# Neural plasticity by spinal cord stimulation and training in people with spinal cord injury

> **NIH NIH K01** · WASHINGTON UNIVERSITY · 2024 · $204,733

## Abstract

PROJECT SUMMARY/ABSTRACT
Spinal cord injury (SCI) is a life-altering event that leads to long-lasting motor impairment. Currently, there is no
cure for paralysis. Electrical spinal cord stimulation (SCS) combined with exercise training can restore posture
control, stepping, and voluntary walking in humans with SCI. However, the neurorecovery mechanisms induced
by electrical neuromodulation of the spinal cord are poorly understood. This project will generate evidence-based
knowledge of changes in short-term excitability and long-term plasticity of the neural circuits that may mediate
SCS-induced improvements in motor function. Participants with SCI and control subjects will perform 30-min leg
training sessions with a non-invasive body-machine interface controlling a computer cursor, and perform game-
like activities using voluntary movements and/or non-invasive transcutaneous SCS. We will quantify changes in
corticospinal, reticulospinal, and spinal neural excitability will be quantified by comparing motor-evoked potentials
elicited by transcranial magnetic stimulation, the StartReact response, and the F-wave responses respectively
before and after training. We will determine (1) short-term changes in neural excitability that are independently
enabled by SCS and activity-based training, (2) whether task-specific training used commonly used in
rehabilitation enhances short-term changes in neural excitability, and (3) long-term changes in neural plasticity
mediated by SCS combined with activity-based training in individuals with chronic SCI. A clear understanding of
SCS-enhanced neural mechanisms and how they promote neural plasticity through residual corticospinal,
reticulospinal, and spinal connections will promote the development of personalized therapies that directly target
the specific excitability and plasticity states of these circuits to promote and enhance functional recovery in
individuals with SCI. Throughout the award period, I will obtain new skills and expertise in conducting clinical
studies as the lead investigator. In addition, I will gain further training in neurophysiological evaluations of motor
and sensory function, evaluation of cortical and spinal cord plasticity, spinal cord stimulation, career
development, and R01-level grant writing. To accomplish the proposed research and training, I have assembled
a multi-disciplinary team of world class mentors who are committed to my success. This training will build on my
previous experience in clinical and translational research as a trainee and ultimately provide me with the
knowledge and skillset to establish an independent research program and transition into an independent R01-
funded investigator leading global progress in understanding and exploiting neuroplasticity after SCI.

## Key facts

- **NIH application ID:** 10925176
- **Project number:** 5K01NS127936-03
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Ismael Seanez
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $204,733
- **Award type:** 5
- **Project period:** 2022-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10925176

## Citation

> US National Institutes of Health, RePORTER application 10925176, Neural plasticity by spinal cord stimulation and training in people with spinal cord injury (5K01NS127936-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10925176. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
