Evidence map›Paper›PMID 41929291›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Recovery of Dexterous Motor Control via Non-Monosynaptic Corticospinal Pathways.

Erynn Sorensen, Luigi Borda, Julia Ostrowski, Roberto M de Freitas, Nikhil Verma, Lee E Fisher, George F Wittenberg, Peter Gerszten, Doug J Weber, Elvira Pirondini and 3 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. 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

13 authors.

Erynn SorensenRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0003-0988-4132
Luigi BordaDepartment of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.ORCID 0009-0003-4670-8530
Julia OstrowskiRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0009-0000-9245-7996
Roberto M de FreitasRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0002-4169-5692
Nikhil VermaDepartment of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.ORCID 0009-0004-5533-6887
Lee E FisherRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0002-9072-3119
George F WittenbergRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0001-5603-1197
Peter GersztenDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Doug J WeberDepartment of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.ORCID 0000-0002-9782-3497
Elvira PirondiniRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0002-8078-3951
Monica GorassiniDepartment of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-3079-6129
John W KrakauerDepartment of Neurology, Johns Hopkins University, Baltimore, MD, USA.ORCID 0000-0002-4316-1846
Marco CapogrossoRehabilitation and Neural Engineering Labs (RNEL), University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0002-0975-316X

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

Fine motor control of the human arm is assumed to depend on monosynaptic connections between the motor cortex and spinal motoneurons. We report that people with post-stroke hemiparesis could regain dexterous control using non-monosynaptic corticospinal tract (CST) projections during epidural cervical spinal cord stimulation (SCS). Participants in our pilot clinical study demonstrated the ability to improve strength, reaching smoothness, and fine force control of the arm and hand while receiving continuous stimulation. Detailed electrophysiology of corticospinal connectivity with transcranial magnetic stimulation, electromyography spectral analysis, and single motor-unit firing showed that SCS did not reliably strengthen CST-activation of motoneurons. Instead, residual CST axons sculpted the strength of spinal reflexes produced by each pulse of SCS via polysynaptic mechanisms, including presynaptic gating of sensory afferent excitability, to promote functionally relevant muscle activation patterns. Our findings reveal the ability of non-monosynaptic CST pathways to finely tune spinal motor output in humans after stroke.

Indexed as

armCorticospinal tractdexterityhandmonosynapticmotor controlprimary afferent depolarizationspinal cord stimulationstroke

Identifiers

PMID41929291
PMCPMC13042134

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.