NeuroMap - Evaluation of nTMS cortical mapping in SCI v1
Research type
Research Study
Full title
NeuroMap - An evaluation study for enhancing clinical assessment using neuronavigational Transcranial Magnetic Stimulation for cortical mapping of upper limb muscles in spinal cord injury
IRAS ID
262930
Contact name
Maurizio Belci
Contact email
Sponsor organisation
Buckinghamshire Healthcare NHS Trust
Duration of Study in the UK
1 years, 10 months, 31 days
Research summary
This study investigates the use of Transcranial Magnetic Stimulation (TMS) for the detection of connections between the brain and arm and hand muscles in people with spinal cord injury (SCI). TMS is a non-invasive technique which uses a coil positioned on the head to produce painless stimulation of a targeted area of the brain. This generates electrical signals which travel from the brain via the spinal cord to the muscles along nerve pathways. The presence of a muscle response to the stimulation demonstrates that the nerve pathways are still intact.
In SCI, the nerve tracts are often damaged, leading to a reduced ability to contract the muscles voluntarily. The level of impairment is assessed by the standard clinical neurological assessment for SCI (ASIA), which in conjunction with imaging (e.g. MRI), allows classification of the severity of the injury. Recent peer-reviewed research demonstrated that in a small-scale study of people with SCI, TMS produced responses in wrist muscles, despite patients not being able to move these muscles, suggesting that there were still connections between the brain and the muscle. The use of TMS may therefore provide enhanced understanding of the integrity of the nerve tracts in SCI, however, TMS is not currently used for routine neurological assessment, as it is deemed costly and unnecessary.
Therefore, the key aim of this feasibility study is to evaluate the use of TMS in people with SCI to extend and replicate previous findings, determining how many patients with SCI have intact nerve pathways, despite reduced ability to move voluntarily. This research may lead to enhanced clinical assessment, potentially benefiting patients, where information from TMS can be used for improved targeting of arm and hand rehabilitation.
REC name
London - City & East Research Ethics Committee
REC reference
23/PR/0386
Date of REC Opinion
10 May 2023
REC opinion
Favourable Opinion