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. 2023 Feb 3;17:1095259. doi: 10.3389/fncel.2023.1095259

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Copyright © 2023 Dorrian, Berryman, Lauto and Leonard.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Summary of the potential mechanisms that electrical stimulation may improve outcomes post-SCI. (1) Electrical stimulation can immediately restore function by activating local neural circuitry and facilitating spared, residual supraspinal inputs to regain functional control below the lesion. (2) Stimulation may also modulate glial cells and neuroinflammation, and (3) upregulate neurotrophic factors. (4) When combined with long-term stimulation and rehabilitation, this may promote neuroplastic remodeling of the spinal cord and possibly axonal regeneration, facilitating supraspinal control below the injury. (5) These mechanisms may account for the restored function and neuropathic pain relief observed in electrical stimulation studies.