# Harnessing Neuroplasticity of Postural Sensorimotor Networks Using Non-Invasive Spinal Neuromodulation to Maximize Functional Recovery After Spinal Cord Injury

> **NIH NIH R01** · METHODIST HOSPITAL RESEARCH INSTITUTE · 2022 · $657,591

## Abstract

ABSTRACT
Transcutaneous (TSS) and epidural spinal stimulation (ESS) are both electrophysiological techniques that have
been used to investigate the interactions between exogenous electrical stimuli and spinal sensorimotor networks
that integrate descending motor signals with afferent inputs from the periphery during motor tasks such as
standing and stepping. Recently, pilot phase clinical trials using each of these stimulation modalities have
demonstrated restoration of motor functions that were previously lost due to spinal cord injury (SCI). However,
the spinal network interactions that occur in response to TSS or ESS with rehabilitation training have yet to be
characterized and directly compared. Thus, it is imperative to (1) understand the neurophysiological profiles of
individual participants comprehensively, thereby delineating the underlying mechanisms and (2) establish the
relative effectiveness of TSS versus ESS in regaining motor function. Our central hypothesis is that ESS and
TSS will promote similar levels of stimulation-augmented standing. We will compare the immediate functional
and neurophysiological effects of TSS versus ESS in the same participants (Aim 1). We hypothesize that
ESS and TSS will generate comparable motor output during standing due to similar level of modulated excitability
of sensorimotor networks. Then, we will compare immediate and delayed effects of standing training
combined with TSS versus ESS (Aim 2). We hypothesize that both TSS- and ESS-combined trainings will result
in similar functional gain. We further predict that after one month of rest following standing training with TSS or
ESS, the excitability and responsiveness of spinal and supraspinal sensorimotor networks will differ from
baseline levels and Sham. Completion of this study will establish the efficacy of both non-invasive and invasive
spinal neuromodulatory approaches to improve functions after SCI, impacting both research and clinical
communities. Further, it will shed light on the underlying mechanisms of spinal neuromodulation, allowing
ourselves and others to refine and improve stimulation protocols to maximize functional recovery.

## Key facts

- **NIH application ID:** 10298841
- **Project number:** 1R01NS119587-01A1
- **Recipient organization:** METHODIST HOSPITAL RESEARCH INSTITUTE
- **Principal Investigator:** Dimitry Sayenko
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $657,591
- **Award type:** 1
- **Project period:** 2021-12-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10298841

## Citation

> US National Institutes of Health, RePORTER application 10298841, Harnessing Neuroplasticity of Postural Sensorimotor Networks Using Non-Invasive Spinal Neuromodulation to Maximize Functional Recovery After Spinal Cord Injury (1R01NS119587-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10298841. Licensed CC0.

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