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The effect of device-based neuromodulation on the motor recovery of patients with spinal cord injury

Spinal Cord volume 63, pages 621–632 (2025)Cite this article

Subjects

Abstract

Study design

This paper systematically analyzes literature from PubMed, MEDLINE, Embase, and Cochrane databases over the past 10 years (up to May 25, 2025). It employs defined search terms, inclusion/exclusion criteria, and a documented search flow to evaluate mechanisms, efficacy, challenges, and future directions of neuromodulation technologies for spinal cord injury rehabilitation. The results synthesize findings from clinical trials, and representative papers.

Objective

This review aims to evaluate the mechanisms and clinical applications of device-based neuromodulation technologies in spinal cord injury (SCI) rehabilitation, focusing on their efficacy, challenges, and future directions.

Setting

The countries and regions worldwide participating in neuromodulation.

Methods

We systematically analyzed advancements in neuromodulation over the past decade, including brain-spinal interfaces (BSI), brain-computer interfaces (BCI), cranial stimulation techniques (DBS, TMS, tDCS), spinal cord stimulation (SCS), robotic exoskeletons. The review integrates findings from clinical trials.

Results

Neuromodulation technologies demonstrate significant potential in restoring motor and sensory function post-SCI. BSI and BCI improve mobility but face infection and cybersecurity risks. Cranial stimulation techniques enhance neuroplasticity, with DBS and TMS showing efficacy, while tDCS requires further validation. Epidural SCS enables motor recovery in complete paralysis but has high infection rates. Robotic exoskeletons benefit younger patients.

Conclusion

Neuromodulation technologies represent promising interventions for SCI, yet challenges remain in precision, safety, and efficacy. Future research should prioritize AI-driven parameter optimization, wearable device development, and multicenter randomized trials to establish these methods as core treatments, ultimately improving patient outcomes and quality of life.

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Fig. 1: Types of Neuromodulation.
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Acknowledgements

We thank ChatGPT (OpenAI) for assistance with English-language polishing of the manuscript.

Funding

This research project is supported by Luzhou Science and Technology Program, with the project number: (2022-SYF-76). Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study;collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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Author notes

  1. These authors contributed equally: Jingchi Li, Tianshun Chen, Xuyan Yan.

Authors and Affiliations

  1. Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, NO.182, Chunhui Road, Longmatan District, Luzhou, Sichuan Province, 646000, P.R. China

    Jingchi Li & Lin Luo

  2. School of Basic Medicine, Southwest Medical University, Luzhou, Sichuan, 646000, China

    Tianshun Chen & Xuyan Yan

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  1. Jingchi Li
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  2. Tianshun Chen
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  3. Xuyan Yan
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  4. Lin Luo
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Contributions

Jingchi Li and LIN LUO proposed the plan, conducted research, and wrote the manuscript; Tianshun Chen and Xuyan Yan created the illustrations, wrote, and translated; LIN LUO reviewed and submitted the work.LIN LUO is fully responsible.

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Correspondence to Lin Luo.

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Li, J., Chen, T., Yan, X. et al. The effect of device-based neuromodulation on the motor recovery of patients with spinal cord injury. Spinal Cord 63, 621–632 (2025). https://doi.org/10.1038/s41393-025-01133-6

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