tDCS plus robotic gait training and cortical connectivity in SCI

• A study combined tDCS with robotic gait training and evaluated cortical connectivity changes in spinal cord injury (SCI) rehabilitation.¹
• Cortical connectivity metrics serve as outcome variables for combined neuromodulation + robotics.^{1 1}

Weekly enrichment (2026-07-20)

• The indexed item is a Letter, “Cortical connectivity reorganization induced by tDCS and robotic-assisted gait training in individuals with spinal cord injury,” for which no structured abstract is posted (thin source; numeric detail below is drawn from the underlying trial and prior RCTs).²
• The underlying randomized, double-blind trial enrolled 26 individuals with incomplete SCI, allocated to active (n=13) or sham (n=13) tDCS followed by robot-assisted gait training (RAGT) on the Lokomat system.³
• The anode was placed over the leg motor representation of the primary motor cortex (M1); functional near-infrared spectroscopy (fNIRS) measured cortical hemodynamics before and after 30 sessions (3×/week over 12 weeks or 5×/week over 6 weeks).³
• Active tDCS produced significant increases in oxyhemoglobin (oxy-Hb) in the supplementary motor area (SMA) and M1, while the dorsolateral prefrontal cortex and primary somatosensory cortex (S1) showed no significant change.³
• These fNIRS activation gains correlated positively with improvement on the Walking Index for Spinal Cord Injury II (WISCI-II), tying cortical reorganization to gait recovery.³
• An earlier randomized, sham-controlled trial (43 participants; 30 sessions of 20-min, 2-mA tDCS before each 30-min Lokomat session) found 70.0% of the active group improved on WISCI-II versus 33.3% of sham (p=0.046; OR 3.7, 95% CI 1.0–13.5), with the benefit sustained at 3-month follow-up.⁴
• In that trial 15 sessions produced no significant effect, indicating a dose threshold near 30 sessions for measurable walking gains.⁴
• Mechanistically, anodal M1 tDCS raises corticospinal excitability, which paired with repetitive gait training is proposed to reinforce intact descending pathways and promote use-dependent plasticity.⁴
• Cortical activation/connectivity metrics (fNIRS oxy-Hb, EEG connectivity) act as objective biomarkers for combined neuromodulation-plus-robotics rehabilitation, though clinical superiority over RAGT alone remains inconsistent across trials.²³

Footnotes

1. https://news.google.com/rss/articles/CBMiX0FVX3lxTE5YR0dLbHZ3NkZuSmRZNE9BVFBWRjZDd2dJdzBuWk1ZSmJGSVpzaW9mTGd0OEw0MEZpZExPUTVkaGlmeHZMaGg2LUxIVEZfRHZ2UFJrUktJUXJiWWQtVA?oc=5 ↩ ↩² ↩³

2. https://pubmed.ncbi.nlm.nih.gov/41455235/ ↩ ↩²

3. https://read.qxmd.com/read/40153922/neurorehabilitation-in-spinal-cord-injury-increased-cortical-activity-through-tdcs-and-robotic-gait-training ↩ ↩² ↩³ ↩⁴ ↩⁵

4. https://doi.org/10.1038/s41394-021-00448-9 ↩ ↩² ↩³