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| Manuscript Number | Article Type | Title | Current Status | Date Submitted | Action |
|---|---|---|---|---|---|
| JNO-26-08417 | Original Investigation | Epidural Electrical Stimulation Promotes Motor Recovery in Severe Acute Cervical Spinal Cord Injury: A Nonrandomized Clinical Trial | Decision in Process | 10 Jul 2026 | View |
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| Manuscript # | Title | Status | Submitted |
|---|---|---|---|
| JNO-26-08417 | Epidural Electrical Stimulation Promotes Motor Recovery in Severe Acute Cervical Spinal Cord Injury: A Nonrandomized Clinical Trial | Decision in Process | 10 Jul 2026 |
| Manuscript Number | JNO-26-08417 | Article Type | Original Investigation |
|---|---|---|---|
| Current Status | Decision in Process | Status Date | 15 Oct 2026 (2026-10-15) |
| Previous Status | With Editor | Date Submitted | 10 Jul 2026 (2026-07-10) |
| Section | Surgery | Manuscript Word Count | 2,564 |
| Corresponding Author | Fan Jin, MD, PhD | Co-Corresponding Author | Yin Guoyong, MD, PhD |
| Corresponding Email | fanjin@njmu.edu.cn | Trial Registration | ChiCTR2500095515 |
| Funding | None reported | Conflicts of Interest | None reported |
| Title | Epidural Electrical Stimulation Promotes Motor Recovery in Severe Acute Cervical Spinal Cord Injury: A Nonrandomized Clinical Trial | ||
| Authors | Li Wenbo, Wang Qingyuan, Wang Siming, Li Cong, Ge Tongfei, Deng Mingyang, Xiong Wu, Cai Bowen, Wu Jiayang, Qin Tao, Yao Li, Zhou Yan, Yin Guoyong, Fan Jin | ||
| Keywords | Spinal cord injury; epidural electrical stimulation; neuromodulation; motor recovery; proteomics | ||
Epidural electrical stimulation may improve motor recovery after spinal cord injury, but its efficacy in acute cervical injury and the mechanisms underlying non-response are unclear.
To evaluate the efficacy and safety of epidural electrical stimulation in acute traumatic cervical spinal cord injury and to identify proteomic biomarkers of treatment response.
Nonrandomized clinical trial with a prospective intervention group and a mixed control group (historical and concurrent non-intervention patients), conducted from January 2022 to August 2025 at Jiangsu Province Hospital. A total of 141 consecutive patients with acute traumatic cervical spinal cord injury (AIS grade A) were enrolled: 51 received epidural electrical stimulation plus standard care and 90 received standard care alone.
The intervention group underwent posterior decompression, implantation of a high-density epidural electrode array, and active stimulation optimized by intraoperative free-run electromyography. Controls received conventional surgery and standard care alone.
Primary outcomes were motor (AIS motor score, Upper Extremity Motor Score) and sensory function, and functional independence (Spinal Cord Independence Measure) at 1, 3, and 6 months. Safety outcomes included acute and chronic complications. Cerebrospinal fluid proteomics identified differential pathways between responders and non-responders.
At 1 month, the stimulation group had greater sensory improvement (AIS sensory: 56.67 vs 52.67; P = .005). At 3 months, motor scores improved more (AIS motor: 28.49 vs 24.12; P < .001; Upper Extremity Motor Score: 27.92 vs 23.76; P < .001). At 6 months, functional independence was higher (Spinal Cord Independence Measure: 45.30 vs 40.35; P = .011). Stimulation increased ventilator weaning (90.2% vs 65.6%; odds ratio = 0.19; P = .0018) and reduced muscle spasms (2.0% vs 20.0%; odds ratio = 9.19; P = .0344). Proteomics linked non-response to downregulated glycan metabolism pathways.
Epidural electrical stimulation was associated with enhanced sensorimotor recovery, functional independence, and fewer complications in acute cervical spinal cord injury. Non-response linked to impaired glycan metabolism offers a potential stratification biomarker.
Chinese Clinical Trial Registry Identifier: ChiCTR2500095515
Files uploaded with the original submission on 10 Jul 2026. The manuscript PDF is the version used for editorial assessment.
| File Name | File Type | Size | Actions |
|---|---|---|---|
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Manuscript
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1.1 MB | Download | |
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Cover Letter
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114 KB | Download | |
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Supplementary Material
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850 KB | Download | |
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Study Protocol
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101 KB | Download | |
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Figure 1
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PNG | 106 KB | Download |
Download all files (.zip) · 5 submission files, 2.2 MB; archive includes editable source files.
| Date | Status | Notes |
|---|---|---|
| 15 Oct 2026 | Decision in Process | Manuscript is with the editor for a decision. No external peer review was initiated. |
| 16 Jul 2026 | With Editor | Assigned to the handling editor for editorial assessment. The manuscript remained with the editor and was not sent for external review. |
| 13 Jul 2026 | With Editorial Office | Initial editorial and technical checks completed. |
| 10 Jul 2026 | Submitted | Manuscript received by the JAMA Network Open editorial office. |
| External Peer Review | Not initiated | Reviewers Assigned | 0 |
|---|---|---|---|
| Current Status | Decision in Process | Status Date | 15 Oct 2026 |
| With Editor Since | 16 Jul 2026 | Last Editorial Action | Decision in Process |
This manuscript did not enter external peer review. It has been handled by the editor since 16 Jul 2026 and entered the decision process on 15 Oct 2026.
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