Stimulation-induced plasticity in the motor pathway in the spinal cord
As the corticospinal pathway is the main pathway for control of voluntary movement in humans, damage to this pathway, such as with stroke or other brain injury, results in paralysis or weakness. Much of the rehabilitation for these disorders concentrates on retraining the brain. However, for people who do not have a complete loss of the pathway, the spinal end of the corticospinal pathway is another potential site for improvement. Previously, we have shown that stimulation with a technique that pairs magnetic brain stimulation with stimulation of a peripheral nerve can briefly improve the connections between the corticospinal pathway and the motoneurones. Others have shown that this can also work in patients with incomplete spinal cord injury. However, the technique is not reliable from person to person, and it is unknown whether the effect can be prolonged to provide functional improvements in muscle strength. Current and proposed studies will work towards improving reliability and prolonging the duration of the effect.