{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:19:38Z","timestamp":1791065978894,"version":"4.1.0"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Veteran Affairs Administration"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Combinatorial approaches targeting multiple aspects of spinal cord injury (SCI) pathophysiology are needed to maximize functional recovery. We hypothesized that enhancing neuronal activity\u2014by strengthening corticospinal synapses through Hebbian stimulation and increasing neuronal transmission with 4-aminopyridine (4-AP), a potassium blocker\u2014could accelerate locomotor recovery in individuals with chronic SCI.<\/jats:p>\n                  <jats:p>Participants were randomly assigned to receive 10\u2005mg of 4-AP or placebo, where both groups followed with 60\u2005min of Hebbian stimulation targeting corticospinal-motor neuronal synapses supplying leg muscles involved in locomotion and 60\u2005min of standard exercise rehabilitation for 40 sessions over 8\u201314 weeks. During Hebbian stimulation, 720 paired pulses were delivered to elicit corticospinal action potentials via electrical stimulation of the thoracic spine, ensuring volleys reached the spinal cord 1\u20132\u2005ms before motor neurons were retrogradely activated through bilateral electrical stimulation of the femoral, common peroneal, and posterior tibial nerves (targeting the quadriceps femoris, tibialis anterior and soleus muscles, respectively).<\/jats:p>\n                  <jats:p>Results showed that participants who received 4-AP exhibited significantly greater improvements in walking speed and endurance, corticospinal excitability, and light touch sensation compared to those who received the placebo. The minimal clinically important difference in walking speed and endurance was achieved after 20 sessions in the 4-AP group, but was not consistently reached in the placebo group. Although walking continued to improve in both groups over the course of 40 sessions, the 4-AP group demonstrated significantly greater progress. Improvement in the 4-AP group was still present approximately 12 months later.<\/jats:p>\n                  <jats:p>These findings suggest that 4-AP represents a strategy to potentiate and accelerate Hebbian stimulation effects on motor recovery in individuals with chronic SCI.<\/jats:p>","DOI":"10.1093\/brain\/awaf099","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T08:38:15Z","timestamp":1742719095000},"page":"1911-1923","source":"Crossref","is-referenced-by-count":13,"title":["Combinatorial approaches increasing neuronal activity accelerate recovery after spinal cord injury"],"prefix":"10.1093","volume":"148","author":[{"given":"Bing","family":"Chen","sequence":"first","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University , Chicago, IL 60611 ,","place":["USA"]},{"name":"Edward Jr. Hines VA Hospital , Hines, IL 60141 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Gaikwad","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H","family":"Powell","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang Jin","family":"Jo","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Rehabilitation Science, University at Buffalo , Buffalo, NY 14260 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison B","family":"Kessler","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chen","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles J","family":"Heckman","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Thomas Jefferson University , Philadelphia, PA 19107 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D","family":"Guest","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Miami Project to Cure Paralysis, University of Miami , Miami, FL 33136 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R","family":"Wolpaw","sequence":"additional","affiliation":[{"name":"National Center for Adaptive Neurotechnologies, Albany Stratton VA Medical Center , Albany, NY 12208 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Oudega","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Edward Jr. Hines VA Hospital , Hines, IL 60141 ,","place":["USA"]},{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Neuroscience, Northwestern University , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R","family":"Blight","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Plymouth , Plymouth PL4 8AA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A","family":"Perez","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab , Chicago, IL 60611 ,","place":["USA"]},{"name":"Department of Physical Medicine and Rehabilitation, Northwestern University , Chicago, IL 60611 ,","place":["USA"]},{"name":"Edward Jr. Hines VA Hospital , Hines, IL 60141 ,","place":["USA"]},{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University , Chicago, IL 60611 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"2026071504105428400_awaf099-B1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1006\/exnr.1995.1056","article-title":"A combination of BDNF and NT-3 promotes supraspinal axonal regeneration into Schwann cell grafts in adult rat thoracic spinal cord","volume":"134","author":"Xu","year":"1995","journal-title":"Exp Neurol"},{"key":"2026071504105428400_awaf099-B2","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/(SICI)1097-4547(19971201)50:5<888::AID-JNR24>3.0.CO;2-W","article-title":"Influence of IN-1 antibody and acidic FGF-fibrin glue on the response of injured corticospinal tract axons to human Schwann cell grafts","volume":"50","author":"Guest","year":"1997","journal-title":"J Neurosci Res"},{"key":"2026071504105428400_awaf099-B3","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.expneurol.2012.06.006","article-title":"Systemic administration of a deoxyribozyme to xylosyltransferase-1 mRNA promotes recovery after a spinal cord contusion injury","volume":"237","author":"Oudega","year":"2012","journal-title":"Exp Neurol"},{"key":"2026071504105428400_awaf099-B4","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/107385840100700409","article-title":"Bridging areas of injury in the spinal cord","volume":"7","author":"Bunge","year":"2001","journal-title":"Neuroscientist"},{"key":"2026071504105428400_awaf099-B5","doi-asserted-by":"crossref","first-page":"818","DOI":"10.4103\/1673-5374.382230","article-title":"Regenerative medicine strategies for chronic complete spinal cord injury","volume":"19","author":"Hashimoto","year":"2024","journal-title":"Neural Regen Res"},{"key":"2026071504105428400_awaf099-B6","doi-asserted-by":"crossref","first-page":"e11505","DOI":"10.15252\/emmm.201911505","article-title":"Therapeutic repair for spinal cord injury: Combinatory approaches to address a multifaceted problem","volume":"12","author":"Griffin","year":"2020","journal-title":"EMBO Mol Med"},{"key":"2026071504105428400_awaf099-B7","doi-asserted-by":"crossref","first-page":"977679","DOI":"10.3389\/fncel.2022.977679","article-title":"Fighting for recovery on multiple fronts: The past, present, and future of clinical trials for spinal cord injury","volume":"16","author":"Dietz","year":"2022","journal-title":"Front Cell Neurosci"},{"key":"2026071504105428400_awaf099-B8","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1002\/ana.26622","article-title":"Multisite Hebbian plasticity restores function in humans with spinal cord injury","volume":"93","author":"Jo","year":"2023","journal-title":"Ann Neurol"},{"key":"2026071504105428400_awaf099-B9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1038\/s41586-018-0649-2","article-title":"Targeted neurotechnology restores walking in humans with spinal cord injury","volume":"563","author":"Wagner","year":"2018","journal-title":"Nature"},{"key":"2026071504105428400_awaf099-B10","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s00586-014-3416-6","article-title":"Effects of transplantation of olfactory ensheathing cells in chronic spinal cord injury: A systematic review and meta-analysis","volume":"24","author":"Li","year":"2015","journal-title":"Eur Spine J"},{"key":"2026071504105428400_awaf099-B11","doi-asserted-by":"crossref","first-page":"2950","DOI":"10.1089\/neu.2016.4895","article-title":"Safety of autologous human Schwann cell transplantation in subacute thoracic spinal cord injury","volume":"34","author":"Anderson","year":"2017","journal-title":"J Neurotrauma"},{"key":"2026071504105428400_awaf099-B12","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1089\/neu.2020.7590","article-title":"Phase 1 safety trial of autologous human Schwann cell transplantation in chronic spinal cord injury","volume":"39","author":"Gant","year":"2022","journal-title":"J Neurotrauma"},{"key":"2026071504105428400_awaf099-B13","first-page":"455","article-title":"Clinical effectiveness and safety of powered exoskeleton-assisted walking in patients with spinal cord injury: systematic review with meta-analysis","volume":"9","author":"Miller","year":"2016","journal-title":"Med Devices (Auckl)"},{"key":"2026071504105428400_awaf099-B14","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780198523758.001.0001","volume-title":"Corticospinal function and voluntary movement","author":"Porter","year":"1995"},{"key":"2026071504105428400_awaf099-B15","first-page":"77","article-title":"Key mechanisms for setting the input-output gain across the motoneuron pool","volume":"143","author":"Hultborn","year":"2004","journal-title":"Prog Brain Res"},{"key":"2026071504105428400_awaf099-B16","doi-asserted-by":"crossref","first-page":"3647","DOI":"10.1113\/jphysiol.2012.233189","article-title":"Corticospinal reorganization after spinal cord injury","volume":"590","author":"Oudega","year":"2012","journal-title":"J Physiol"},{"key":"2026071504105428400_awaf099-B17","first-page":"335","article-title":"Organization of behavior. New York: Wiley","volume":"6","author":"Hebb","year":"1949","journal-title":"J Clin Psychol"},{"key":"2026071504105428400_awaf099-B18","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1016\/j.cub.2012.10.046","article-title":"Motor recovery after spinal cord injury enhanced by strengthening corticospinal synaptic transmission","volume":"22","author":"Bunday","year":"2012","journal-title":"Curr Biol"},{"key":"2026071504105428400_awaf099-B19","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1093\/brain\/awaa052","article-title":"Corticospinal-motor neuronal plasticity promotes exercise-mediated recovery in humans with spinal cord injury","volume":"143","author":"Jo","year":"2020","journal-title":"Brain"},{"key":"2026071504105428400_awaf099-B20","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1152\/jn.00111.2017","article-title":"Spike-timing-dependent plasticity in lower-limb motoneurons after human spinal cord injury","volume":"118","author":"Urbin","year":"2017","journal-title":"J Neurophysiol"},{"key":"2026071504105428400_awaf099-B21","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1152\/jn.00499.2022","article-title":"Increased paired stimuli enhance corticospinal-motoneuronal plasticity in humans with spinal cord injury","volume":"129","author":"Grover","year":"2023","journal-title":"J Neurophysiol"},{"key":"2026071504105428400_awaf099-B22","doi-asserted-by":"crossref","first-page":"11708","DOI":"10.1523\/JNEUROSCI.2217-09.2009","article-title":"Voluntary motor output is altered by spike-timing-dependent changes in the human corticospinal pathway","volume":"29","author":"Taylor","year":"2009","journal-title":"J Neurosci"},{"key":"2026071504105428400_awaf099-B23","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.clinph.2015.03.013","article-title":"More conditioning stimuli enhance synaptic plasticity in the human spinal cord","volume":"127","author":"Fitzpatrick","year":"2016","journal-title":"Clin Neurophysiol"},{"key":"2026071504105428400_awaf099-B24","first-page":"36","article-title":"Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity","volume":"8","author":"D\u2019Amico","year":"2014","journal-title":"Front Integr Neurosci"},{"key":"2026071504105428400_awaf099-B25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0022-510X(89)90072-5","article-title":"Demyelination in spinal cord injury","volume":"91","author":"Waxman","year":"1989","journal-title":"J Neurol Sci"},{"key":"2026071504105428400_awaf099-B26","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jchemneu.2019.01.009","article-title":"Axonal degeneration and demyelination following traumatic spinal cord injury: A systematic review and meta-analysis","volume":"97","author":"Hassannejad","year":"2019","journal-title":"J Chem Neuroanat"},{"key":"2026071504105428400_awaf099-B27","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1113\/jphysiol.1981.sp013666","article-title":"The effects of 4-aminopyridine and tetraethylammonium ions on normal and demyelinated mammalian nerve fibres","volume":"313","author":"Bostock","year":"1981","journal-title":"J Physiol"},{"key":"2026071504105428400_awaf099-B28","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0006-8993(82)90649-7","article-title":"Effects of 4-aminopyridine on synaptic transmission in the cat spinal cord","volume":"240","author":"Jankowska","year":"1982","journal-title":"Brain Res"},{"key":"2026071504105428400_awaf099-B29","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/0361-9230(89)90126-3","article-title":"Effect of 4-aminopyridine on axonal conduction-block in chronic spinal cord injury","volume":"22","author":"Blight","year":"1989","journal-title":"Brain Res Bull"},{"issue":"Pt 1","key":"2026071504105428400_awaf099-B30","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/brain\/123.1.171","article-title":"Effects of 4-aminopyridine on demyelinated axons, synapses and muscle tension","volume":"123","author":"Smith","year":"2000","journal-title":"Brain"},{"key":"2026071504105428400_awaf099-B31","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1089\/neu.1994.11.433","article-title":"4-Aminopyridine-sensitive neurologic deficits in patients with spinal cord injury","volume":"11","author":"Hayes","year":"1994","journal-title":"J Neurotrauma"},{"key":"2026071504105428400_awaf099-B32","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1089\/neu.1997.14.135","article-title":"Effects of 4-aminopyridine on motor evoked potentials in patients with spinal cord injury","volume":"14","author":"Qiao","year":"1997","journal-title":"J Neurotrauma"},{"key":"2026071504105428400_awaf099-B33","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1592\/phco.19.9.713.31540","article-title":"Safety and efficacy of 4-aminopyridine in humans with spinal cord injury: A long-term, controlled trial","volume":"19","author":"Segal","year":"1999","journal-title":"Pharmacotherapy"},{"key":"2026071504105428400_awaf099-B34","doi-asserted-by":"crossref","first-page":"1034730","DOI":"10.3389\/fneur.2022.1034730","article-title":"Functional improvement in individuals with chronic spinal cord injury treated with 4-aminopyridine: A systematic review","volume":"13","author":"Paredes-Cruz","year":"2022","journal-title":"Front Neurol"},{"key":"2026071504105428400_awaf099-B35","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/sj.sc.3100559","article-title":"Sustained improvements in neurological function in spinal cord injured patients treated with oral 4-aminopyridine: Three cases","volume":"36","author":"Potter","year":"1998","journal-title":"Spinal Cord"},{"key":"2026071504105428400_awaf099-B36","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1152\/jn.90380.2008","article-title":"Noninvasive stimulation of human corticospinal axons innervating leg muscles","volume":"100","author":"Martin","year":"2008","journal-title":"J Neurophysiol"},{"key":"2026071504105428400_awaf099-B37","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc"},{"key":"2026071504105428400_awaf099-B38","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1179\/108331907X223128","article-title":"Clinical significance testing in rehabilitation research: What, why, and how?","volume":"12","author":"Musselman","year":"2007","journal-title":"Phys Ther Rev."},{"key":"2026071504105428400_awaf099-B39","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1038\/sj.sc.3102134","article-title":"A systematic review of functional ambulation outcome measures in spinal cord injury","volume":"46","author":"Lam","year":"2008","journal-title":"Spinal Cord"},{"key":"2026071504105428400_awaf099-B40","doi-asserted-by":"crossref","first-page":"e94108","DOI":"10.1371\/journal.pone.0094108","article-title":"Are the 10 meter and 6 minute walk tests redundant in patients with spinal cord injury?","volume":"9","author":"Forrest","year":"2014","journal-title":"PLoS One"},{"key":"2026071504105428400_awaf099-B41","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/jcmm.13353","article-title":"Fibroblast growth factors in the management of spinal cord injury","volume":"22","author":"Zhou","year":"2018","journal-title":"J Cell Mol Med"},{"key":"2026071504105428400_awaf099-B42","doi-asserted-by":"crossref","first-page":"10464","DOI":"10.1523\/JNEUROSCI.18-24-10464.1998","article-title":"Synaptic modifications in cultured hippocampal neurons: Dependence on spike timing, synaptic strength, and postsynaptic cell type","volume":"18","author":"Bi","year":"1998","journal-title":"J Neurosci"},{"key":"2026071504105428400_awaf099-B43","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1152\/japplphysiol.01116.2003","article-title":"Noninvasive stimulation of the human corticospinal tract","volume":"96","author":"Taylor","year":"2004","journal-title":"J Appl Physiol (1985)"},{"issue":"Pt 1","key":"2026071504105428400_awaf099-B44","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1113\/jphysiol.1994.sp020170","article-title":"Is presynaptic inhibition distributed to corticospinal fibres in man?","volume":"477","author":"Nielsen","year":"1994","journal-title":"J Physiol"},{"issue":"Pt 1","key":"2026071504105428400_awaf099-B45","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1113\/jphysiol.2005.100537","article-title":"Tests for presynaptic modulation of corticospinal terminals from peripheral afferents and pyramidal tract in the macaque","volume":"573","author":"Jackson","year":"2006","journal-title":"J Physiol"},{"key":"2026071504105428400_awaf099-B46","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.neuron.2012.08.001","article-title":"The spike-timing dependence of plasticity","volume":"75","author":"Feldman","year":"2012","journal-title":"Neuron"},{"key":"2026071504105428400_awaf099-B47","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1046\/j.1471-4159.2000.0750174.x","article-title":"Changes in NMDA receptor subunit expression in response to contusive spinal cord injury","volume":"75","author":"Grossman","year":"2000","journal-title":"J Neurochem"},{"key":"2026071504105428400_awaf099-B48","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1089\/neu.1991.8.103","article-title":"The effects of 4-aminopyridine on neurological deficits in chronic cases of traumatic spinal cord injury in dogs: A phase I clinical trial","volume":"8","author":"Blight","year":"1991","journal-title":"J Neurotrauma"},{"key":"2026071504105428400_awaf099-B49","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/S0306-4522(96)00477-0","article-title":"Differential effects of low and high concentrations of 4-aminopyridine on axonal conduction in normal and injured spinal cord","volume":"77","author":"Shi","year":"1997","journal-title":"Neuroscience"},{"key":"2026071504105428400_awaf099-B50","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1006\/exnr.1997.6706","article-title":"Conduction block in acute and chronic spinal cord injury: Different dose-response characteristics for reversal by 4-aminopyridine","volume":"148","author":"Shi","year":"1997","journal-title":"Exp Neurol"},{"key":"2026071504105428400_awaf099-B51","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/0006-8993(87)91255-8","article-title":"Characterization of postsynaptic potentials evoked by sural nerve stimulation in hindlimb motoneurons from acute and chronic spinal cats","volume":"420","author":"Baker","year":"1987","journal-title":"Brain Res"},{"issue":"Pt 6","key":"2026071504105428400_awaf099-B52","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1093\/brain\/awn050","article-title":"Changes in sensory-evoked synaptic activation of motoneurons after spinal cord injury in man","volume":"131","author":"Norton","year":"2008","journal-title":"Brain"},{"key":"2026071504105428400_awaf099-B53","doi-asserted-by":"crossref","first-page":"7401","DOI":"10.1523\/JNEUROSCI.1838-05.2005","article-title":"How to enhance ipsilateral actions of pyramidal tract neurons","volume":"25","author":"Jankowska","year":"2005","journal-title":"J Neurosci"},{"key":"2026071504105428400_awaf099-B54","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1113\/jphysiol.1981.sp013974","article-title":"Modifications to synaptic transmission at group ia synapses on cat spinal motoneurones by 4-aminopyridine","volume":"321","author":"Jack","year":"1981","journal-title":"J Physiol"},{"key":"2026071504105428400_awaf099-B55","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1185\/03007995.2011.583229","article-title":"Dalfampridine: A brief review of its mechanism of action and efficacy as a treatment to improve walking in patients with multiple sclerosis","volume":"27","author":"Dunn","year":"2011","journal-title":"Curr Med Res Opin"},{"key":"2026071504105428400_awaf099-B56","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/sc.2012.175","article-title":"Light touch and pin prick disparity in the International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI)","volume":"51","author":"Vasquez","year":"2013","journal-title":"Spinal Cord"},{"key":"2026071504105428400_awaf099-B57","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2522\/ptj.20090359","article-title":"Influence of a locomotor training approach on walking speed and distance in people with chronic spinal cord injury: A randomized clinical trial","volume":"91","author":"Field-Fote","year":"2011","journal-title":"Phys Ther"},{"key":"2026071504105428400_awaf099-B58","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1038\/s41394-020-00359-1","article-title":"Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury","volume":"6","author":"McHugh","year":"2020","journal-title":"Spinal Cord Ser Cases"},{"key":"2026071504105428400_awaf099-B59","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1592\/phco.23.7.823.32731","article-title":"Efficacy and safety of 4-aminopyridine in patients with long-term spinal cord injury: A randomized, double-blind, placebo-controlled trial","volume":"23","author":"Grijalva","year":"2003","journal-title":"Pharmacotherapy"},{"key":"2026071504105428400_awaf099-B60","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.arcmed.2010.10.001","article-title":"High doses of 4-aminopyridine improve functionality in chronic complete spinal cord injury patients with MRI evidence of cord continuity","volume":"41","author":"Grijalva","year":"2010","journal-title":"Arch Med Res"},{"key":"2026071504105428400_awaf099-B61","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s004150170111","article-title":"Randomized trial of 4-aminopyridine in patients with chronic incomplete spinal cord injury","volume":"248","author":"van der Bruggen","year":"2001","journal-title":"J Neurol"},{"key":"2026071504105428400_awaf099-B62","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1038\/sj.sc.3101653","article-title":"Effect of 4-aminopyridine on gait in ambulatory spinal cord injuries: A double-blind, placebo-controlled, crossover trial","volume":"42","author":"DeForge","year":"2004","journal-title":"Spinal Cord"},{"key":"2026071504105428400_awaf099-B63","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0003-9993(03)00651-8","article-title":"Pharmacokinetics and safety of multiple oral doses of sustained-release 4-aminopyridine (Fampridine-SR) in subjects with chronic, incomplete spinal cord injury","volume":"85","author":"Hayes","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"key":"2026071504105428400_awaf099-B64","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.brs.2018.05.006","article-title":"Potentiating paired corticospinal-motoneuronal plasticity after spinal cord injury","volume":"11","author":"Bunday","year":"2018","journal-title":"Brain Stimul"},{"issue":"Suppl 1","key":"2026071504105428400_awaf099-B65","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1080\/10790268.2021.1970908","article-title":"Paired corticospinal-motoneuronal stimulation and exercise after spinal cord injury","volume":"44","author":"Jo","year":"2021","journal-title":"J Spinal Cord Med"}],"container-title":["Brain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/brain\/advance-article-pdf\/doi\/10.1093\/brain\/awaf099\/62573790\/awaf099.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/brain\/article-pdf\/148\/6\/1911\/62573790\/awaf099.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/brain\/article-pdf\/148\/6\/1911\/62573790\/awaf099.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T08:11:04Z","timestamp":1784103064000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/brain\/article\/148\/6\/1911\/8092433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,24]]},"references-count":65,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3,24]]},"published-print":{"date-parts":[[2025,6,3]]}},"URL":"https:\/\/doi.org\/10.1093\/brain\/awaf099","relation":{},"ISSN":["0006-8950","1460-2156"],"issn-type":[{"value":"0006-8950","type":"print"},{"value":"1460-2156","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,3,24]]}}}