{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:19:33Z","timestamp":1777943973952,"version":"3.51.4"},"reference-count":43,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS115877"],"award-info":[{"award-number":["R01 NS115877"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the feasibility and potential efficacy of percutaneous spinal stimulation (epidural stimulation, ES) combined with task-specific training to reduce spasticity and improve gait and balance in individuals with progressive multiple sclerosis (MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two men with progressive MS (EDSS 6.5) underwent ES lead implantation targeting the lower spinal cord, followed by one month of rehabilitation involving 12 ES-assisted training sessions. Assessments included instrumented gait analysis, Modified Ashworth Scale (MAS), pendulum test, and static balance testing performed at baseline, and at end of the study with ES-Off and ES-On conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participant 1, with spastic hemiparetic gait, demonstrated improved lower extremity joint kinematics and muscle activation during gait, reduced knee extensor spasticity, and enhanced functional movement patterns with ES-On. Participant 2, with significant paraparesis and minimal spasticity, showed limited gait changes but experienced marked improvements in static balance, particularly under eyes-closed conditions. No adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pilot study demonstrates the feasibility and tolerability of ES paired with task-specific training in progressive MS. Participant-specific responses were observed, including improvements in gait kinematics, neuromuscular activation, spasticity, or balance; however, spatiotemporal gait parameters did not improve. These preliminary findings highlight response heterogeneity and the need for individualized ES parameter tuning.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial registry name and URL:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06019611\">https:\/\/clinicaltrials.gov\/study\/NCT06019611<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173261432301","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:27:17Z","timestamp":1777465637000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous spinal stimulation to enhance gait and alleviate functional impairments in multiple sclerosis: A pilot study"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5379-1462","authenticated-orcid":false,"given":"Omid","family":"Jahanian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders J","family":"Asp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan L","family":"Gill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel D","family":"Veith","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina A","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia A","family":"Hogen","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candee J","family":"Mills","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew R","family":"Thoreson","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Solinsky","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenton R","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Grahn","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin D","family":"Zhao","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Mayo Clinic"},{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8141-2394","authenticated-orcid":false,"given":"W Oliver","family":"Tobin","sequence":"additional","affiliation":[{"name":"Mayo Clinic School of Medicine"},{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.4.765"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.4.839"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.104614"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003235"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518781979"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000435"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.09.352"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1191\/1352458504ms1085oa"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-11-89"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458506070658"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903433528"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520940983"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007944"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1803588"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-018-0175-7"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnsys.2020.590231"},{"key":"e_1_3_3_18_2","doi-asserted-by":"crossref","unstructured":"Grahn PJ Lavrov IA Sayenko DG et al. 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