Trial reportAnnals of neurology2023
Multisite Hebbian Plasticity Restores Function in Humans with Spinal Cord Injury.
Trial report in Annals of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Brain Plasticity in Patients with Spinal Cord Injuries: A Systematic Review.International journal of molecular sciences · 2024Pooled it
- Paired associative stimulation improves outcomes when applied at the subacute stage after incomplete cervical spinal cord injury.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Trial
- Combinatorial approaches increasing neuronal activity accelerate recovery after spinal cord injury.Brain : a journal of neurology · 2025Trial
- The damaged connectome: Mechanisms and consequences of brain network reorganization following neurotrauma.Neuroimage. Reports · 2026Review
- Neurorehabilitation in the 21st Century: New Science, New Strategies, New Expectations.Neurorehabilitation and neural repair · 2026Review
- Neuroplasticity in Spinal Cord Injury: A Scoping Review of Characterized Mechanisms.Biomedicines · 2026Review
- Spasticity and Abnormal Tone Regulation After Spinal Cord Injury: Mechanisms and the Effects of Neuromodulation.Biomedicines · 2026Review
- Study design considerations in clinical trials testing transcutaneous stimulation for spinal cord injury.Spinal cord · 2026Review
- Paired corticospinal-motoneuronal stimulation enhances ballistic motor learning and corticospinal plasticity in older adults.The Journal of physiology · 2026Article
- Electrophysiological evidence of Hebbian plasticity in awake adult rats.Journal of neurophysiology · 2025Article
- Biomaterials and cell-based therapy post spinal cord injury.Journal of translational medicine · 2025Review
- Differences in Hebbian stimulation effects between biceps and triceps brachii in humans.Journal of neurophysiology · 2025Article
- Article
- Pathophysiology of voluntary motor commands at the level of the spinal motoneuron in patients with multiple sclerosis.medRxiv : the preprint server for health sciences · 2025Article
- Proprioceptive synaptic dysfunction is a key feature in mice and humans with spinal muscular atrophy.Brain : a journal of neurology · 2025Article
- Microstructural integrity within the damaged region of the residual corticofugal projection from primary motor cortex predicts the effect of noninvasive neuromodulation targeting the spinal cord in chronic stroke.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Article
- More is more: combining therapies to enhance spinal cord injury recovery.Brain : a journal of neurology · 2025Article
- Prospects and challenges in NMDAR signaling in spinal cord injury recovery and neural circuit remodeling.Regenerative therapy · 2025Review
- Spatiotemporal spinal cord stimulation with real-time triggering exoskeleton restores walking capability: a case report.Annals of clinical and translational neurology · 2025Article
- Transspinal stimulation preceding assisted step training reorganizes neuronal excitability and function of inhibitory networks in spinal cord injury: a randomized controlled trial.Frontiers in neurology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveSpinal cord injury (SCI) damages synaptic connections between corticospinal axons and motoneurons of many muscles, resulting in devastating paralysis. We hypothesized that strengthening corticospinal-motoneuronal synapses at multiple spinal cord levels through Hebbian plasticity (i.e., "neurons that fire together, wire together") promotes recovery of leg and arm function.
methodsTwenty participants with chronic SCI were randomly assigned to receive 20 sessions of Hebbian or sham stimulation targeting corticospinal-motoneuronal synapses of multiple leg muscles followed by exercise. Based on the results from this study, in a follow-up prospective study, 11 more participants received 40 sessions of Hebbian stimulation targeting corticospinal-motoneuronal synapses of multiple arm and leg muscles followed by exercise. During Hebbian stimulation sessions, 180 paired pulses elicited corticospinal action potentials by magnetic (motor cortex) and/or electrical (thoracic spine) stimulation allowing volleys to arrive at the spinal cord 1-2 milliseconds before motoneurons were activated retrogradely via bilateral electrical stimulation (brachial plexus, ulnar, femoral, and common peroneal nerves) for biceps brachii, first dorsal interosseous, quadriceps femoris, and tibialis anterior muscles as needed.
resultsWe found in our randomized study that participants receiving Hebbian stimulation improved their walking speed and corticospinal function to a greater extent than individuals receiving sham stimulation. In agreement, prospective study participants improved their grasping and walking, corticospinal function, and quality of life metrics, exhibiting greater improvements with more sessions that persisted 9-month post-therapy.
interpretationOur findings suggest that multisite Hebbian stimulation, informed by the physiology of the corticospinal system, represents an effective strategy to promote functional recovery following SCI. ANN NEUROL 2023;93:1198-1213.
Indexed as
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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.