Corticospinal-motor neuronal plasticity promotes exercise-mediated recovery in humans with spinal cord injury

This study investigates whether combining exercise with a non-invasive stimulation technique called paired corticospinal-motor neuronal stimulation (PCMS) can improve functional recovery in individuals with spinal cord injury (SCI). PCMS aims to enhance transmission in the corticospinal pathway at the spinal level. The researchers found that PCMS, whether combined with exercise or not, increased corticospinal drive and maximal voluntary contraction in targeted muscles. Improvements were observed in both upper and lower limb function. This suggests that PCMS could be an effective strategy to boost residual corticospinal connections and enhance recovery in individuals with SCI. The benefits of PCMS combined with exercise were also found to persist six months after the intervention, indicating that the stimulation helped preserve exercise gains. This highlights the potential of PCMS as a tool to facilitate and maintain long-term functional improvements in people with SCI.

• 1
  The amplitude of corticospinal responses and the magnitude of maximal voluntary contractions in targeted muscles increased after PCMS combined or not with exercise, but not after sham-PCMS combined with exercise.
• 2
  Behavioral and physiological effects were preserved for 6 months in the group receiving exercise with PCMS but not in the group receiving exercise combined with sham-PCMS.
• 3
  The time to complete subcomponents of the GRASSP and the 10-m walk test decreased on average by 20% after all protocols.