The Interplay Between Neuromodulation and Stem Cell Therapy for Sensory-Motor Neuroplasticity After Spinal Cord Injury: A Perspective View

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Spinal Cord Injury (SCI) rehabilitation is undergoing a transformative shift with the emergence of new treatment strategies. Historically, treatment options were limited, and few offered meaningful recovery. Recent work in human models has shown that neuromodulation specifically with spinal cord epidural stimulation (SCES) paired with task-specific training (TsT) can partially restore motor function such as the ability to stand, step, and perform volitional movements. Despite these advances, the recovery has been shown to plateau even with the combination of therapies. The recovery process typically leads to partial rather than complete restoration of function. This limitation arises because current approaches primarily reactivate existing circuits rather than repair the disrupted pathways. Scar tissue and loss of descending and ascending connections remain major barriers to full recovery, restricting the transmission of neural signals. We argue that the next phase of research should be a synergistic strategy building upon the successes of neuromodulation and TsT while incorporating a regenerative therapy such as stem-cell-based interventions. Whereas neuromodulation and task-specific training increases excitability and reorganizes existing networks, stem cells have the potential to repair structural damage and re-establish communication across injured regions or facilitating t

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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