Evidence map›Paper›PMID 41019413›Full record

ArticleTopics in spinal cord injury rehabilitation2025

Percutaneous Spinal Cord Stimulator Enables Novel Clonus Biomarker and Management in Persons With Spinal Cord Injury and Multiple Sclerosis: An Exploratory Study.

Anders J Asp, Megan L Gill, Daniel D Veith, Omid Jahanian, K A Fernandez, Candee J Mills, Andrew R Thoreson, Jonathan M Hagedorn, Markus A Bendel, Ryan J Solinsky and 3 more

Abstract readCase Reports
In one paragraph

Article in Topics in spinal cord injury rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Anders J AspAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Megan L GillAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Daniel D VeithAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Omid JahanianAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
K A FernandezAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Candee J MillsAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Andrew R ThoresonAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Jonathan M HagedornPain Medicine, Mayo Clinic, Rochester, Minnesota.
Markus A BendelPain Medicine, Mayo Clinic, Rochester, Minnesota.
Ryan J SolinskyAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
W Oliver TobinDepartment of Neurology, Mayo Clinic, Rochester, Minnesota.
Kristin D ZhaoAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.
Peter J GrahnAssistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota.

Funding

Elucidating spinal sensorimotor network components that underlie recovery of motor functions via lumbosacral epidural electrical stimulation in humans with spinal cord injuryR01NS115877 · NINDS · MAYO CLINIC ROCHESTER · PI GRAHN, PETER JONAS · 2020 to 2024
$3.0M
NINDS NIH HHS R01 NS115877
6 · The paper itself

Abstract

Background: Spasticity is common in spinal cord injury (SCI) and multiple sclerosis (MS), and it can manifest as repeated, rhythmic muscle contractions called clonus. The spontaneous nature of clonus can disrupt independent performance of activities of daily living and negatively impact overall health and quality of life. Objectives: To quantify biomarkers of clonus and explore management of clonus in individuals with SCI or progressive MS using epidural spinal cord stimulation (ES) or dorsal root stimulation (DRS). Methods: Four male participants were included in this case series study: 3 with SCI and 1 with MS. All participants underwent temporary percutaneous ES lead placement over the dorsolateral thoracolumbar region of the spinal cord. Participants with SCI were also implanted with DRS leads at the L4 dorsal root. Clonus was elicited mechanically at the ankle while recording electromyography of the soleus muscle synchronized to direct spinal cord field potential recordings from ES and DRS percutaneous leads. Results: Clonus was evident as a prominent band (5-8 Hz) in recordings from ES leads, DRS leads, soleus muscle, and accelerometry. In 4 participants, percutaneous spinal stimulation reduced median clonus duration and cycle count. Clonus was immediately suppressed upon activation of spinal cord stimulation, and the suppression persisted even when clonus was reinitiated after turning off the stimulation. Conclusion: The use of objective biomarkers, including spinal cord potentials, to quantify clonus in real time combined with the immediate and reversible effects of stimulation highlight the potential of neuromodulation as a therapeutic tool for managing clonus. These data demonstrate preliminary efficacy of ES and DRS for clonus monitoring and treatment in 4 participants.

Indexed as

Multiple SclerosisMuscle SpasticitySpinal Cord InjuriesSpinal Cord StimulationAdultBiomarkersElectromyographyHumansMaleMiddle AgedBiomarkersbiomarkersclonusdorsal root ganglion stimulationepidural dorsal column spinal cordmultiple sclerosisspasticityspinal cord injury

Identifiers

PMID41019413
PMCPMC12464483

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Registered trials

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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.