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Related Experiment Video

Updated: May 5, 2026

Combined Shuttle-Box Training with Electrophysiological Cortex Recording and Stimulation as a Tool to Study Perception and Learning
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Electrical spinal cord stimulation promotes focal sensorimotor activation that accelerates brain-computer interface

Hussein Alawieh1, Deland Liu1, Jonathan Madera2

  • 1Chandra Family Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, TX 78712.

Proceedings of the National Academy of Sciences of the United States of America
|June 10, 2025
PubMed
Summary

Cervical transcutaneous electrical spinal stimulation (TESS) enhances brain-computer interface (BCI) control by improving sensorimotor rhythms (SMRs). This method accelerates motor rehabilitation and BCI skill learning in individuals with and without spinal cord injury.

Keywords:
brain–computer interfacesmotor rehabilitationneuromodulationskill learningspinal cord stimulation

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Area of Science:

  • Neuroscience
  • Rehabilitation Engineering
  • Biomedical Engineering

Background:

  • Central nervous system injuries can cause motor deficits by disrupting neural pathways.
  • Brain-computer interfaces (BCIs) decode sensorimotor rhythms (SMRs) for assistive devices and motor recovery.
  • Noninvasive BCIs face challenges due to SMR instability, necessitating extensive user training.

Purpose of the Study:

  • To accelerate the skill learning process for brain-computer interface (BCI) control.
  • To investigate the effect of cervical transcutaneous electrical spinal stimulation (TESS) on SMRs and BCI performance.
  • To enhance motor rehabilitation possibilities using TESS and BCI.

Main Methods:

  • Applied cervical transcutaneous electrical spinal stimulation (TESS) to inhibit the motor cortex.
  • Integrated TESS with longitudinal upper-limb BCI training protocols.
  • Assessed SMR focality, strength, and BCI control acquisition in healthy subjects and an individual with spinal cord injury.

Main Results:

  • TESS significantly increased the focality and strength of sensorimotor rhythms (SMRs).
  • BCI control was accelerated following TESS intervention, even in users previously unable to achieve control.
  • Improvements in BCI control were observed after only two TESS sessions and persisted for at least one week.

Conclusions:

  • Cortical inhibition induced by TESS plays a mechanistic role in enhancing SMRs for BCI applications.
  • TESS offers a promising method to accelerate BCI skill learning and improve motor rehabilitation outcomes.
  • This approach holds potential for advancing BCI-based therapies for individuals with motor deficits.