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Spinal cord stimulation modulates post-synaptic inhibition to improve arm neuromotor control after chronic stroke.

Overview

Authors: Luigi Borda1,2, Nikhil Verma1,2, Erynn Sorensen3,4, Erick Carranza3,4, Roberto de Freitas3,5, Scott Ensel3,4, Amy Boos3,6, Peter C. Gerszten5, Daryl P. Fields3,5, George F. Wittenberg3,4,6,7, Lee E. Fisher3,4,8,9, Elvira Pirondini3,4,8,10, Marco Capogrosso3,5,4, Douglas J. Weber1,2,11
ORCID iDs: Luigi Borda, Douglas J. Weber
  1. NeuroMechatronics Lab, Carnegie Mellon University, Pittsburgh, PA, USA
  2. Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
  3. Rehabilitation and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
  4. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
  5. Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
  6. Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
  7. TECH-GRECC & HERL, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
  8. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
  9. Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
  10. Clinical and Translational Science Institute (CTSI), University of Pittsburgh, Pittsburgh, PA, USA
  11. The Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, USA
Institutions: Carnegie Mellon University (United States); University of Pittsburgh (United States); VA Pittsburgh Healthcare System (United States)
Journal: Cell reports. Medicine, volume 7, issue 8, article 102925
Dates: received 27 September 2025; accepted 23 June 2026; published online 17 July 2026; in print August 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1016/j.xcrm.2026.102925 · PMID 42468533 · PMCID PMC13522750 · OpenAlex W7169532656
Open access: gold, a free copy (OpenAlex)
Status: code on request
Categories: human (organism), stroke (population), clinical / translational (subfield)
Methods: Spectral & time-frequency, Connectivity, Preprocessing, Evoked potentials, Graphs, Statistics, fMRI & imaging, Single-unit activity, calcium imaging, Smoothing, state filtering, decompositions, Physiology & signal measures
Keywords: epidural spinal cord stimulation, stroke, motor improvements, spinal cord stimulation, SCS, stroke rehabilitation, hemiparesis, reciprocal inhibition, neuromodulation, upper limb motor recovery, sensorimotor control, motor coordination, spinal circuits
MeSH: Arm*, Spinal Cord*, Spinal Cord Stimulation*, Stroke*, Aged, Female, Humans, Male, Middle Aged, Motor Neurons, Neural Inhibition, Stroke Rehabilitation (* major topic)
Topic: Spinal Cord Injury Research (Pathology and Forensic Medicine, Medicine), according to OpenAlex
Funding: National Institutes of Health BRAIN Initiative (UG3NS123135-01A1); Department of Neurological Surgery at the University of Pittsburgh; Department of Mechanical Engineering; Neuroscience Institute at Carnegie Mellon University; Department of Physical Medicine and Rehabilitation; University of Pittsburgh
Citations: not cited yet (Europe PMC); 49 references in the paper

Abstract

Epidural spinal cord stimulation has been shown to be a promising neurotechnology to improve upper limb function in people affected by stroke. It is well established that spinal cord stimulation (SCS) targeting the dorsal root entry zone increases excitatory drive to α-motoneurons via the monosynaptic reflex pathway. However, the effects of SCS on inhibitory neural pathways remain unexplored. We hypothesized that SCS improves the neuromotor control of arm movement by strengthening both excitatory and inhibitory circuit function. We show in three individuals with post-stroke motor symptoms that SCS enhances postsynaptic Ia reciprocal inhibition. These changes correlate with enhanced muscle coordination and arm kinematics, resulting in smoother and faster trajectories. Our study provides further insights into the neural targets of spinal cord stimulation and the use of this technology to treat post-stroke motor deficits. This study was registered at ClinicalTrials.gov (NCT04512690).

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.

The paper's code and data availability statement is in the Data section.

Tracing map

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Data

No dataset and no data link were found in the paper.

Data and code availability

Data reported in this paper will be shared by the lead contact upon request. This paper does not report the original code. Any additional information required to reanalyze the data will be shared by the lead contact upon request.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 2, 28 September 2026

  • Authors: added Douglas J. Weber (0000-0002-9782-3497); removed Douglas J. Weber

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 14 authors, 12 keywords, 12 MeSH terms, 6 funders, 45 references.

Cite

This paper

Borda, L., Verma, N., Sorensen, E., Carranza, E., de Freitas, R., Ensel, S., Boos, A., Gerszten, P. C., Fields, D. P., Wittenberg, G. F., Fisher, L. E., Pirondini, E., Capogrosso, M., & Weber, D. J. (2026). Spinal cord stimulation modulates post-synaptic inhibition to improve arm neuromotor control after chronic stroke. Cell reports. Medicine, 7(8), 102925. https://doi.org/10.1016/j.xcrm.2026.102925

BibTeX

@article{borda2026spinal,
author = {Borda, Luigi and Verma, Nikhil and Sorensen, Erynn and Carranza, Erick and de Freitas, Roberto and Ensel, Scott and Boos, Amy and Gerszten, Peter C. and Fields, Daryl P. and Wittenberg, George F. and Fisher, Lee E. and Pirondini, Elvira and Capogrosso, Marco and Weber, Douglas J.},
title = {{Spinal cord stimulation modulates post-synaptic inhibition to improve arm neuromotor control after chronic stroke}},
journal = {Cell reports. Medicine},
year = {2026},
month = jul,
volume = {7},
number = {8},
pages = {102925},
publisher = {Elsevier},
issn = {2666-3791},
doi = {10.1016/j.xcrm.2026.102925},
url = {https://doi.org/10.1016/j.xcrm.2026.102925},
pmid = {42468533},
pmcid = {PMC13522750}
}

RIS

TY - JOUR
AU - Borda, Luigi
AU - Verma, Nikhil
AU - Sorensen, Erynn
AU - Carranza, Erick
AU - de Freitas, Roberto
AU - Ensel, Scott
AU - Boos, Amy
AU - Gerszten, Peter C.
AU - Fields, Daryl P.
AU - Wittenberg, George F.
AU - Fisher, Lee E.
AU - Pirondini, Elvira
AU - Capogrosso, Marco
AU - Weber, Douglas J.
TI - Spinal cord stimulation modulates post-synaptic inhibition to improve arm neuromotor control after chronic stroke
T2 - Cell reports. Medicine
J2 - Cell Rep Med
PY - 2026
DA - 2026/07/17
VL - 7
IS - 8
SP - 102925
SN - 2666-3791
PB - Elsevier
DO - 10.1016/j.xcrm.2026.102925
UR - https://doi.org/10.1016/j.xcrm.2026.102925
LA - en
ER -

CSL-JSON

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