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Updated 10/27/2020


Project Summary

Rehabilitative exercise aims to engage residual neural networks in humans with spinal cord injury to improve functional recovery. In our recent studies, we combined exercise with noninvasive stimulation targeting spinal synapses to further promote functional recovery. In the current protocol, individuals with chronic incomplete spinal cord injury participate in 40 sessions of exercise combined with paired corticospinal-motoneuronal stimulation (PCMS). During PCMS, stimuli are timed to have corticospinal volleys evoked by transcranial magnetic stimulation over the primary motor cortex arrive at corticospinal-motoneuronal synapses of upper- and lower-limb muscles before antidromic potentials were elicited in motoneurons by electrical stimulation of peripheral nerve. Following stimulation, participants exercise for about 1 hour. Our previous study using similar protocol for 10 sessions showed improvements in physiological and functional outcomes that preserved functionality for at least 6 months after the intervention, which suggests that targeted noninvasive stimulation of spinal synapses might represent an effective strategy to facilitate exercise-mediated recovery in humans with spinal cord injury.


Related Publications

Urbin MA, Ozdemir RA, Tazoe T, Perez MA. Spike-timing-dependent plasticity in lower-limb motoneurons after human spinal cord injury. J Neurophysiology 2017; 118(4): 2171-80.

Bunday KL, Urbin MA, Perez MA. Potentiating paired corticospinal-motoneuronal plasticity after spinal cord injury. Brain Stimulation 2018; 11(5): 1083-92.

Jo, HJ, Perez MA, Corticospinal-Motoneuronal Plasticity Further Promotes Exercise-Mediated Recovery in Humans with Spinal Cord Injury. Brain, 2020: p. doi:10.1093/brain/awaa052.

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