Zapping the brain with precision electricity may supercharge hand rehab after spinal injury

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Age between 18 and 75 years * Physician diagnosed cervical incomplete spinal cord injury or lesion (iSCI) * Classified by the American Spinal Cord Association (AIS) impairment scale as AIS C or D * iSCI occurred at least 18 months ago * Level of injury or lesion is between C2 and T1 * Bicep strength must be classified as ≥ 3 muscle grade as defined by the medical research council (MRC) scale * Tricep strength must be at least an MRC grade of 2 and be at least 1 muscle grade lower than bicep * Both the biceps and triceps will be required to elicit an active motor evoked potential \>200 uV with transcranial magnetic stimulation * Must maintain current medication regime * Must present with a weaker side of the body, as indicated by a Upper Extremity Motor Score (UEMS) score difference between the left and right side * UEMS \< 40 (50 max score) Exclusion Criteria: * Pacemaker or other implanted device * Metal in the skull * History of seizures * Pregnancy * First-degree relative with medication-resistant epilepsy * Current participation in upper limb rehabilitation therapies * Current use of illicit drugs, abusing alcohol, or have withdrawn from alcohol in the last 6 months * Other neurological impairment or condition * Pressure ulcers * Significant lower motor neuron loss at C7 as noted by a nerve conduction velocity \<50 m/s * History of traumatic brain injury, as documented by Rancho Scale Impairment of ≤ 5 * History of brain MRI documented focal cerebral cortex infarct (e.g. hydrocephalus) * Contractures at the elbow * Severe spasticity as noted by a Modified Ashworth Scale (MAS) \> 4. * Documented, non-sedated post-traumatic amnesia lasting more than 48 hours * Demonstrated present gains in motor recovery as noted by a \>10% change in triceps strength from pre-test #1 to pre-test #2 * A neuroactive medication that has the potential to lower the seizure threshold