Neural Regeneration Research ›› 2022, Vol. 17 ›› Issue (9): 2036-2042.doi: 10.4103/1673-5374.335161

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Nerve root magnetic stimulation improves locomotor function following spinal cord injury with electrophysiological improvements and cortical synaptic reconstruction

Ya Zheng1, Dan Zhao1, †, Dong-Dong Xue2, Ye-Ran Mao3, Ling-Yun Cao4, Ye Zhang5, Guang-Yue Zhu1, Qi Yang1, Dong-Sheng Xu4, 6, 7, *   

  1. 1Department of Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China; 2Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, Hebei Province, China; 3Department of Rehabilitation, Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China; 4School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 5Department of Rehabilitation, The Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China; 6Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China; 7Rehabilitation Engineering Research Center for Integrated Traditional Chinese and Western Medicine, Ministry of Education, Shanghai, China
  • Online:2022-09-15 Published:2022-03-08
  • Contact: Dong-Sheng Xu, MD, dxu0927@shutcm.edu.cn.
  • Supported by:
    This study was supported by the National Natural Science Foundation of China (General Program), Nos. 81772453, 81974358 (both to DSX). 

Abstract: Following a spinal cord injury, there are usually a number of neural pathways that remain intact in the spinal cord. These residual nerve fibers are important, as they could be used to reconstruct the neural circuits that enable motor function. Our group previously designed a novel magnetic stimulation protocol, targeting the motor cortex and the spinal nerve roots, that led to significant improvements in locomotor function in patients with a chronic incomplete spinal cord injury. Here, we investigated how nerve root magnetic stimulation contributes to improved locomotor function using a rat model of spinal cord injury. Rats underwent surgery to clamp the spinal cord at T10; three days later, the rats were treated with repetitive magnetic stimulation (5 Hz, 25 pulses/train, 20 pulse trains) targeting the nerve roots at the L5–L6 vertebrae. The treatment was repeated five times a week over a period of three weeks. We found that the nerve root magnetic stimulation improved the locomotor function and enhanced nerve conduction in the injured spinal cord. In addition, the nerve root magnetic stimulation promoted the recovery of synaptic ultrastructure in the sensorimotor cortex. Overall, the results suggest that nerve root magnetic stimulation may be an effective, noninvasive method for mobilizing the residual spinal cord pathways to promote the recovery of locomotor function. 

Key words: evoked potentials, H-reflex, motor activity, nerve conduction, neural plasticity, rehabilitation, sensorimotor cortex, spinal cord injury, synapses, transcranial magnetic stimulation