Evidence map›Paper›PMID 41282831›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Spinal Cord Stimulation Improves Feedback Control of Reaching Post-Stroke.

Omar Refy, Luigi Borda, Jacob Hsu, Erick Carranza, Nikhil Verma, Roberto de Freitas, Erynn Sorensen, Amy Boos, Marc Powell, Lee Fisher and 7 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

17 authors.

Omar RefyNeuroMechatronics Lab, Carnegie Mellon University, Pittsburgh, PA, USA.ORCID 0000-0001-5832-134X
Luigi BordaNeuroMechatronics Lab, Carnegie Mellon University, Pittsburgh, PA, USA.ORCID 0009-0003-4670-8530
Jacob HsuNeuroMechatronics Lab, Carnegie Mellon University, Pittsburgh, PA, USA.
Erick CarranzaRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0002-8502-3222
Nikhil VermaNeuroMechatronics Lab, Carnegie Mellon University, Pittsburgh, PA, USA.
Roberto de FreitasRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0002-4169-5692
Erynn SorensenRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0003-0988-4132
Amy BoosRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.
Marc PowellReach Neuro, Inc., University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0002-4880-2745
Lee FisherRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0002-9072-3119
Peter GersztenDepartment of Neurosurgery, University of Pittsburgh, Pittsburgh, USA.
Elvira PirodiniRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.
John W KrakauerDepartment of Neurology, Johns Hopkins University, Baltimore, USA.ORCID 0000-0002-4316-1846
George F WittenbergRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0001-5603-1197
Hartmut GeyerLegged Systems Lab, Carnegie Mellon University, Pittsburgh, PA, USA.
Marco CapogrossoRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, USA.ORCID 0000-0002-0975-316X
Douglas J WeberNeuroMechatronics Lab, Carnegie Mellon University, Pittsburgh, PA, USA.ORCID 0000-0002-9782-3497

Funding

Spinal Cord Stimulation to Improve Motor Function in People with Post-Stroke HemiplegiaUG3NS123135 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAPOGROSSO, MARCO, WEBER, DOUGLAS J · 2022 to 2024
$4.7M
NINDS NIH HHS UG3 NS123135
6 · The paper itself

Abstract

Cervical spinal cord stimulation (SCS) improves arm function in people with chronic post-stroke hemiparesis, yet its mechanism remains unclear. The leading hypothesis is that SCS enhances motor drive to agonist muscles. To test this, we developed a proportional-derivative (PD) control model of agonist-antagonist interactions and estimated feedback control gains in 12 healthy and 5 stroke participants. In healthy individuals, gains followed a stereotypical structure that we showed was optimal for generating smooth, stable movements. In stroke participants, this structure was disrupted but shifted toward neurotypical (optimal) values with SCS. Contrary to the prevailing hypothesis, the most consistent effect of SCS was a reduction in stabilization (derivative) gains rather than an increase in motor drive (proportional) gains, suggesting engagement of inhibitory control mechanisms of antagonist (and agonist) muscles. SCS also tuned feedback gains in a frequency-dependent manner, indicating that controller gains could guide stimulation parameter selection. This model-based framework offers an objective means to quantify neuromodulation effects on motor control and identify mechanisms of functional recovery after stroke.

Identifiers

PMID41282831
PMCPMC12637764

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.