{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:49:18Z","timestamp":1787237358219,"version":"build-2736575974"},"reference-count":97,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Spinal cord stimulation (SCS) has expanded beyond pain treatment, becoming a neuromodulatory method capable of recruiting spinal and supraspinal circuits involved in motor recovery. This review summarises mechanistic knowledge, supports engineering developments, and describes the changing clinical translation of SCS in rehabilitation. Mounting scientific data shows that SCS\u2019s effects go beyond dorsal column modulation and may involve segmental networks that promote activity-dependent plasticity and sensorimotor pathway restoration, probably due to a combination of Hebbian and non-Hebbian mechanisms (synaptic potentiation, interneuronal reorganisation, and altered afferent\u2013efferent coupling). More recent advances, such as bursts and the high-frequency paradigm, closed-loop control, and data-driven parameter optimisation methods, improve the precision, stability, and calibration of stimulation for each individual. By combining SCS with non-invasive forms of neuromodulation (TMS, tDCS, and peripheral nerve stimulation), one can potentially further intensify corticospinal plasticity and maintain improvements in functions. Spinal cord stimulation remains an established treatment for chronic neuropathic pain, including failed back surgery syndrome and complex regional pain syndrome. In recent years, however, increasing attention has been directed toward its potential role in motor recovery after spinal cord injury and stroke. Progress in this area is limited by patient heterogeneity, variability in outcome measures, the complexity of multimodal rehabilitation protocols, and regulatory and logistical constraints\u2014particularly when adaptive or closed-loop systems are used. Current evidence suggests that motor-restorative applications of SCS should be interpreted cautiously and integrated within carefully designed rehabilitation programmes, with attention to patient selection and realistic expectations regarding the durability of the benefit.<\/jats:p>","DOI":"10.3390\/brainsci16050476","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:46:11Z","timestamp":1777455971000},"page":"476","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Harnessing Spinal Cord Stimulation and Neuromodulation for Functional Restoration: From Pain Management to Motor Recovery"],"prefix":"10.3390","volume":"16","author":[{"given":"Wende","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, the Seventh Medical Center of Chinese PLA General Hospital, Beijing 100700, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, the Seventh Medical Center of Chinese PLA General Hospital, Beijing 100700, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5607898","DOI":"10.1155\/2021\/5607898","article-title":"Spinal Cord Stimulation and Treatment of Peripheral or Central Neuropathic Pain: Mechanisms and Clinical Application","volume":"2021","author":"Sun","year":"2021","journal-title":"Neural Plast."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1016\/S0140-6736(21)00794-7","article-title":"Neuromodulation for chronic pain","volume":"397","author":"Knotkova","year":"2021","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1089\/neu.2022.0007","article-title":"Advances in Epidural Spinal Cord Stimulation to Restore Function after Spinal Cord Injury: History and Systematic Review","volume":"39","author":"Mansour","year":"2022","journal-title":"J. Neurotrauma"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1109\/TNSRE.2021.3113636","article-title":"Optimization of Spinal Cord Stimulation Using Bayesian Preference Learning and Its Validation","volume":"29","author":"Zhao","year":"2021","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Gu\u00e9rout, N. (2021). Plasticity of the Injured Spinal Cord. Cells, 10.","DOI":"10.3390\/cells10081886"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1545968319893298","article-title":"Transcutaneous Spinal Cord Stimulation and Motor Rehabilitation in Spinal Cord Injury: A Systematic Review","volume":"34","author":"Taylor","year":"2020","journal-title":"Neurorehabilit. Neural Repair"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/S0140-6736(11)60547-3","article-title":"Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: A case study","volume":"377","author":"Harkema","year":"2011","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s12984-022-01062-y","article-title":"Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke","volume":"19","author":"Veldema","year":"2022","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Misbaah, F., Lui, W.L., Ng, Z.Y.V., Wee, S.K., Phua, M.W., So, R.Q., Premchand, B., Susanto, K., Saffari, S.E., and Justin Ker, R.X. (2025). Recruitment Challenges in Spinal Cord Stimulation Trial for Motor Recovery in Patients with Chronic Complete Spinal Cord Injury. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113925"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1152\/jn.00802.2018","article-title":"On the reflex mechanisms of cervical transcutaneous spinal cord stimulation in human subjects","volume":"121","author":"Milosevic","year":"2019","journal-title":"J. Neurophysiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Eisdorfer, J.T., Sobotka-Briner, H., Schramfield, S., Moukarzel, G., Chen, J., Campion, T.J., Smit, R., Rauscher, B.C., Lemay, M.A., and Smith, G.M. (2022). Chemogenetic modulation of sensory afferents induces locomotor changes and plasticity after spinal cord injury. Front. Mol. Neurosci., 15.","DOI":"10.3389\/fnmol.2022.872634"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.clinph.2024.10.011","article-title":"Effects of cervical transcutaneous spinal direct current stimulation on spinal excitability","volume":"168","author":"Pierantoni","year":"2024","journal-title":"Clin. Neurophysiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"114754","DOI":"10.1016\/j.expneurol.2024.114754","article-title":"Multi-session transcutaneous spinal cord stimulation prevents chloride homeostasis imbalance and the development of hyperreflexia after spinal cord injury in rat","volume":"376","author":"Malloy","year":"2024","journal-title":"Exp. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1007\/s00221-024-06926-4","article-title":"Transcutaneous spinal cord stimulation phase-dependently modulates spinal reciprocal inhibition induced by pedaling in healthy individuals","volume":"242","author":"Takano","year":"2024","journal-title":"Exp. Brain Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1093\/brain\/awu038","article-title":"Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans","volume":"137","author":"Angeli","year":"2014","journal-title":"Brain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3290","DOI":"10.1093\/brain\/awaf115","article-title":"Non-invasive spinal neuromodulation enables stepping in children with complete spinal cord injury","volume":"148","author":"Lucas","year":"2025","journal-title":"Brain"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"136705","DOI":"10.1016\/j.neulet.2022.136705","article-title":"Simultaneous 10 kHz and 40 Hz spinal cord stimulation increases dorsal horn inhibitory interneuron activity","volume":"782","author":"Lee","year":"2022","journal-title":"Neurosci. Lett."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4637","DOI":"10.1113\/JP287804","article-title":"Transcutaneous spinal random noise stimulation enhances motor memory consolidation and corticospinal transmission in humans","volume":"603","author":"Nito","year":"2025","journal-title":"J. Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.brainresrev.2007.12.002","article-title":"The spinal pattern generator for ejaculation","volume":"58","year":"2008","journal-title":"Brain Res. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1152\/jn.00203.2017","article-title":"Variations on a theme: Species differences in synaptic connectivity do not predict central pattern generator activity","volume":"118","author":"Gunaratne","year":"2017","journal-title":"J. Neurophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"109761","DOI":"10.1016\/j.neuropharm.2023.109761","article-title":"Serotonergic and noradrenergic contributions to motor cortical and spinal motoneuronal excitability in humans","volume":"242","author":"Thorstensen","year":"2024","journal-title":"Neuropharmacology"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Kim, H., Lim, C., Lee, J.S., Kim, D., Song, C.B., and Dhaher, Y. (2023, January 24\u201327). Effect of Non-invasive Spinal Stimulation on Self-sustained Firing Motoneuron Model: In-Silico Study Using Human Body Model. Proceedings of the 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), Sydney, Australia.","DOI":"10.1109\/EMBC40787.2023.10340056"},{"key":"ref_23","first-page":"Cd014789","article-title":"Spinal cord stimulation for low back pain","volume":"3","author":"Traeger","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1146\/annurev.neuro.24.1.807","article-title":"Activity-dependent spinal cord plasticity in health and disease","volume":"24","author":"Wolpaw","year":"2001","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/10790268.2017.1361562","article-title":"Transcranial direct current stimulation (tDCS) paired with massed practice training to promote adaptive plasticity and motor recovery in chronic incomplete tetraplegia: A pilot study","volume":"41","author":"Janini","year":"2018","journal-title":"J. Spinal Cord Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3121","DOI":"10.1113\/JP281146","article-title":"In vivo electrophysiological mechanisms underlying cervical epidural stimulation in adult rats","volume":"599","author":"Sharma","year":"2021","journal-title":"J. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e37727","DOI":"10.7554\/eLife.37727","article-title":"Effects of spinal cord stimulation on postural control in Parkinson\u2019s disease patients with freezing of gait","volume":"7","author":"Coelho","year":"2018","journal-title":"eLife"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"15","DOI":"10.46292\/sci23-00040S","article-title":"Combinatorial Effects of Transcutaneous Spinal Stimulation and Task-Specific Training to Enhance Hand Motor Output after Paralysis","volume":"29","author":"Oh","year":"2023","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chhabra, H.S., Kalidindi, K.K.V., Garg, N., Sharma, A., Chhibber, B., Kumar, H., Vishwakarma, G., Gupta, M., and Bhat, M.R. (2025). Spinal epidural electrical stimulation for the recovery of motor function in lower limbs after spinal cord injury: A pilot study. J. Spinal Cord Med., 1\u201312.","DOI":"10.1080\/10790268.2025.2517935"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3171\/2012.5.AOSPINE1296","article-title":"Quantitative testing in spinal cord injury: Overview of reliability and predictive validity","volume":"17","author":"Boakye","year":"2012","journal-title":"J. Neurosurg. Spine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.resp.2016.07.001","article-title":"High frequency spinal cord stimulation\u2014New method to restore cough","volume":"232","author":"Kowalski","year":"2016","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s40122-024-00628-z","article-title":"Durability of Evoked Compound Action Potential (ECAP)-Controlled, Closed-Loop Spinal Cord Stimulation (SCS) in a Real-World European Chronic Pain Population","volume":"13","author":"Nijhuis","year":"2024","journal-title":"Pain Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.4103\/1673-5374.274332","article-title":"Multimodal treatment for spinal cord injury: A sword of neuroregeneration upon neuromodulation","volume":"15","author":"Zheng","year":"2020","journal-title":"Neural Regen. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2111372","DOI":"10.1016\/j.clinph.2025.2111372","article-title":"Timing-dependent synergies between noninvasive motor cortex and spinal cord stimulation in chronic cervical spinal cord injury","volume":"180","author":"Murray","year":"2025","journal-title":"Clin. Neurophysiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s11916-023-01146-x","article-title":"Therapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives","volume":"27","author":"Tang","year":"2023","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1152\/jn.00235.2022","article-title":"Intraoperative electrical stimulation of the human dorsal spinal cord reveals a map of arm and hand muscle responses","volume":"129","author":"McIntosh","year":"2023","journal-title":"J. Neurophysiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"102809","DOI":"10.1016\/j.conb.2023.102809","article-title":"Fast Hebbian plasticity and working memory","volume":"83","author":"Lansner","year":"2023","journal-title":"Curr. Opin. Neurobiol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Stachowski, N.J., and Dougherty, K.J. (2021). Spinal Inhibitory Interneurons: Gatekeepers of Sensorimotor Pathways. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052667"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2961","DOI":"10.1113\/JP286183","article-title":"Timing-dependent synergies between motor cortex and posterior spinal stimulation in humans","volume":"602","author":"McIntosh","year":"2024","journal-title":"J. Physiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0006-8993(03)02530-7","article-title":"Spinal cord stimulation inhibits long-term potentiation of spinal wide dynamic range neurons","volume":"973","author":"Wallin","year":"2003","journal-title":"Brain Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/ner.13381","article-title":"Clinical Trial Designs for Neuromodulation in Chronic Spinal Cord Injury Using Epidural Stimulation","volume":"24","author":"Boakye","year":"2021","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/j.juro.2017.11.066","article-title":"Motor Response Matters: Optimizing Lead Placement Improves Sacral Neuromodulation Outcomes","volume":"199","author":"Gill","year":"2018","journal-title":"J. Urol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.neuroscience.2020.05.050","article-title":"Corticospinal Pathways and Interactions Underpinning Dexterous Forelimb Movement of the Rodent","volume":"450","author":"Basista","year":"2020","journal-title":"Neuroscience"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1111\/j.1460-9568.2009.07001.x","article-title":"Long-term synaptic plasticity is impaired in rats with lesions of the ventrolateral preoptic nucleus","volume":"30","author":"Arrigoni","year":"2009","journal-title":"Eur. J. Neurosci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"429","DOI":"10.3727\/096368915X686904","article-title":"Electrical stimulation and motor recovery","volume":"24","author":"Young","year":"2015","journal-title":"Cell Transplant."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.neuropharm.2014.01.001","article-title":"Transcriptional and epigenetic regulation of Hebbian and non-Hebbian plasticity","volume":"80","author":"Meadows","year":"2014","journal-title":"Neuropharmacology"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"von Bernhardi, R., Bernhardi, L.E., and Eugen\u00edn, J. (2017). What Is Neural Plasticity?. The Plastic Brain, Springer.","DOI":"10.1007\/978-3-319-62817-2"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1017\/cjn.2021.158","article-title":"An Overview of Noninvasive Brain Stimulation: Basic Principles and Clinical Applications","volume":"49","author":"Bhattacharya","year":"2022","journal-title":"Can. J. Neurol. Sci. J. Can. Sci. Neurol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Kumru, H., Rodr\u00edguez-Ca\u00f1\u00f3n, M., Edgerton, V.R., Garc\u00eda, L., Flores, \u00c1., Soriano, I., Opisso, E., Gerasimenko, Y., Navarro, X., and Garc\u00eda-Al\u00edas, G. (2021). Transcutaneous Electrical Neuromodulation of the Cervical Spinal Cord Depends Both on the Stimulation Intensity and the Degree of Voluntary Activity for Training. A Pilot Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153278"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/j.neurom.2023.03.006","article-title":"Spinal Cord Stimulation Increases Chemoefficacy and Prevents Paclitaxel-Induced Pain via CX3CL1","volume":"26","author":"Sivanesan","year":"2023","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ibneur.2022.08.005","article-title":"Corticospinal circuit neuroplasticity may involve silent synapses: Implications for functional recovery facilitated by neuromodulation after spinal cord injury","volume":"14","author":"Chen","year":"2023","journal-title":"IBRO Neurosci. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"959","DOI":"10.4103\/1673-5374.324828","article-title":"Semaphorin7A: Its role in the control of serotonergic circuits and functional recovery following spinal cord injury","volume":"17","author":"Fourneau","year":"2022","journal-title":"Neural Regen. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1111\/ejn.13568","article-title":"Motor deficits and beta oscillations are dissociable in an alpha-synuclein model of Parkinson\u2019s disease","volume":"46","author":"Brys","year":"2017","journal-title":"Eur. J. Neurosci."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Gogeascoechea, A., Kuck, A., van Asseldonk, E., Negro, F., Buitenweg, J.R., Yavuz, U.S., and Sartori, M. (2020). Interfacing With Alpha Motor Neurons in Spinal Cord Injury Patients Receiving Trans-spinal Electrical Stimulation. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.00493"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1146\/annurev.neuro.31.060407.125547","article-title":"Descending pathways in motor control","volume":"31","author":"Lemon","year":"2008","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_56","first-page":"e61436","article-title":"Electrical Stimulation and Motor Function Rehabilitation in Spinal Cord Injury: A Systematic Review","volume":"16","author":"Kanakis","year":"2024","journal-title":"Cureus"},{"key":"ref_57","first-page":"311","article-title":"Isometric contraction interferes with transcranial direct current stimulation (tDCS) induced plasticity: Evidence of state-dependent neuromodulation in human motor cortex","volume":"29","author":"Thirugnanasambandam","year":"2011","journal-title":"Restor. Neurol. Neurosci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"036019","DOI":"10.1088\/1741-2552\/ab8fc4","article-title":"Anatomical and technical factors affecting the neural response to epidural spinal cord stimulation","volume":"17","author":"Zander","year":"2020","journal-title":"J. Neural Eng."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2580","DOI":"10.1152\/jn.01289.2005","article-title":"Changes in cortically related intermuscular coherence accompanying improvements in locomotor skills in incomplete spinal cord injury","volume":"95","author":"Norton","year":"2006","journal-title":"J. Neurophysiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1017\/S0317167100000196","article-title":"The time course of changes in motor cortex excitability associated with voluntary movement","volume":"26","author":"Chen","year":"1999","journal-title":"Can. J. Neurol. Sci. J. Can. Sci. Neurol."},{"key":"ref_61","first-page":"B4823","article-title":"Contributions to the understanding of gait control","volume":"61","author":"Simonsen","year":"2014","journal-title":"Dan. Med. J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1016\/j.neurom.2023.05.003","article-title":"Neurostimulation for Chronic Pain: A Systematic Review of High-Quality Randomized Controlled Trials With Long-Term Follow-Up","volume":"26","author":"Zheng","year":"2023","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1152\/jn.00457.2012","article-title":"Theories of pain: From specificity to gate control","volume":"109","author":"Moayedi","year":"2013","journal-title":"J. Neurophysiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1001\/jamaneurol.2021.0538","article-title":"Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial","volume":"78","author":"Petersen","year":"2021","journal-title":"JAMA Neurol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1186\/s13063-023-07433-7","article-title":"Differential target multiplexed spinal cord stimulation using a paddle-type lead placed at the appropriate site for neuropathic pain after spinal cord injury in patients with past spinal surgical histories: Study protocol for an exploratory clinical trial","volume":"24","author":"Tanei","year":"2023","journal-title":"Trials"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1136\/rapm-2022-104097","article-title":"Evidence-based consensus guidelines on patient selection and trial stimulation for spinal cord stimulation therapy for chronic non-cancer pain","volume":"48","author":"Shanthanna","year":"2023","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e2444608","DOI":"10.1001\/jamanetworkopen.2024.44608","article-title":"Spinal Cord Stimulation vs Medical Management for Chronic Back and Leg Pain: A Systematic Review and Network Meta-Analysis","volume":"7","author":"Huygen","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.neurom.2023.06.003","article-title":"Spinal Cord Stimulation for Gait Disorders in Parkinson\u2019s Disease and Atypical Parkinsonism: A Systematic Review of Preclinical and Clinical Data","volume":"26","author":"Ciocca","year":"2023","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_69","first-page":"142","article-title":"Studies on the feasibility of urinary bladder evacuation by direct spinal cord stimulation. I. Parameters of most effective stimulation","volume":"13","author":"Jonas","year":"1975","journal-title":"Investig. Urol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1743-0003-10-2","article-title":"Development of a multi-electrode array for spinal cord epidural stimulation to facilitate stepping and standing after a complete spinal cord injury in adult rats","volume":"10","author":"Gad","year":"2013","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1007\/s40122-021-00332-2","article-title":"Percutaneous Spinal Cord Stimulation Lead Placement Under Deep Sedation and General Anesthesia","volume":"10","author":"Hasoon","year":"2021","journal-title":"Pain Ther."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e460","DOI":"10.1016\/j.wneu.2022.07.017","article-title":"Stereotaxic Atlas of the Human Lumbar-Sacral Spinal Cord","volume":"166","author":"Grossman","year":"2022","journal-title":"World Neurosurg."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Danner, S.M., Krenn, M., Hofstoetter, U.S., Toth, A., Mayr, W., and Minassian, K. (2016). Body Position Influences Which Neural Structures Are Recruited by Lumbar Transcutaneous Spinal Cord Stimulation. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0147479"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2334398","DOI":"10.1080\/07853890.2024.2334398","article-title":"A brief review of complex regional pain syndrome and current management","volume":"56","author":"Stark","year":"2024","journal-title":"Ann. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.neurom.2023.04.468","article-title":"Intraoperative Neurophysiological Monitoring During Lead Placement for Dorsal Root Ganglion Stimulation: A Literature Review and Case Series","volume":"27","author":"Lu","year":"2024","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"a034314","DOI":"10.1101\/cshperspect.a034314","article-title":"Closed-Loop Neuromodulation in Physiological and Translational Research","volume":"9","author":"Zanos","year":"2019","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"jrm43423","DOI":"10.2340\/jrm.v57.43423","article-title":"Influence of gait-synchronized functional electrical stimulation during exoskeleton-assisted ambulation on cardiorespiratory outcomes in individuals with incomplete spinal cord injury","volume":"57","author":"Voicu","year":"2025","journal-title":"J. Rehabil. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/s12984-025-01690-0","article-title":"Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: A randomized, controlled trial","volume":"22","author":"Tani","year":"2025","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.neubiorev.2019.05.009","article-title":"Reviewing working memory training gains in healthy older adults: A meta-analytic review of transfer for cognitive outcomes","volume":"103","author":"Moreira","year":"2019","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/bs.irn.2024.10.013","article-title":"Neuromodulation for neuropathic pain","volume":"179","author":"Lapa","year":"2024","journal-title":"Int. Rev. Neurobiol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/papr.13295","article-title":"Neuromodulation for the management of chronic pelvic pain syndromes: A systematic review","volume":"24","author":"Gish","year":"2024","journal-title":"Pain Pract."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.neurom.2023.06.002","article-title":"Transcutaneous Electrical Stimulation for Neurogenic Bladder After Spinal Cord Injury: A Systematic Review and Meta-Analysis","volume":"27","author":"Jiang","year":"2024","journal-title":"Neuromodul. Technol. Neural Interface"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.1038\/npp.2015.105","article-title":"A Novel Methodology to Estimate the Treatment Effect in Presence of Highly Variable Placebo Response","volume":"40","author":"Gomeni","year":"2015","journal-title":"Neuropsychopharmacology"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Du, J., Luo, S., and Shi, P. (2025). AI-Driven Multimodal Brain-State Decoding for Personalized Closed-Loop TENS: A Comprehensive Review. Brain Sci., 15.","DOI":"10.3390\/brainsci15090903"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.1016\/j.pain.2013.06.004","article-title":"Interventional management of neuropathic pain: NeuPSIG recommendations","volume":"154","author":"Dworkin","year":"2013","journal-title":"Pain"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2050312120951369","DOI":"10.1177\/2050312120951369","article-title":"10\u2009kHz spinal cord stimulation for the treatment of chronic back and\/or leg pain: Summary of clinical studies","volume":"8","author":"Luecke","year":"2020","journal-title":"SAGE Open Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/papr.12692","article-title":"Spinal Cord Stimulation: Clinical Efficacy and Potential Mechanisms","volume":"18","author":"Sdrulla","year":"2018","journal-title":"Pain Pract."},{"key":"ref_88","first-page":"586","article-title":"Spinal cord stimulation: Beyond pain management","volume":"37","year":"2022","journal-title":"Neurologia"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1038\/s41591-022-02202-6","article-title":"Epidural stimulation of the cervical spinal cord for post-stroke upper-limb paresis","volume":"29","author":"Powell","year":"2023","journal-title":"Nat. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/brain\/awl333","article-title":"Functional potential in chronic stroke patients depends on corticospinal tract integrity","volume":"130","author":"Stinear","year":"2007","journal-title":"Brain"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/1742395311433132","article-title":"Qualitative exploration of psychological factors associated with spinal cord stimulation outcome","volume":"8","author":"Sparkes","year":"2012","journal-title":"Chronic Illn."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e213361","DOI":"10.1212\/WNL.0000000000213361","article-title":"Epidural Steroids for Cervical and Lumbar Radicular Pain and Spinal Stenosis Systematic Review Summary: Report of the AAN Guidelines Subcommittee","volume":"104","author":"Armon","year":"2025","journal-title":"Neurology"},{"key":"ref_93","first-page":"32","article-title":"Theories and control models and motor learning: Clinical applications in neuro-rehabilitation","volume":"30","author":"Torricelli","year":"2015","journal-title":"Neurologia"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1055\/s-2003-40768","article-title":"The role of the brachioradialis H reflex in the management and prognosis of obstetrical brachial plexus palsy","volume":"35","author":"Kao","year":"2003","journal-title":"Handchir. Mikrochir. Plast. Chir."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/1073858416654115","article-title":"The Basal Ganglia in Action","volume":"23","author":"Yin","year":"2017","journal-title":"Neuroscientist"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Mascarenhas, M., Martins, M., Ribeiro, T., Afonso, J., Cardoso, P., Mendes, F., Cardoso, H., Almeida, R., Ferreira, J., and Fonseca, J. (2024). Software as a Medical Device (SaMD) in Digestive Healthcare: Regulatory Challenges and Ethical Implications. Diagnostics, 14.","DOI":"10.3390\/diagnostics14182100"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10143-015-0651-1","article-title":"Spinal cord stimulation for Parkinson\u2019s disease: A systematic review","volume":"39","author":"Ghilardi","year":"2016","journal-title":"Neurosurg. Rev."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/5\/476\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:31:55Z","timestamp":1777458715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/5\/476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":97,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["brainsci16050476"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16050476","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]}}}