PAS for Post-SCI Neuropathic Pain

Paired Associative Stimulation for Post- Spinal Cord Injury Neuropathic Pain

The investigators have shown in incomplete SCI patients that long-term paired associative stimulation is capable of restoring voluntary control over some paralyzed muscles and enhancing motor output in the weak muscles. In this study, the investigators will administer long-term paired associative stimulation to patients with incomplete cervical level SCI and SCI- associated neuropathic pain, and investigate its effectiveness for neuropathic pain treatment.

Inclusion Criteria:

• incomplete cervical spinal cord injury
• time from injury at least 1.5 years
• chronic SCI- induced neuropathic pain in the upper limb

Exclusion Criteria:

• Diagnosed brain damage, visible in MRI or CT.
• No activity in hands/fingers and no MEPs recorded from distal hand muscles.
• Epilepsy
• Metal inclusion in the head area
• High intracranial pressure
• Pacemaker
• Implanted hearing device
• Progressive diseases of spinal cord or brain (e.g. malignant tumors, degenerative diseases).
• Previous head or spinal cord injury affecting the motor performance of upper extremities.
• Congenital anomaly in the anatomical structure of spinal canal/cord or dura.
• Significant systemic disease or other condition that could cause neurological deficit, or may affect subject's capability to undergo investigation-related procedures.
• Acute severe infection.
• Contraindications for MRI.
• Current severe psychiatric diseases.
• Current chronic drug and/or alcohol abuse.
• Pregnancy.
• Pressure ulcer affecting the subject's capability to undergo the procedure safely