Edwards, D.J., Forrest, G., Cortes, M., Weightman, M.M., Sadowsky C., Chang, S-H., Furman, K., Bialek, A., Prokup, S., Carlow, J., VanHiel, L., Kemp, L., Musick, D., Campo, M., Jayaraman, A.: Walking improvement in chronic incomplete spinal cord injury with exoskeleton robotic training (WISE): a randomized controlled trial. Spinal Cord. 2022.

Individuals with incomplete spinal cord injury and residual gait function have demonstrated improved walking function after engaging in intensive gait training. This multi-site, randomized, controlled trial compared 12 weeks of exoskeleton gait training with standard gait training or no gait training in people with chronic incomplete spinal cord injury. The study confirmed the safety and feasibility of the intervention in an outpatient setting. Though mean change in gait speed did not differ significantly between groups, the proportion of participants with improvement in clinical ambulation category from home to community speed post-intervention was greatest with exoskeleton gait training.

Boato, F., Guan, X., Zhu, Y., Ryu, Y., Voutounou, M., Rynne, C., Freschlin, C.R., Zumbo, P., Betel, D., Matho K.S.H., Makarov, S.N., Wu, Z., Son, Y., Nummenmaa, A., Huang, J.Z., Edwards, D.J., Zhong, J. Activation of MAP2K signaling by genetic engineering or HF-rTMS promotes corticospinal axon sprouting and functional regeneration, Science Translational Medicine, 2023 15: 677.

Based on its role in axon growth in nervous system development, the RAF–MAP2K (mitogen-activated protein kinase kinase) signaling cascade has been identified as a potential target for intervention to facilitate axon regrowth and regeneration after spinal cord injury. Our study showed that genetically activating this pathway led to sprouting and regeneration in corticospinal tract (CST) axons, improved motor recovery, and de novo synaptogenesis of CST collaterals in animal models of spinal cord injury. In addition, non-invasive high frequency repetitive transcranial magnetic stimulation (HF-rTMS) also activated this signaling pathway, and this activation was necessary for enhanced CST axon sprouting, axon regeneration, and functional recovery in animal models of spinal cord injury. This study provides important pre-clinical evidence that HF-rTMS should be explored as a safe and non-invasive approach that may potentially facilitate rehabilitation in human spinal cord injury.

Fried, P.J., Santarnecchi, E., Antal, A., Bartres-Faz, D., Bestmann, S., Carpenter, L.L., Celnik, P., Edwards, D., Farzan, F., Fecteau, S., George, M.S., He, B., Kim, Y-H., Leocani, L., Lisanby, S.H., Loo, C., Luber, B., Nitsche, M.A., Paulus, W., Rossi S., Rossini, P.M., Rothwell, J., Sack, A.T., Thut, G., Ugawa, Y., Ziemann, U., Hallett, .M., & Pascual-Leone, A.: Training in the practice of noninvasive brain stimulation: Recommendations from an IFCN committee. Clinical Neurophysiology, 132(3):819-837, 2021.

Dr. Edwards was among the experts on the International Federation for Clinical Neurophysiology (IFCN) Committee to develop the first formal Training Guidelines in Non-Invasive Brain Stimulation. With the increased interest in using non-invasive brain stimulation in research and clinical practice, it was critical to establish comprehensive guidelines for training users in how to use non-invasive brain stimulation safely and effectively. This review provided practical recommendations for the structure and content of training for different types of users (technicians, clinicians, and scientists).

Van der Groen, O., Potok, W., Wenderoth, N., Edwards, G., Mattlingley, J.B., Edwards, D.: Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior. Neurosci Biobehav Rev. 2022 May 17;138:104702.

Transcranial random noise stimulation (tRNS) is one type of non-invasive electrical stimulation of the brain that is being actively explored for clinical and research purposes. This was the first narrative review focusing specifically on tRNS. We summarized the current evidence on the effects of tRNS on human perception, cognition, and learning. In addition, we examined the potential mechanisms, synthesized results from studies using tRNS for rehabilitation, and provided recommendations for future research on tRNS. 

Edwards D., Kumar S., Brinkman L., et al. Telerehabilitation Initiated Early in Post-Stroke Recovery: A Feasibility Study. Neurorehabil Neural Repair. 2023 Feb-Mar;37(2-3):131-141. Epub 2023 Mar 6.

Intensive rehabilitation therapy in the early stages after stroke may improve outcomes, but various barriers limit how much therapy a patient receives. Telerehabilitation is a promising approach that can address many common barriers. In this study, we demonstrated the feasibility, safety, and potential efficacy of providing intense telerehabilitation therapy early after stroke, laying the groundwork for larger future clinical trials.