Brain and spinal cord paired stimulation coupled with locomotor training affects polysynaptic flexion reflex circuits in human spinal cord injury

This study investigates how combining brain and spinal cord stimulation with assisted walking training affects reflex pathways in people with spinal cord injury (SCI). The goal is to improve walking ability by modifying these pathways. The researchers used transcranial magnetic stimulation (TMS) to stimulate the brain and transcutaneous spinal cord stimulation to stimulate the spinal cord during robotic-assisted step training. They found that the order of stimulation (brain-then-spinal cord vs. spinal cord-then-brain) influenced the modulation of the tibialis anterior (TA) flexion reflex, a key reflex involved in walking.

• 1
  Transspinal-TMS paired with locomotor training significantly reduced the amplitude of the flexion reflex during stepping in individuals with SCI.
• 2
  TMS-transspinal paired with locomotor training did not significantly alter the amplitude of the early or late TA flexion reflex.
• 3
  The different behavior of the early TA flexion reflex in the two randomized groups may be the result of many factors associated to the nature of SCI.