Multilevel Multimodal Neurophysiological Integration for Investigating the Network Modulatory Mechanisms of Epidural Spinal Cord Stimulation

This study will examine how the brain, spinal cord, and muscles communicate in people with spinal cord injury. Researchers will use noninvasive brain and muscle recordings together with spinal electrical recordings to better understand how epidural spinal cord stimulation (EES) affects nerve function. The results may help develop more effective and personalized rehabilitation treatments for people with spinal cord injury.

Inclusion Criteria: A. Non-Spinal Cord Injury (Non-SCI) Group * Individuals without spinal cord injury. * Patients diagnosed with chronic neuropathic pain who meet the criteria for routine temporary epidural spinal cord stimulation (EES) implantation therapy. * Patients who have undergone temporary epidural spinal cord stimulation (EES) implantation. * Ability to understand and follow motor instructions. * Age between 20 and 70 years. B. Spinal Cord Injury (SCI) Group * Patients with chronic spinal cord injury. * Patients who have undergone temporary epidural spinal cord stimulation (EES) implantation. * American Spinal Injury Association Impairment Scale (AIS) grades A-D. * Spinal cord injury levels between C3 and L1. * Ability to understand and follow motor instructions. * Age between 20 and 70 years. Exclusion Criteria: * Individuals with severe psychiatric disorders or cognitive impairments, including major depressive disorder, schizophrenia, or dementia, that may affect their ability to understand the study procedures or comply with study instructions. * Individuals who are unable to maintain consciousness, follow instructions, or complete study tasks, including motor tasks, isometric contractions, or resting-state tasks. * Individuals with severe medical conditions and unstable clinical status, such as uncontrolled cardiovascular disease, severe infection, respiratory failure, or other conditions deemed unsuitable for study participation by the attending physician. * Individuals with abnormal positioning, inadequate fixation, or complications related to temporary epidural spinal cord stimulation (EES) leads, including infection, significant pain, or neurological deterioration, as determined by clinical evaluation to be unsuitable for study recordings. * Individuals currently using medications that may significantly affect neurophysiological signals, such as high-dose sedatives, anesthetic agents, or other medications considered by the research team to interfere with data interpretation.