Evidence map›Paper›PMID 42335147›Full record

Trial reportPloS one2026

Additive effect of tDCS and neuromotor recruitment on functional recovery in chronic paraplegia: A randomized controlled trial.

Ahmad Rifai Sarraj, Jihan Allaw, Eliane Rached, Joy Khayat, Hassan Karaki, Ahmad Diab, Antonio Pinti

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04790149 (Synergistic Effect of tDCS and Neuromotor Recruitment on Functional Recovery in Chronic Paraplegia), which is not on this 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.

NCT04790149 nacompletednot on this map

Synergistic Effect of tDCS and Neuromotor Recruitment on Functional Recovery in Chronic Paraplegia: A Randomized Controlled Trial

TypeinterventionalSponsorLebanese UniversityRan2022 to 2024Enrolled56ConditionsSpinal Cord InjuriesArmsConventional Rehabilitation, NEUROM + tDCS, NEUROM
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

7 authors.

Ahmad Rifai SarrajFaculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.ORCID https://orcid.org/0000-0003-4719-890X
Jihan AllawFaculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.
Eliane RachedFaculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.
Joy KhayatFaculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.
Hassan KarakiFaculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.
Ahmad DiabBiomedical Engineering Department, Signal Processing Research Group, Lebanese International University, Tripoli, Lebanon.ORCID https://orcid.org/0000-0002-8847-5961
Antonio PintiLaboratoire de Recherche Sociétés et Humanité (LARSH DeVisu), Université Polytechnique Hauts-De-France, Valenciennes, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Functional recovery in chronic spinal cord injury (SCI) is traditionally viewed as limited, particularly after the spontaneous recovery window has closed. This single-blind randomized controlled trial investigated whether adding anodal Transcranial Direct Current Stimulation (tDCS) to the Neuromotor Recruitment Method (NEUROM)-a protocol combining motor imagery with intensive peripheral sensory stimulation-provides a additive benefit for sensorimotor recovery. Fifty participants with chronic paraplegia (mean time since injury: 15.4 ± 3.2 months; ASIA Impairment Scale A, B, or C) were recruited and randomized into three arms: Reference (standard care, n = 10), NEUROM (n = 20), or NEUROM+tDCS (n = 20). The intervention was administered over 10 days. Outcomes included the Lower Extremity Motor Score (LEMS), Light Touch and Pin Prick sensory scores, and the Assessment of Movement Attempt (AMA). The Reference group showed no significant recovery. Both active groups (NEUROM and NEUROM+tDCS) achieved substantial and statistically identical improvements in sensory function compared to the Reference group (p < 0.001), suggesting that peripheral recruitment alone is sufficient for afferent restoration. However, a significant dissociation was observed in motor function: the NEUROM+tDCS group demonstrated superior LEMS recovery (Mean change: 18 points) compared to the NEUROM group (14 points; p = 0.01) and reported significantly higher volitional drive (p < 0.001). These findings indicate a clear dissociation between sensory and motor plasticity in chronic SCI; while peripheral somatosensory recruitment drives afferent sensory restoration, the addition of central stimulation via tDCS is critical for maximizing efferent motor output. This suggests that restoring motor function in chronic paraplegia requires a "top-down" cortical prime to complement "bottom-up" peripheral signaling. Trial Registration: ClinicalTrials.gov NCT04790149.

Indexed as

ParaplegiaRecovery of FunctionRecruitment, NeurophysiologicalTranscranial Direct Current StimulationAdultChronic DiseaseFemaleHumansMaleMiddle AgedSingle-Blind MethodSpinal Cord Injuries

Identifiers

PMID42335147
PMCPMC13289888

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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.