Neurostimulation for Respiratory Function After Spinal Cord Injury

Inclusion Criteria:

1. Male and females between ages 18-85 years

2. SCI at least 6 months post-injury

3. Spinal Cord injury at C1-C5

4. Demonstrate respiratory deficit following spinal cord injury as following: (1)Individuals using mechanical ventilation, and (2) individuals with pulmonaryfunction testing (PFT) deficits corresponding to having a vital capacity (VC) < 80% (predicted)

5. Must have a family member or caregiver who is trained and willing to operate themechanical ventilator during study visits.

Exclusion Criteria:

1. Any illness or condition that based on the research team's assessment, willcompromise with the participant's ability to comply with the protocol, patientsafety, or the validity of the data collected during this study.

2. Any debilitating disease prior to the SCI that caused exercise intolerance.

3. Individuals entirely dependent on the support of a diaphragmatic pacer (24 hours perday).

4. Premorbid, ongoing major depression or psychosis, altered cognitive status.

5. History of head injury or stroke

6. Vascular, traumatic, tumoral, infectious, or metabolic lesion of the brain, evenwithout a history of seizure, and without anticonvulsant medication

7. History of seizures or epilepsy

8. Receiving drugs acting primarily on the central nervous system, which lower theseizure threshold

9. Pregnant females

10. If a woman of childbearing age is unsure of the pregnancy, and does not want to takethe pregnancy test

11. Ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinalcord disease such as spinal stenosis, spina bifida, MS, or herniated disk

12. Metal plate in skull

13. Individuals with scalp shrapnel, cochlear implants, or aneurysm clips

14. Individuals taking Bupropion, Dolutegravir, Lacosamide, Trilaciclib, or PR Intervalprolonging drugs