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The search for therapeutics to induce functional motor recovery is essential. One promising noninvasive therapeutic tool that could harness plasticity in a spared descending respiratory circuit is repetitive transcranial magnetic stimulation (rTMS). Here, we tested the effect of chronic high-frequency (10 Hz) rTMS above the cortical areas in C2 hemisected rats when applied for 7 days, 1 month, or 2 months. An increase in intact hemidiaphragm electromyogram (EMG) activity and excitability (diaphragm motor evoked potentials) was observed after 1 month of rTMS application. Interestingly, despite no real functional effects of rTMS treatment on the injured hemidiaphragm activity during eupnea, 2 months of rTMS treatment strengthened the existing crossed phrenic pathways, allowing the injured hemidiaphragm to increase its activity during the respiratory challenge (i.e., asphyxia). This effect could be explained by a strengthening of respiratory descending fibers in the ventrolateral funiculi (an increase in GAP-43 positive fibers), sustained by a reduction in inflammation in the C1\u2013C3 spinal cord (reduction in CD68 and Iba1 labeling), and acceleration of intracellular plasticity processes in phrenic motoneurons after chronic rTMS treatment. These results suggest that chronic high-frequency rTMS can ameliorate respiratory dysfunction and elicit neuronal plasticity with a reduction in deleterious post-traumatic inflammatory processes in the cervical spinal cord post-SCI. Thus, this therapeutic tool could be adopted and\/or combined with other therapeutic interventions in order to further enhance beneficial outcomes.<\/jats:p>","DOI":"10.3390\/biology11030473","type":"journal-article","created":{"date-parts":[[2022,3,20]],"date-time":"2022-03-20T21:25:00Z","timestamp":1647811500000},"page":"473","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Effects of Chronic High-Frequency rTMS Protocol on Respiratory Neuroplasticity Following C2 Spinal Cord Hemisection in Rats"],"prefix":"10.3390","volume":"11","author":[{"given":"Pauline","family":"Michel-Flutot","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isley","family":"Jesus","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Vanhee","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille H.","family":"Bourcier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"},{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, Infection et Inflammation (2I), 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"Emam","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, Infection et Inflammation (2I), 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abderrahim","family":"Ouguerroudj","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5654-6502","authenticated-orcid":false,"given":"Kun-Ze","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung 80424, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4995-8466","authenticated-orcid":false,"given":"Lyandysha V.","family":"Zholudeva","sequence":"additional","affiliation":[{"name":"Gladstone Institutes, San Francisco, CA 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1375-6483","authenticated-orcid":false,"given":"Michael A.","family":"Lane","sequence":"additional","affiliation":[{"name":"Marion Murray Spinal Cord Research Center, Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA 19129, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Mansart","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, Infection et Inflammation (2I), 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1446-7456","authenticated-orcid":false,"given":"Marcel","family":"Bonay","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Vinit","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Saclay, UVSQ, Inserm, END-ICAP, 78000 Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1097\/01.PHM.0000078184.08835.01","article-title":"Effect of spinal cord injury on the respiratory system","volume":"82","author":"Winslow","year":"2003","journal-title":"Am. 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