Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Diffusion tensor imaging biomarkers for assessing cognitive and physical function in aging.","authors":"Jungsoo Lee, Woohee Han, Hyunjin Kim","doi":"10.1186/s12984-025-01698-6","DOIUrl":"10.1186/s12984-025-01698-6","url":null,"abstract":"<p><strong>Background: </strong>As the global population ages, the decline in cognitive and physical functions presents significant challenges for individuals and healthcare systems. In older adults, conventional assessment methods are often subjective, time-consuming, and influenced by external factors, highlighting the need for objective and efficient evaluation tools. Neuroimaging biomarkers, particularly diffusion tensor imaging (DTI) metrics, offer promising insights into brain structure and function, potentially serving as reliable indicators of functional decline.</p><p><strong>Methods: </strong>This study examines the relationship between DTI-derived metrics and cognitive and physical functions in older adults (n = 106). Four primary diffusion metrics, such as fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity, were analyzed to assess their strength of association with functional decline. To enhance this association, principal component analysis (PCA) was applied, integrating multiple diffusion features. Age, sex, and educational level were included as covariates to control for their potential confounding effects.</p><p><strong>Results: </strong>Neuroimaging biomarkers were significantly associated with both cognitive and physical functions in older adults. Key neural pathways, including the corpus callosum, anterior and retrolenticular internal capsule, fornix, and superior fronto-occipital fasciculus, showed strong associations across domains. PCA combining metrics enhanced these associations, highlighting integrated patterns of white matter contributions. Models selecting multiple neural tracts demonstrated increased predictive accuracy, especially when adjusting for age, sex, and education. Distinct tract-function relationships were observed across physical and cognitive subdomains, emphasizing the complex and domain-specific roles of white matter in functional outcomes.</p><p><strong>Conclusions: </strong>The findings highlight the potential of neuroimaging biomarkers as objective tools for evaluating functional decline in aging. Identifying key neural pathways linked to cognitive and physical functions may contribute to early diagnosis and targeted interventions. The integration of multiple neuroimaging features enhances the strength of associations, suggesting that advanced neuroimaging techniques could play a crucial role in aging research and clinical applications.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"157"},"PeriodicalIF":5.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of subject-specific musculoskeletal model calibration strategies on muscle force and fatigue estimation.","authors":"Florian Michaud, Gonzalo Márquez, Manuel A Giraldez-García, Javier Cuadrado","doi":"10.1186/s12984-025-01691-z","DOIUrl":"10.1186/s12984-025-01691-z","url":null,"abstract":"<p><p>Muscle force and fatigue modeling and simulation are powerful tools for rehabilitation, sports performance, ergonomics, and injury prevention. However, their accuracy is challenged by dynamic mechanical and physiological factors. Since musculoskeletal models are typically derived from cadaver data and scaled to individuals, careful subject-specific calibration is recommended to achieve accurate simulation results. This study investigates how different muscle models and calibration strategies affect the accuracy of muscle force estimation at the elbow level. Two models-a simplified static model and a rigid-tendon Hill-type model-were compared. Several calibration approaches were tested using isometric and isokinetic measurements to identify the parameters that most enhance model performance. The models were used to estimate muscle forces, and their outputs were compared to experimental data collected from seventeen healthy subjects. In the first phase, estimations were made during short maximal voluntary contractions (MVCs) without fatigue, in order to isolate muscle force from fatigue effects. In the second phase, the calibrated parameters from each strategy were used to estimate muscle forces and fatigue during a short-duration, high-intensity dynamic exercise by incorporating a muscle fatigue model. The highest accuracy was achieved with the Hill-type model, which involved refining individual muscle length and force parameters based on concentric and eccentric MVCs and adjusting two parameters of the force-velocity relationship. However, incorporating subject-specific muscle fatigue parameters did not significantly improve force estimation under fatigue conditions.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"156"},"PeriodicalIF":5.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Kickstart exoskeleton lower extremity walking system on improving lower extremity walking ability in subacute stroke patients: a randomized controlled trial.","authors":"Chengpan Liang, Chunli Wan, Jinyu Yang, Xiaowen Shen, Cui Yu, Yi Shao, Pei Che, Yuting Zhang, Yongqiang Li","doi":"10.1186/s12984-025-01676-y","DOIUrl":"10.1186/s12984-025-01676-y","url":null,"abstract":"<p><strong>Background: </strong>Walking dysfunction is a primary cause of a reduced ability to perform activities of daily living and decreased quality of life in stroke patients. The Kickstart^® Walk assist system is portable and easy to don and remove. There is a lack of high-quality, randomized controlled trials to validate its effectiveness. The aim of this study was to evaluate the effectiveness of the Kickstart^® Walk Assist system in improving lower limb muscle strength and walking ability in stroke patients.</p><p><strong>Methods: </strong>Forty-six patients were enrolled and randomly assigned to either a control group (n = 23) or a Kickstart group (n = 23). Both groups received conventional rehabilitation therapy. In addition, patients in the Kickstart group wore the Kickstart^® Walk Assist system for 20 min, and patients in the control group received walking training for 20 min. The outcome measures included the Fugl-Meyer Assessment of Lower Extremity Motor Function (FMA-LE), gait parameters, the 10MWT, the Borg Subjective Fatigue Scale (Borg), and surface electromyography (sEMG).</p><p><strong>Results: </strong>Compared with the control group, the Kickstart group showed more significant improvements in FMA-LE at 4 and 8 weeks (P = 0.025, P = 0.028), 10-MWT (P = 0.256), Borg at 8 weeks (P = 0.035), sEMG (P < 0.05), and gait parameters (P > 0.05). No adverse events were observed during or after the intervention.</p><p><strong>Conclusion: </strong>The Kickstart^® Walk assist system can increase stroke patients' lower limb strength and motor function and improve their walking ability.</p><p><strong>Trial registration: </strong>This study was registered in the Chinese Clinical Trial Registry (Unique Identifier ChiCTR2300067605) on January 13, 2023.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"155"},"PeriodicalIF":5.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial.","authors":"Mami Tani, Tomofumi Yamaguchi, Kaoru Honaga, Yoko Takahashi, Hidemi Kono, Yuhei Murakami, Reina Isayama, Koshiro Haruyama, Yuji Fujino, Tadamitsu Matsuda, Issei Fukunaga, Masaaki Hori, Akira Tanuma, Futoshi Wada, Kozo Hatori, Toshiyuki Fujiwara","doi":"10.1186/s12984-025-01690-0","DOIUrl":"10.1186/s12984-025-01690-0","url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial.</p><p><strong>Methods: </strong>All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study.</p><p><strong>Results: </strong>Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η² = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time.</p><p><strong>Conclusions: </strong>The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"154"},"PeriodicalIF":5.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrophysiological-based automatic subgroups diagnosis of patients with chronic dysimmune polyneuropathies.","authors":"Sara Ballanti, Piergiuseppe Liuzzi, Paolo Luca Mattiolo, Maenia Scarpino, Sabrina Matà, Bahia Hakiki, Francesca Cecchi, Calogero Maria Oddo, Andrea Mannini, Antonello Grippo","doi":"10.1186/s12984-025-01685-x","DOIUrl":"10.1186/s12984-025-01685-x","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"153"},"PeriodicalIF":5.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impacts of transcranial direct current stimulation combined with aquatic neuromuscular training on pain, function, kinesiophobia, knee instability, and quality of life in knee osteoarthritis: a double-blind randomized trial.","authors":"Asma Tapeh Kaboodi, Farzaneh Gandomi, Parviz Soufivand, Shirin Assar","doi":"10.1186/s12984-025-01670-4","DOIUrl":"10.1186/s12984-025-01670-4","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"151"},"PeriodicalIF":5.2,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging and biological markers of different paretic hand outcomes after stroke.","authors":"Zhujun Wang, Manxu Zheng, Binke Yuan, Yingteng Zhang, Wenjun Hong, Chaozheng Tang, Wen Wu","doi":"10.1186/s12984-025-01682-0","DOIUrl":"10.1186/s12984-025-01682-0","url":null,"abstract":"<p><strong>Background: </strong>Hand dysfunction significantly affects independence after stroke, with outcomes varying across individuals. Exploring biomarkers associated with the paretic hand can improve the prognosis and guide personalized rehabilitation. However, whether biomarkers derived from resting-state fMRI (rs-fMRI) can effectively classify and predict different hand outcomes and their biological mechanisms remain unclear.</p><p><strong>Methods: </strong>This study analyzed 65 patients with chronic subcortical stroke, including 32 patients with partially paretic hand (PPH) and 33 patients with completely paretic hand (CPH). For patients with PPH and CPH respectively, the age was 56.19 ± 10.53 and 55.60 ± 9.00 years, disease duration was 15.31 ± 14.87 and 14.12 ± 17.36 months, lesion volume was 9.45 ± 5.57 and 16.00 ± 11.33 ml, Fugl-Meyer Assessment for Hand and Wrist (FMA-HW) was 11.25 ± 6.15 and 1.24 ± 1.22. Four rs-fMRI metrics were analyzed, including amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), degree centrality (DC), and voxel-mirrored homotopic connectivity (VMHC). Multivariate pattern analysis was used to classify and predict paretic hand performance. To explore the biological mechanisms of neuroimaging biomarkers, partial least squares regression was conducted to associate gene expression data (from Allen Human Brain Atlas), neurotransmitter maps, neuron types and developmental stages with the classification weight maps of rs-fMRI metrics.</p><p><strong>Results: </strong>ALFF achieved a higher classification accuracy of 0.88 in differentiating PPH from CPH, outperforming the other three rs-fMRI metrics. Machine learning further identified the top contributing regions from the ALFF classification weight maps, such as the ipsilesional precentral gyrus, contralesional cerebellum posterior lobe, and ipsilesional parietal lobule. Neuroimaging-transcriptome analysis revealed that macroscopic biomarkers from the ALFF were associated with the G protein-coupled receptor signaling pathway and the detection of chemical stimuli involved in sensory perception. Additionally, these neuroimaging biomarkers from ALFF showed prominent expression in astrocytes and early fetal stages. Most importantly, the neurotransmitter noradrenaline positively correlated with the distribution of ALFF biomarkers.</p><p><strong>Conclusions: </strong>The ALFF is an effective macroscopic biomarker for classifying and predicting paretic hand outcomes in individuals following chronic stroke. These neuroimaging biomarkers correspond to molecular transcriptional profiles and neurotransmitter distributions, offering insights into the potential of personalized stroke rehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"150"},"PeriodicalIF":5.2,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wristful thinking: exploring the effects of robotic rehabilitation and cross-education for persons with multiple sclerosis.","authors":"Kailynn Mannella, Giulia A Albanese, Valentina Massone, Kevin E Power, Duane C Button, Jonathan P Farthing, Shawn M Beaudette, Dave S Ditor, Craig D Tokuno, Jacopo Zenzeri, Michael W R Holmes","doi":"10.1186/s12984-025-01684-y","DOIUrl":"10.1186/s12984-025-01684-y","url":null,"abstract":"<p><p>The goal of this work was to develop an adaptive rehabilitation technique using a haptic wrist robot that would induce cross-education to an untrained limb. Fourteen individuals with Multiple Sclerosis (MS) and eight non-affected adults completed an eight-week intervention. MS participants were placed into two groups, training their more affected limb (direct training), and training their less affected limb (indirect training). The purpose of the intervention was to improve wrist and grip strength (measured via maximal grip and isometric wrist strength) and motor control (measured via robotic assessments). Participants trained with the robotic device three times per week for eight consecutive weeks. Training consisted of eccentric contractions as the participant resisted a force elicited from the robotic device as it moved in flexion, extension, and radial-ulnar deviation. The MS group reported significant increases in wrist strength. The indirect training group significantly improved in flexion, extension, radial and ulnar deviation in the trained limb, and flexion and radial deviation in the untrained limb. The direct training group showed improvements in extension and ulnar deviation in both limbs. The control group improved in radial and ulnar deviation, with radial deviation improving in the untrained limb. Grip force remained unchanged for all groups. MS participants significantly decreased tracking and figural error post-intervention suggesting evidence that motor control adaptations occurred following an adaptive and resistive robotic intervention of the upper limb. Results of this work provide evidence that eight-week robotic rehabilitation can elicit cross-education effects to the untrained limb.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"152"},"PeriodicalIF":5.2,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of transcranial direct current stimulation over the primary motor cortex on short-term balance acquisition in healthy individuals.","authors":"Ömer Burak Tor, Michael A Nitsche, Edmund Wascher, Nevin A Guzel, Charles S Layne","doi":"10.1186/s12984-025-01663-3","DOIUrl":"10.1186/s12984-025-01663-3","url":null,"abstract":"<p><strong>Background: </strong>The primary motor cortex (M1) is central to motor learning processes, and an increasing number of studies have suggested its role in balance control. However, the specific role of M1 in balance control remains unclear, and a causal contribution to improvements in balance ability after balance training has not yet been proven. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modifies brain activity and enables to probe the involvement of M1 in balance learning. The current study aims to explore the role of M1 in the acquisition of balance skills by applying tDCS during short-term perturbation-based balance training.</p><p><strong>Methods: </strong>Thirty-four participants were randomly assigned to one of three groups receiving balance training combined with tDCS: anodal tDCS, sham tDCS, and a control group without stimulation. All participants were involved in a structured, three-session perturbation-based balance training program completed within one week. During these sessions, the assigned tDCS protocol was applied over the M1 leg area concurrently with the training sessions. We analyzed electroencephalography (EEG) and balance ability during balance perturbations and changes in cortico-spinal excitability at rest. Balance perturbations were applied by translating the standing surface forward and backward. An acoustic signal was given two seconds before perturbation in an additional condition to reveal the effect of perturbation anticipation on reactive cortical responses.</p><p><strong>Results: </strong>The results indicate that balance ability, measured by center of mass (COM) displacement and joint excursions, was improved in forward perturbation across all groups, with the anodal stimulation group showing the largest improvement relative to baseline performance following training. Moreover, the anodal stimulation group showed a significant decrease in alpha band power following forward perturbations compared to baseline values after training. N1 latency was reduced across all participants in both perturbation directions after training. However, only the anodal stimulation group showed a significant reduction in backward perturbations compared to baseline values. While training did not induce any significant change in short-interval intracortical inhibition (SICI) measured by Transcranial Magnetic Stimulation (TMS), it increased intracortical facilitation (ICF) in the right tibialis anterior (TA) muscle across all groups, independent of the stimulation condition.</p><p><strong>Conclusions: </strong>This study provides evidence that tDCS over the M1 area facilitates balance skill acquisition, possibly by facilitating motor preparation and execution and improving the efficiency of sensorimotor integration processes, as shown by decreased alpha power and N1 latency. These findings may have implications for the potential use of tDCS in improving balance control.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"146"},"PeriodicalIF":5.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving nerve and muscle function: an exploration of targeted nerve function replacement following differential delay periods in a rat model.","authors":"Chunxiao Tang, Yuanheng Li, Xinxian Fan, Jiamei Guo, Yifeng Lin, Yifan Gao, Lin Yang","doi":"10.1186/s12984-025-01666-0","DOIUrl":"10.1186/s12984-025-01666-0","url":null,"abstract":"<p><strong>Background: </strong>Targeted Muscle Reinnervation (TMR) improves real-time control of EMG-based prostheses by connecting severed nerves to adjacent muscles, creating new EMG signals. However, TMR requires cutting original nerve connections, which can cause denervation atrophy and limit functional recovery. As an alternative, Targeted Nerve Function Replacement (TNFR) offers a fundamentally different approach by establishing a direct end-to-end anastomosis between an intact donor nerve and the original nerve of a target muscle, preserving existing neural pathways while providing supplementary neural input. This study evaluates TNFR efficacy in restoring denervated muscle function across different postoperative intervals in a rat model.</p><p><strong>Methods: </strong>Thirty Sprague-Dawley rats (220-250 g) were divided into five equal groups (n = 6 per group): control (no transection), denervated (transection without repair), immediate TNFR after median nerve transection, 2-week delayed TNFR, and 4-week delayed TNFR. The median nerve was selected for reinnervation with the musculocutaneous nerve innervating the brachialis muscle serving as the anastomosis target. All assessments were conducted 4 weeks post-TNFR intervention, including intramuscular bipolar EMG recordings (1024 Hz sampling rate), behavioral assessment, muscle tension measurement, dorsal root ganglia (DRG) histology, and spinal cord motor neuron evaluation.</p><p><strong>Results: </strong>Immediate TNFR significantly outperformed delayed interventions across all parameters. EMG amplitude and root mean square values were significantly higher in the immediate group (P < 0.05). Maximum contraction and tetanic contraction forces of biceps brachii showed superior recovery with immediate TNFR (P < 0.05). Histological examination revealed greater preservation of DRG sensory neurons following TNFR (P < 0.05). Immunofluorescence showed better preservation of synaptic protein expression in spinal cord motor neurons with immediate intervention. Immediate TNFR also prevented autophagic behavior seen in delayed intervention groups, suggesting improved neuropathic pain prevention.</p><p><strong>Conclusion: </strong>Timing critically influences TNFR outcomes, with immediate intervention yielding optimal restoration of both motor and sensory functions. This study provides valuable insights for optimizing surgical strategies in peripheral nerve injury, with important implications for limb reconstruction, rehabilitation protocols, and prosthetic development.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"145"},"PeriodicalIF":5.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}