task will also be recorded. The total score, time and number of drops for all four tasks will then be calculated. The maximum score is 20 with higher scores denoting better UE function.
Time frame: Twice during each of the four testing & intervention sessions through study completion, an average of two weeks.
Change in upper extremity (UE) strength
Strength will be measured in the right UE using key pinch force. The participant will be positioned with the shoulder in neutral, elbow flexed at approximately 90º, and forearm and wrist in neutral. Force will be quantified with an electronic pinchmeter positioned between the middle phalanx of the index finger and thumb pad. The participant will be given a command of "ready, set, go" upon which they will be instructed to pinch as hard as possible for 3 seconds. Three trials will be completed with a 60 second rest period between trials, and the mean force will be calculated.
Time frame: Twice during each of the four testing & intervention sessions through study completion, an average of two weeks.
Change in upper extremity (UE) sensation
Sensation will be measured in the right UE using the Graded Redefined Assessment of Strength Sensibility and Prehension version 2 (GRASSP v2) sensation subtest. Semmes-Weinstein monofilaments ranging in size from 3.61 to 6.65 will be used in three locations on the palmar surface of the hand while the participant's vision is occluded with a blindfold. The smallest monofilament (3.61) will be tested 3 times per location with 2/3 accurate responses indicating intact sensation. If the participant cannot detect the 3.61 filament at all locations, testing will continue with the next heaviest filament until the participant detects a filament at all three test locations or until testing with the heaviest filament is complete. In contrast to the 3.61 filament, the three other filaments will be tested once per location. The total score will be calculated by summing the scores for each test location. The maximum score is 12 with higher scores denoting better UE sensation.
Time frame: Twice during each of the four testing & intervention sessions through study completion, an average of two weeks.
Plan to share: No
No publications or documents are linked to this record.
Start is estimated for Dec 2026; primary completion for Aug 2027, 8 months later.
Of 790 non-industry interventional studies with no phase under Spinal Cord Injuries, half reached primary completion within 37 months of starting (the median), counting those still running; a quarter within 18 and three quarters within 65. This study's planned 8 months is below that.
Counting every sponsor, half of 839 studies reached it within 36 months; a quarter within 17 and three quarters within 64.
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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Shepherd Center, Atlanta GA