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Myokines (factors released from muscle cells during contractions), such as brain-derived neurotrophic factor (BDNF), are thought to have beneficial effects on cognition. Neuromuscular electrical stimulation (NMES) was shown to elicit a large release of myokines. However, the effects of NMES on cognitive function have not been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To present the study protocol for a clinical trial evaluating the effects of NMES aimed at improving cognition and BDNF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A replicated randomized three-phases single-case experimental design (SCED) with sequential multiple baseline time series and a single-armed prospective trial will be conducted with 15 adults with chronic SCI (&gt;\u200912\u00a0months after injury) above L1 neurological level undergoing 30-min quadriceps NMES, 3\u00a0days per week for 12\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main study endpoints<\/jats:title>\n                    <jats:p>Primary endpoint is cognitive performance (assessed by a smartphone test) conducted three times per week during the baseline phase with random duration of 3 to 8\u00a0weeks, the intervention phase of 12\u00a0weeks, and the follow-up phase of 3\u00a0weeks after a no measurement rest period of 12\u00a0weeks. Secondary endpoints are changes in BDNF levels and cognitive performance measured before the baseline period, before and after intervention and after a 12\u00a0weeks follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This will be the first study investigating the effects of 12\u00a0weeks NMES on both cognition and BDNF levels in individuals with SCI. The SCED results provide information on individual treatment effect courses which may direct future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov (NCT05822297, 12\/01\/2023).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-024-03699-9","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T03:02:37Z","timestamp":1718074957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Neuromuscular electrical stimulation to combat cognitive aging in people with spinal cord injury: protocol for a single case experimental design study"],"prefix":"10.1186","volume":"24","author":[{"given":"Wouter A. 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