Neural signals encoded by specific frequencies of closed-loop electrical stimulation structurally and functionally reconstruct spinal sensorimotor circuits after spinal cord injury

Epidural electrical stimulation restores locomotion in animals and humans with spinal cord injury (SCI). However, the coding rules underlying electrical stimulation remain poorly understood, which has greatly limited the application of such electrical neuromodulation techniques in SCI clinical treatment. To elucidate the coding rules of electrical stimulation on spinal sensorimotor circuit reconstruction after complete SCI, we initially developed a spinal-muscle closed-loop stimulation protocol to mimic feedforward and feedback electrical signals in spinal sensorimotor circuits. Afterwards, using methods of sensorimotor function evaluation, neural circuit tracing and neural signal recording, we discovered a unique stimulus frequency of 10-20 Hz under closed-loop conditions was required for structural and functional reconstruction of spinal sensorimotor circuits. The single-cell transcriptome analysis of activated motoneurons characterized molecular networks involved in spinal sensorimotor circuit reconstruction. This study provides insights into neural signal decoding during spinal sensorimotor circuit reconstruction, and indicates a technological approach for the clinical treatment of SCI.