ArticleNature neuroscience2018
Electrical spinal cord stimulation must preserve proprioception to enable locomotion in humans with spinal cord injury.
Article in Nature neuroscience, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 206 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acute Effects of Pharmacological Neuromodulation on Leg Motor Activity in Patients With Spinal Cord Injury Treated With Epidural Electrical Stimulation
Priming With High-Frequency Trans-spinal Stimulation to Augment Locomotor Benefits in Spinal Cord Injury
Study on Preliminary Safety and Efficacy of the ARC Therapy Using the ARC-IM Lumbar System to Support Mobility in People With Chronic Spinal Cord Injury
Who cites it
206 citing papers in PubMed, 3 syntheses or guidelines pooled it, 356 citations in OpenAlex.
- Comparative efficacy of robotic exoskeleton and conventional gait training in patients with spinal cord injury: a meta-analysis of randomized controlled trials.Journal of neuroengineering and rehabilitation · 2025Pooled it
- A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies.Movement disorders clinical practice · 2024Pooled it
- A systematic review of computational models for the design of spinal cord stimulation therapies: from neural circuits to patient-specific simulations.The Journal of physiology · 2023Pooled it
- Transspinal stimulation preceding step training reorganizes spinal locomotor circuits in human spinal cord injury: a randomized sham-controlled clinical trial.Frontiers in neural circuits · 2026Trial
- Functional outcomes and participants' perspectives during short-term application of spinal stimulation in individuals with spinal cord injury.The journal of spinal cord medicine · 2025Trial
- First-in-human study of epidural spinal cord stimulation in individuals with spinal muscular atrophy.Nature medicine · 2025Trial
- Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.Nature medicine · 2022Trial
- A new approach of inducing proprioceptive illusion by transcutaneous electrical stimulation.Journal of neuroengineering and rehabilitation · 2021Trial
- From Trial to Chronic Epidural Electrical Stimulation: A Single-Patient Feasibility Study in Motor-Complete Spinal Cord Injury.Journal of clinical medicine · 2026Article
- Spinal cord stimulation modulates post-synaptic inhibition to improve arm neuromotor control after chronic stroke.Cell reports. Medicine · 2026Article
- Spinal cord stimulation: An emerging strategy for chronic pain relief after spinal cord injury.Neural regeneration research · 2026Article
- Clinical trial landscape of cell therapy for spinal cord injury: from integrated practices to future developments.BMC medicine · 2026Article
- Frequency-dependent effects of motor thalamus deep brain stimulation on speech and swallowing.Nature communications · 2026Article
- Sensor Inputs and Closed-Loop Neuromodulation in Spinal Cord Injury: From Animal Models to Clinical Translation.Sensors (Basel, Switzerland) · 2026Review
- Surface circumferential spinal cord recording in freely moving rodents.Nature communications · 2026Article
- Motor Recovery After a Hemispherectomy: Review of Mechanisms and the Potential of Neuromodulation to Enhance Motor Outcomes.Journal of child neurology · 2026Review
- Cervical spinal cord stimulation disrupts proprioception yet improves voluntary arm reaching.bioRxiv : the preprint server for biology · 2026Article
- Predict neuromuscular performance in human epidural electrical stimulation: phase 1 trial interim results.Communications medicine · 2026Article
- Neural mechanisms underlying leg muscle responses during cervical transcutaneous spinal cord stimulation.Journal of neural engineering · 2026Article
- Partitioning of the nervous system following exoskeleton and epidural stimulation in spinal cord injury.Scientific reports · 2026Article
146 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Epidural electrical stimulation (EES) of the spinal cord restores locomotion in animal models of spinal cord injury but is less effective in humans. Here we hypothesized that this interspecies discrepancy is due to interference between EES and proprioceptive information in humans. Computational simulations and preclinical and clinical experiments reveal that EES blocks a significant amount of proprioceptive input in humans, but not in rats. This transient deafferentation prevents modulation of reciprocal inhibitory networks involved in locomotion and reduces or abolishes the conscious perception of leg position. Consequently, continuous EES can only facilitate locomotion within a narrow range of stimulation parameters and is unable to provide meaningful locomotor improvements in humans without rehabilitation. Simulations showed that burst stimulation and spatiotemporal stimulation profiles mitigate the cancellation of proprioceptive information, enabling robust control over motor neuron activity. This demonstrates the importance of stimulation protocols that preserve proprioceptive information to facilitate walking with EES.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.