{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:08:18Z","timestamp":1787695698879,"version":"build-2784847793"},"reference-count":72,"publisher":"American Physiological Society","issue":"2","content-domain":{"domain":["journals.physiology.org"],"crossmark-restriction":true},"short-container-title":["Journal of Neurophysiology"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>This 2-year longitudinal case report extends beyond motor outcomes to examine systems-level changes in cerebral palsy (CP). Using combined qualitative and quantitative evidence, we show that pairing transcutaneous spinal neuromodulation with proprioceptive-derived intervention can engage activity-dependent neuroplasticity across multiple physiological domains. Coordinated improvements in motor, autonomic, and cognitive function, with distinct temporal dynamics and reversibility, suggest that enhancing proprioceptive signaling may modulate and improve distributed physiological networks and reveal clinically relevant targets for future study.<\/jats:p>","DOI":"10.1152\/jn.00518.2025","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:10:42Z","timestamp":1782213042000},"page":"445-458","update-policy":"https:\/\/doi.org\/10.1152\/aps-crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Neuromodulatory strategies overcome multiple inevitable impairments of cerebral palsy"],"prefix":"10.1152","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5168-5217","authenticated-orcid":false,"given":"Susan D.","family":"Hastings","sequence":"first","affiliation":[{"name":"Susan Hastings Pediatric Physical Therapy","place":["United States"]},{"name":"Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1292-3983","authenticated-orcid":false,"given":"Hui","family":"Zhong","sequence":"additional","affiliation":[{"name":"Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Kijima","sequence":"additional","affiliation":[{"name":"Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center","place":["United States"]},{"name":"Kyushu University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3648-8534","authenticated-orcid":false,"given":"Casey","family":"Gonnella","sequence":"additional","affiliation":[{"name":"Susan Hastings Pediatric Physical Therapy","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen","family":"Gonnella","sequence":"additional","affiliation":[{"name":"Susan Hastings Pediatric Physical Therapy","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrin J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC","place":["United States"]},{"name":"University of Southern California Neurorestoration Center, Keck School of Medicine","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6423-8577","authenticated-orcid":false,"given":"Charles","family":"Liu","sequence":"additional","affiliation":[{"name":"Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center","place":["United States"]},{"name":"Keck School of Medicine of USC","place":["United States"]},{"name":"University of Southern California Neurorestoration Center, Keck School of Medicine","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9345-3791","authenticated-orcid":false,"given":"Yury P.","family":"Gerasimenko","sequence":"additional","affiliation":[{"name":"Russian Academy of Sciences","place":["Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. Reggie","family":"Edgerton","sequence":"additional","affiliation":[{"name":"Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center","place":["United States"]},{"name":"Keck School of Medicine of USC","place":["United States"]},{"name":"University of Southern California Neurorestoration Center, Keck School of Medicine","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1482-9525","authenticated-orcid":false,"given":"Christopher A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15346"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2019.25.7.817"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.625428"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.16080"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0043-6"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-020-1022-z"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15730"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.668544"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-024-03421-y"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00809.2021"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.humov.2025.103361"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2022.2115359"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/00222895.2019.1610860"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2022.2158223"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.643463"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2017.01.003"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-021-01087-6"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-33208-w"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2025.01.016"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2016.2637301"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60547-3"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2015.05.003"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00146.2016"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1177\/1073858416683681"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.01196"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2018.2834339"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fresc.2023.1216281"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.46292\/sci21-00084"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2023.1210328"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1088\/1741-2552\/acf522"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-20703-1"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11061550"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.00784"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1891\/9780826137753.0054"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2010.29388"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2022.01.004"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.20960\/nh.1696"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1097\/01.PEP.0000145930.84009.23"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1097\/PEP.0000000000000705"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13010028"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1097\/PEP.0000000000000224"},{"key":"B42","volume-title":"Failure to Thrive and Pediatric Undernutrician; A Transdisciplinary Approach","author":"Creskoff N","year":"1999"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1123\/mc.2022-0127"},{"key":"B44","first-page":"83","volume-title":"Vision and the Brain: Understanding Cerebral Visual Impairment in Children","author":"Fazzi E","year":"2015"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13071867"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurenf.2023.05.007"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.04.026"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2762"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.conb.2015.04.004"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12065"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2000.5579"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15516"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2024.1445793"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-0964-3_18"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1997.77.2.797"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-199412000-00013"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1998.79.3.1329"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1998.80.1.83"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/0014-4886(86)90094-4"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-018-0560-9"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1126\/science.157.3796.1586"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2017.5082"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1999.87.3.1207"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1997.83.6.2086"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1097\/00003677-200110000-00006"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00855.2003"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.3.1137"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0b013e31819b79cf"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-47617-6"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080465"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2022.01.019"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.3389\/fncom.2011.00038"}],"container-title":["Journal of Neurophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.physiology.org\/doi\/pdf\/10.1152\/jn.00518.2025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:54:10Z","timestamp":1784555650000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.physiology.org\/doi\/10.1152\/jn.00518.2025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":72,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1152\/jn.00518.2025"],"URL":"https:\/\/doi.org\/10.1152\/jn.00518.2025","relation":{},"ISSN":["0022-3077","1522-1598"],"issn-type":[{"value":"0022-3077","type":"print"},{"value":"1522-1598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"assertion":[{"value":"2025-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}