December 15, 2025

@michaelokun

Can we reawaken stepping after spinal cord injury? This research group says YES, and showed us evidence in their experiment where they applied closed-loop spinal stimulation to restore walking function. Closed-loop describes a system where a person’s own muscle signal is fed back into a stimulator to instantly guide the movement. In a new paper in Brain, Tazoe and colleagues describe a non-invasive approach that links hand muscle activity w/ magnetic spinal stimulation in an effort to restore bilateral stepping control in folks living w/ paraplegia. Key Points: - Non-invasive closed-loop spinal stimulation enabled rhythmic bilateral stepping by converting hand EMG signals into magnetic pulses directed at the lumbar spinal circuits. - Repeated closed-loop sessions strengthened spinal circuits, producing larger steps and better coordinated muscle responses, especially in folks whose lumbar spinal cord was spared from previous injury. - Some participants showed improved voluntary stepping without stimulation, suggesting that repeated pairing of intention w/ stimulation may boost residual descending motor pathways. My take: The restoration of function after spinal cord injury is nothing short of remarkable. This work is unveiling another potential power of circuit neuromodulation. Here are 5 points that resonated w/ me about this article: 1- This approach bypasses injured pathways, however still taps into preserved lumbar circuits to help the legs to step again. 2- Hand signals can drive leg movement, showing how creative interfaces can ‘rewire’ control after injury. 3- Repetition strengthens spinal circuits, meaning training frequently can build better stepping patterns, especially over time. 4- Even weak voluntary effort matters, because combining intention w/ stimulation boosted the impact of the intervention. 5- A fully non-invasive strategy could offer hope, especially for folks who cannot or will not pursue implanted stimulators. https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awaf230/8341625 #michaelokun fixelinstitute #parkinson #spinalcordinjury #spinalcordinjuryrecovery