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Carver College of Medicine, University of Iowa","doi-asserted-by":"publisher","award":["StrokeNet Pilot project grant from the Institute for Clinical and Translational Science"],"award-info":[{"award-number":["StrokeNet Pilot project grant from the Institute for Clinical and Translational Science"]}],"id":[{"id":"10.13039\/100015515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Exp Brain Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Stroke is a leading cause of long-term adult disability, and over 80% of survivors have persistent upper limb motor impairment. Spinal electrical stimulation has shown therapeutic potential after neurological disorders. Post-stroke applications have largely relied on invasive implants that limit clinical adoption, and non-invasive high intensity electrical stimulation may be intolerable for those with residual sensory function. Trans-spinal magnetic stimulation offers a non-invasive alternative capable of modulating residual sensorimotor pathways. Fundamental parameters, such as coil position and orientation, remain under-investigated. Two experiments were conducted to fill this gap. Experiment 1: 19 healthy adults underwent spinal mapping involving 30 cervicothoracic sites (3\u00d710 grid). Responses were recorded from 6 upper limb muscles bilaterally at suprathreshold intensity using a rostral-left induced current direction. Friedman ANOVAs revealed significant medial\u2013lateral and rostral\u2013caudal variation in amplitude of spinal motor evoked potentials (sMEPs): ipsilateral&gt;midline&gt;contralateral, with arm responses peaking rostrally, wrist at mid-rows, and hand caudally. Experiment 2: 20 healthy adults received stimulation at three horizontal cervicothoracic sites using eight current directions spaced 45\u00b0 apart. Friedman ANOVAs indicated a bilateral mirror-symmetrical pattern. The largest responses from left-sided muscles were elicited with a rostral-left current direction achieved by rotating the coil handle 45\u00b0 counterclockwise from the caudal direction. Likewise, the largest right-sided muscle responses were elicited with a rostral-right current direction achieved by rotating the coil handle 315\u00b0 counterclockwise. Coil position and orientation are critical determinants of sMEP amplitude. These results provide a foundational framework to further investigate cervicothoracic magnetic stimulation as a potential non-invasive neuromodulatory intervention.<\/jats:p>","DOI":"10.1007\/s00221-026-07390-y","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:26:08Z","timestamp":1788171968000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervicothoracic trans-spinal magnetic stimulation: effect of coil position and orientation on spinal motor evoked potentials"],"prefix":"10.1007","volume":"244","author":[{"given":"Lei","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia G.","family":"Nopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kesten M.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Shields","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6929-5693","authenticated-orcid":false,"given":"Stacey L.","family":"DeJong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"issue":"13","key":"7390_CR1","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1056\/NEJMoa1803588","volume":"379","author":"CA Angeli","year":"2018","unstructured":"Angeli CA, Boakye M, Morton RA, Vogt J, Benton K, Chen Y, Ferreira CK, Harkema SJ (2018) Recovery of over-ground walking after chronic motor complete spinal cord injury. 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