Academic Journal
Additive effect of tDCS and neuromotor recruitment on functional recovery in chronic paraplegia: A randomized controlled trial.
| Τίτλος: | Additive effect of tDCS and neuromotor recruitment on functional recovery in chronic paraplegia: A randomized controlled trial. |
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| Συγγραφείς: | Rifai Sarraj A; Faculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon., Allaw J; Faculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.; Laboratoire de Recherche Sociétés et Humanité (LARSH DeVisu), Université Polytechnique Hauts-De-France, Valenciennes, France., Rached E; Faculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon.; Laboratoire de Recherche Sociétés et Humanité (LARSH DeVisu), Université Polytechnique Hauts-De-France, Valenciennes, France., Khayat J; Faculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon., Karaki H; Faculty of Public Health, Laboratory of Motor System, Handicap and Rehabilitation (MOHAR), Lebanese University, Beirut, Lebanon., Diab A; Biomedical Engineering Department, Signal Processing Research Group, Lebanese International University, Tripoli, Lebanon.; Biomedical Engineering Department, Signal Processing Research Group, The International University IU, Beirut, Lebanon., Pinti A; Laboratoire de Recherche Sociétés et Humanité (LARSH DeVisu), Université Polytechnique Hauts-De-France, Valenciennes, France. |
| Πηγή: | PloS one [PLoS One] 2026 Jun 23; Vol. 21 (6), pp. e0352320. Date of Electronic Publication: 2026 Jun 23 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: San Francisco, CA : Public Library of Science |
| Ιατρικοί όροι (MeSH): | Paraplegia*/therapy , Paraplegia*/physiopathology , Transcranial Direct Current Stimulation*/methods , Recovery of Function*/physiology , Recruitment, Neurophysiological*, Spinal Cord Injuries/physiopathology ; Spinal Cord Injuries/therapy ; Humans ; Female ; Adult ; Male ; Middle Aged ; Chronic Disease ; Single-Blind Method |
| Περίληψη: | Functional recovery in chronic spinal cord injury (SCI) is traditionally viewed as limited, particularly after the spontaneous recovery window has closed. This single-blind randomized controlled trial investigated whether adding anodal Transcranial Direct Current Stimulation (tDCS) to the Neuromotor Recruitment Method (NEUROM)-a protocol combining motor imagery with intensive peripheral sensory stimulation-provides a additive benefit for sensorimotor recovery. Fifty participants with chronic paraplegia (mean time since injury: 15.4 ± 3.2 months; ASIA Impairment Scale A, B, or C) were recruited and randomized into three arms: Reference (standard care, n = 10), NEUROM (n = 20), or NEUROM+tDCS (n = 20). The intervention was administered over 10 days. Outcomes included the Lower Extremity Motor Score (LEMS), Light Touch and Pin Prick sensory scores, and the Assessment of Movement Attempt (AMA). The Reference group showed no significant recovery. Both active groups (NEUROM and NEUROM+tDCS) achieved substantial and statistically identical improvements in sensory function compared to the Reference group (p < 0.001), suggesting that peripheral recruitment alone is sufficient for afferent restoration. However, a significant dissociation was observed in motor function: the NEUROM+tDCS group demonstrated superior LEMS recovery (Mean change: 18 points) compared to the NEUROM group (14 points; p = 0.01) and reported significantly higher volitional drive (p < 0.001). These findings indicate a clear dissociation between sensory and motor plasticity in chronic SCI; while peripheral somatosensory recruitment drives afferent sensory restoration, the addition of central stimulation via tDCS is critical for maximizing efferent motor output. This suggests that restoring motor function in chronic paraplegia requires a "top-down" cortical prime to complement "bottom-up" peripheral signaling. Trial Registration: ClinicalTrials.gov NCT04790149. (Copyright: © 2026 Rifai Sarraj et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
| Competing Interests: | The authors have declared that no competing interests exist. |
| Molecular Sequence: | ClinicalTrials.gov NCT04790149 |
| Entry Date(s): | Date Created: 20260623 Date Completed: 20260623 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13289888 |
| DOI: | 10.1371/journal.pone.0352320 |
| PMID: | 42335147 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1932-6203 |
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| DOI: | 10.1371/journal.pone.0352320 |