Individuals with SCI and ALS usually have residual nerve connections, even if they do not have conscious control over these neural pathways. We are utilizing sophisticated approaches to identify these spared nerve pathways. To strengthen spared nerve pathways, different combinations of physical exercises, magnetic stimulation, electrical stimulation, ischemic conditioning, and medications are being employed in an effort to improve function.
We use the principle of ‘Fire Together, Wire Together’: When nearby nerves fire together repeatedly, connections between those nerves strengthen. The ability to change nerve circuit function is called “neuroplasticity”. Neuroplasticity helps nerve circuits rewire and reconnect, leading to improved movement and control below the injury.
Our research interventions:
Our cutting-edge technologies:
Our group is part of the James J. Peters VA Spinal Cord Damage Research Center. The Center has a thriving mix of senior and junior research faculty and staff, spanning specialties from neurology, rehabilitation, physiology, endocrinology, gastroenterology, engineering, and molecular science.
We are open to enrollment of Veterans AND non-Veterans for our clinical research studies.
The role of pharmacological agents in restoring neuronal excitability after chronic SCI
SCI leads to complex imbalances in central nervous system (CNS) circuits, resulting in a mix of
underactive circuits that drive voluntary movement, overactive circuits that drive uncontrolled
movement (spasticity), and impaired feedback responses. These imbalances act as barriers to functional recovery after SCI. Thus, drugs aiming to restore a normal balance of excitability within the damaged CNS are potential key therapies in SCI rehabilitation.
We are testing magnetic brain and electrical spinal cord stimulation, along with muscle strength and
task performance during an activity, to better understand how the single-dose drugs influence nerve circuits for improving hand function. To stimulate the brain, we use transcranial magnetic stimulation (TMS). To stimulate the spinal cord, we use “low frequency stimulation”. All of these methods are non-invasive.
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Note: This is a research study testing for temporary changes in nerve transmission and hand function. There is no expectation of long-term benefit from this study. Any temporary changes seen in this study will be implemented in future studies attempting to prolong that effect.
INVESTIGATOR
Lynda M. Murray, PhD: 718 584-9000 x5426; Lynda.murray@va.gov
CONTACT
Kyla Holbrook, BS: 718-584-9000 x5824; kyla.holbrook@va.gov
Spinal Cord Associative Plasticity (SCAP)
People with cervical SCI have reduced connections in nerve circuits between the brain and the hands. Activating spared nerve circuits could be a way to improve recovery. Pairing stimulation of two parts of a spared circuit can target modulation more specifically to the intended nerve circuits.
We aim to enhance the demonstrated potential of transcutaneous spinal cord stimulation (TSCS) by synchronizing TSCS with transcranial magnetic stimulation (TMS) pulses in a fashion that triggers spinal cord associative plasticity (SCAP). Preliminary results demonstrate that precisely pairing TSCS and TMS has the potential to facilitate upper extremity responses to cortical stimulation.
Click here for more information.
Note: This is a research study testing for temporary changes in nerve transmission and hand function. There is no expectation of long-term benefit from this study. Any temporary changes seen in this study will be implemented in future studies attempting to prolong that effect.
INVESTIGATOR
Noam Y. Harel, MD, PhD: 718-584-9000 x1742; Noam.harel@va.gov
CONTACT
Kyla Holbrook, BS: 718-584-9000 x5824; kyla.holbrook@va.gov
Paired brain and spinal cord stimulation after cervical SCI
For people with cervical SCI, regaining hand function is their highest priority. We are testing different combinations of magnetic and electrical brain and spinal cord stimulation to better understand how to reconnect nerve circuits for improving hand function.
To stimulate the brain, we use transcranial magnetic stimulation (TMS). To stimulate the spinal cord, we will compare “direct-current stimulation” to “Russian frequency stimulation”. All of these methods are non-invasive.
Click here for more information.
Note: This is a research study testing for temporary changes in nerve transmission and hand function. There is no expectation of long-term benefit from this study. Any temporary changes seen in this study will be implemented in future studies attempting to prolong that effect.
INVESTIGATOR:
Lynda M. Murray, PhD: 718 584-9000 x5426; Lynda.murray@va.gov
CONTACT:
Kyla Holbrook, BS: 718-584-9000 x5824; kyla.holbrook@va.gov
Priming the Spine before Gait Training for SCI
Exercise and body movement have proven therapeutic benefits for individuals with and without SCI. People with SCI are able to practice walking on treadmills using robotic assistance and body weight support. Our lab is interested in seeing if we can enhance this therapy by priming the spine with electrical spinal stimulation before treadmill training.
Multi-center: This is a clinical trial taking place at the Bronx VA and at the College of Staten Island. We will measure both physiological and functional changes in response to a course of locomotor training with or without spinal electrical stimulation.
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Note: This trial involves “randomization” – you will be randomly assigned to either receive spinal stimulation during walking or no stimulation. All participants will get the full treadmill training program.
INVESTIGATOR:
Noam Y. Harel, MD, PhD: 718 584-9000 x1742 noam.harel@va.gov
Maria Knikou, PhD: 718-982-3316; Maria.Knikou@csi.cuny.edu
CONTACT:
Kyla Holbrook, BS: 718-584-9000 x5824; kyla.holbrook@va.gov
Cognition Glove and Arm Brace integrated with Virtual Reality for hand grasping after SCI
People with cervical spinal cord injury (SCI) have difficulty reaching and grasping objects in daily life. In this study we are testing a protocol that involves wearing a “Cognition Glove” or an “Upper-Arm Brace” integrated with a virtual reality (VR) environment that provides multiple types of visual and audio feedback to try to improve control of reaching and grasping. All of these methods are non-invasive.
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Note: This is a research study with no expectation of long-term benefit.
INVESTIGATOR
Noam Y. Harel, MD, PhD: 718-584-9000 x1742; Noam.harel@va.gov
Raviraj Nataraj, PhD: 201-216-3555; RNataraj@stevens.edu
CONTACT
Kyla Holbrook, BS: 718-584-9000 x5824; kyla.holbrook@va.gov
Cognition Glove and Arm Brace integrated with Virtual Reality for hand grasping after SCI
Kyla Holbrook, BS
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