02508nas a2200193   4500008004100000022001400041245009200055210006900147260001600216300002200232520181300254100002402067700002202091700002102113700002202134700001902156700002502175856011402200       2026                        eng d  a1552-684400aNeurorehabilitation in the 21st Century: New Science, New Strategies, New Expectations.0 aNeurorehabilitation in the 21st Century New Science New Strategi  c2026 Feb 16  a154596832514123093 a<p>Background: Neurorehabilitation is among the most vibrant areas of biomedical research. Its main strategy has been skill-specific practice, which often fails to produce adequate recovery. Now, new recognition of central nervous system (CNS) plasticity, new understanding of skills, and new technologies provide new strategies that enhance the efficacy of practice. Objectives: The substrate of a skill is a network of neurons and synapses that extends from cortex to spinal cord and is now called a heksor. A heksor changes continually to maintain the key features of its skill, the attributes that make the skill satisfactory. Muscle activity and kinematics may change; key features are maintained. Heksors share neurons and synapses. Through their concurrent changes, they keep the CNS in a negotiated equilibrium that enables each to maintain its skill. When CNS damage occurs, the goal is to enable damaged heksors to repair themselves. Results: Two new strategies enhance the efficacy of skill-specific practice. One increases plasticity. A damaged heksor shapes the additional plasticity through practice. The other targets beneficial plasticity to a critical site in a damaged heksor. This improves practice, enabling the heksor to achieve wider beneficial plasticity. In animals and humans, protocols that combine these strategies with practice enhance lasting recovery. Conclusions: The challenge is to develop, optimize, and validate these combined protocols. Computational modeling can accelerate the process. Controlled trials and comprehensive outcome assessments are essential. Pre-morbid factors and physiological measures may identify biomarkers that can predict efficacy or guide patient-specific protocol design. Many combined protocols will be noninvasive and suitable for home use.</p>1 aWolpaw, Jonathan, R1 aThompson, Aiko, K1 aPerez, Monica, A1 aNorman, Sumner, L1 aOudega, Martin1 aWinstein, Carolee, J  uhttps://neurotechcenter.org/publications/2026/neurorehabilitation-21st-century-new-science-new-strategies-new00801nas a2200229   4500008004100000022001400041245013800055210006900193260001300262300000800275490000800283653002600291653001300317653001100330653002100341653001100362653001600373653002500389100002000414700002200434856011500456       2024                        eng d  a1872-895200aOperant up-conditioning of the soleus cutaneous reflex to non-noxious stimuli in a person with chronic incomplete spinal cord injury.0 aOperant upconditioning of the soleus cutaneous reflex to nonnoxi  c2024 Jan  a1-30 v15710aConditioning, Operant10aH-Reflex10aHumans10aMuscle, Skeletal10aReflex10aSpinal Cord10aSpinal Cord Injuries1 aPhipps, Alan, M1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2024/operant-conditioning-soleus-cutaneous-reflex-non-noxious-stimuli02534nas a2200169   4500008004100000022001400041245019500055210006900250260001600319520182000335100002102155700001702176700001802193700001802211700002202229856011302251       2024                        eng d  a1432-110600aVariability of corticospinal and spinal reflex excitability for the ankle dorsiflexor tibialis anterior across repeated measurements in people with and without incomplete spinal cord injury.0 aVariability of corticospinal and spinal reflex excitability for   c2024 Jan 253 a<p>To adequately evaluate the corticospinal and spinal plasticity in health and disease, it is essential to understand whether and to what extent the corticospinal and spinal responses fluctuate systematically across multiple measurements. Thus, in this study, we examined the session-to-session variability of corticospinal excitability for the ankle dorsiflexor tibialis anterior (TA) in people with and without incomplete spinal cord injury (SCI). In neurologically normal participants, the following measures were obtained across 4 days at the same time of day (N = 13) or 4 sessions over a 12-h period (N = 9, at 8:00, 12:00, 16:00, and 20:00): maximum voluntary contraction (MVC), maximum M-wave and H-reflex (M and H), motor evoked potential (MEP) amplitude, and silent period (SP) after MEP. In participants with chronic incomplete SCI (N = 17), the same measures were obtained across 4 days. We found no clear diurnal variation in the spinal and corticospinal excitability of the TA in individuals with no known neurological conditions, and no systematic changes in any experimental measures of spinal and corticospinal excitability across four measurement days in individuals with or without SCI. Overall, mean deviations across four sessions remained in a range of 5-13% for all measures in participants with or without SCI. The study shows the limited extent of non-systematic session-to-session variability in the TA corticospinal excitability in individuals with and without chronic incomplete SCI, supporting the utility of corticospinal and spinal excitability measures in mechanistic investigation of neuromodulation interventions. The information provided through this study may serve as the reference in evaluating corticospinal plasticity across multiple experimental sessions.</p>1 aBrangaccio, J, A1 aPhipps, A, M1 aGemoets, D, E1 aSniffen, J, M1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2024/variability-corticospinal-and-spinal-reflex-excitability-ankle02370nas a2200157   4500008004100000022001400041245012900055210006900184260001200253300001100265490000800276520176800284100002002052700002202072856011802094       2023                        eng d  a1522-159800aAltered cutaneous reflexes to non-noxious stimuli in the triceps surae of people with chronic incomplete spinal cord injury.0 aAltered cutaneous reflexes to nonnoxious stimuli in the triceps   c02/2023  a513-230 v1293 a<p>Following spinal cord injury (SCI) task-dependent modulation of spinal reflexes are often impaired. To gain insight into the state of the spinal interneuronal pathways following injury, we studied the amplitude modulation of triceps surae cutaneous reflexes to non-noxious stimuli during standing and early-to-mid stance phase of walking in participants with and without chronic incomplete SCI. Reflex eliciting nerve stimulation was delivered to the superficial peroneal, sural, and distal tibial nerves about the ankle. Reflexes were analyzed in the short (SLR, 50-80 ms post stimulation onset) and the medium (MLR, 80-120 ms) latency response windows. Further, the relation between cutaneous and H-reflexes was also examined during standing. In participants without injuries the soleus SLR was modulated task-dependently with nerve specificity, and the soleus and medial gastrocnemius MLRs were modulated task-dependently. In contrast, participants with SCI, no task-dependent or nerve-specific modulation of triceps cutaneous reflexes was observed. The triceps surae cutaneous and H-reflexes were not correlated in either group (r = 0.01-0.37). The presence of cutaneous reflexes but the absence of significant amplitude modulation may suggest impaired function of spinal interneuronal pathways in this population. The lack of correlation between the cutaneous and H-reflexes may suggest that interneurons that are involved in H-reflex modulation and cutaneous reflex modulation do not receive common input, or the impact of the common input is outweighed by other input. Present findings highlight the importance of examining multiple spinal reflexes to better understanding spinal interneuronal pathways that affect motor control in people after SCI.</p>1 aPhipps, Alan, M1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2023/altered-cutaneous-reflexes-non-noxious-stimuli-triceps-surae-people02281nas a2200253   4500008004100000022001400041245007600055210006900131260001200200300001400212490000800226520146600234653001001700653002901710653001301739653001101752653002101763653002201784653004401806100002001850700002401870700002201894856011101916       2023                        eng d  a1432-110600aEffects of active and sham tDCS on the soleus H-reflex during standing.0 aEffects of active and sham tDCS on the soleus Hreflex during sta  c06/2023  a1611-16220 v2413 a<p>Weak transcranial direct current stimulation (tDCS) is known to affect corticospinal excitability and enhance motor skill acquisition, whereas its effects on spinal reflexes in actively contracting muscles are yet to be established. Thus, in this study, we examined the acute effects of Active and Sham tDCS on the soleus H-reflex during standing. In fourteen adults without known neurological conditions, the soleus H-reflex was repeatedly elicited at just above M-wave threshold throughout 30 min of Active (N = 7) or Sham (N = 7) 2-mA tDCS over the primary motor cortex in standing. The maximum H-reflex (H) and M-wave (M) were also measured before and immediately after 30 min of tDCS. The soleus H-reflex amplitudes became significantly larger (by 6%) ≈1 min into Active or Sham tDCS and gradually returned toward the pre-tDCS values, on average, within 15 min. With Active tDCS, the amplitude reduction from the initial increase appeared to occur more swiftly than with Sham tDCS. An acute temporary increase in the soleus H-reflex amplitude within the first minute of Active and Sham tDCS found in this study indicates a previously unreported effect of tDCS on the H-reflex excitability. The present study suggests that neurophysiological characterization of Sham tDCS effects is just as important as investigating Active tDCS effects in understanding and defining acute effects of tDCS on the excitability of spinal reflex pathways.</p>10aAdult10aEvoked Potentials, Motor10aH-Reflex10aHumans10aMuscle, Skeletal10aStanding Position10aTranscranial Direct Current Stimulation1 aMcCane, Lynn, M1 aWolpaw, Jonathan, R1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2023/effects-active-and-sham-tdcs-soleus-h-reflex-during-standing03026nas a2200265   4500008004100000022001400041245016500055210006900220260001600289490000700305520208500312653002502397653002102422653001302443653001102456653002102467653002202488653002602510100002502536700001702561700002202578700002202600700002202622856011602644       2023                        eng d  a1741-255200aMethods for automated delineation and assessment of EMG responses evoked by peripheral nerve stimulation in diagnostic and closed-loop therapeutic applications.0 aMethods for automated delineation and assessment of EMG response  c2023 Jul 210 v203 a<p>Surface electromyography measurements of the Hoffmann (H-) reflex are essential in a wide range of neuroscientific and clinical applications. One promising emerging therapeutic application is H-reflex operant conditioning, whereby a person is trained to modulate the H-reflex, with generalized beneficial effects on sensorimotor function in chronic neuromuscular disorders. Both traditional diagnostic and novel realtime therapeutic applications rely on accurate definitions of the H-reflex and M-wave temporal bounds, which currently depend on expert case-by-case judgment. The current study automates such judgments.Our novel wavelet-based algorithm automatically determines temporal extent and amplitude of the human soleus H-reflex and M-wave. In each of 20 participants, the algorithm was trained on data from a preliminary 3 or 4 min recruitment-curve measurement. Output was evaluated on parametric fits to subsequent sessions' recruitment curves (92 curves across all participants) and on the conditioning protocol's subsequent baseline trials (∼1200 per participant) performed near. Results were compared against the original temporal bounds estimated at the time, and against retrospective estimates made by an expert 6 years later.Automatic bounds agreed well with manual estimates: 95% lay within ±2.5 ms. The resulting H-reflex magnitude estimates showed excellent agreement (97.5% average across participants) between automatic and retrospective bounds regarding which trials would be considered successful for operant conditioning. Recruitment-curve parameters also agreed well between automatic and manual methods: 95% of the automatic estimates of the current required to elicitfell within±1.4%of the retrospective estimate; for the 'threshold' current that produced an M-wave 10% of maximum, this value was±3.5%.Such dependable automation of M-wave and H-reflex definition should make both established and emerging H-reflex protocols considerably less vulnerable to inter-personnel variability and human error, increasing translational potential.</p>10aElectric Stimulation10aElectromyography10aH-Reflex10aHumans10aMuscle, Skeletal10aPeripheral Nerves10aRetrospective Studies1 aMcKinnon, Michael, L1 aHill, Jeremy1 aCarp, Jonathan, S1 aDellenbach, Blair1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2023/methods-automated-delineation-and-assessment-emg-responses-evoked03126nas a2200313   4500008004100000022001400041245013900055210006900194260001500263520206900278653002002347653002602367653002102393653002202414653001302436653001102449653002702460653002502487100001702512700001702529700001902546700002402565700002302589700002102612700001402633700002402647700002202671856011902693       2022                        eng d  a1940-087X00aThe Evoked Potential Operant Conditioning System (EPOCS): A Research Tool and an Emerging Therapy for Chronic Neuromuscular Disorders.0 aEvoked Potential Operant Conditioning System EPOCS A Research To  c2022 08 253 a<p>The Evoked Potential Operant Conditioning System (EPOCS) is a software tool that implements protocols for operantly conditioning stimulus-triggered muscle responses in people with neuromuscular disorders, which in turn can improve sensorimotor function when applied appropriately. EPOCS monitors the state of specific target muscles-e.g., from surface electromyography (EMG) while standing, or from gait cycle measurements while walking on a treadmill-and automatically triggers calibrated stimulation when pre-defined conditions are met. It provides two forms of feedback that enable a person to learn to modulate the targeted pathway's excitability. First, it continuously monitors ongoing EMG activity in the target muscle, guiding the person to produce a consistent level of activity suitable for conditioning. Second, it provides immediate feedback of the response size following each stimulation and indicates whether it has reached the target value. To illustrate its use, this article describes a protocol through which a person can learn to decrease the size of the Hoffmann reflex-the electrically-elicited analog of the spinal stretch reflex-in the soleus muscle. Down-conditioning this pathway's excitability can improve walking in people with spastic gait due to incomplete spinal cord injury. The article demonstrates how to set up the equipment; how to place stimulating and recording electrodes; and how to use the free software to optimize electrode placement, measure the recruitment curve of direct motor and reflex responses, measure the response without operant conditioning, condition the reflex, and analyze the resulting data. It illustrates how the reflex changes over multiple sessions and how walking improves. It also discusses how the system can be applied to other kinds of evoked responses and to other kinds of stimulation, e.g., motor evoked potentials to transcranial magnetic stimulation; how it can address various clinical problems; and how it can support research studies of sensorimotor function in health and disease.</p>10aChronic Disease10aConditioning, Operant10aElectromyography10aEvoked Potentials10aH-Reflex10aHumans10aNeuromuscular Diseases10aSpinal Cord Injuries1 aHill, Jeremy1 aGupta, Disha1 aEftekhar, Amir1 aBrangaccio, Jodi, A1 aNorton, James, J S1 aMcLeod, Michelle1 aFake, Tim1 aWolpaw, Jonathan, R1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2022/evoked-potential-operant-conditioning-system-epocs-research-tool-and02816nas a2200181   4500008004100000022001400041245007700055210006900132260000900201300001100210490000600221520221200227100002202439700002302461700001602484700002202500856011202522       2022                        eng d  a2673-686100aOperant down-conditioning of the soleus H-reflex in people after stroke.0 aOperant downconditioning of the soleus Hreflex in people after s  c2022  a8597240 v33 a<p>Through operant conditioning, spinal reflex behaviors can be changed. Previous studies in rats indicate that the sensorimotor cortex and corticospinal tract are essential in inducing and maintaining reflex changes induced through conditioning. In people with incomplete spinal cord injury (SCI), an operant down-conditioning protocol decreased the soleus H-reflex size and improved walking speed and symmetry, suggesting that a partially preserved spinal cord can support conditioning-induced plasticity and benefit from it. This study examined whether down-conditioning can decrease the soleus H-reflex in people with supraspinal injury (i.e., cortical or subcortical stroke). Operant down-conditioning was applied to the soleus H-reflex in a cohort of 12 stroke people with chronic spastic hemiparesis (>12 months from stroke onset of symptoms). Each participant completed 6 baseline and 30 conditioning sessions over 12 weeks. In each baseline session, 225 control H-reflexes were elicited without any feedback on H-reflex size. In each conditioning session, 225 conditioned H-reflexes were elicited while the participant was asked to decrease H-reflex size and was given visual feedback as to whether the resulting H-reflex was smaller than a criterion value. In six of 12 participants, the conditioned H-reflex became significantly smaller by 30% on average, whereas in other 6 participants, it did not. The difference between the subgroups was largely attributable to the difference in across-session control reflex change. Ten-meter walking speed was increased by various extent (+0.04 to +0.35, +0.14 m/s on average) among the six participants whose H-reflex decreased, whereas the change was 0.00 m/s on average for the rest of participants. Although less than what was seen in participants with SCI, the fact that conditioning succeeded in 50% of stroke participants supports the feasibility of reflex down-conditioning in people after stroke. At the same time, the difference in across-session control reflex change and conditioning success rate may reflect a critical role of supraspinal activity in producing long-term plasticity in the spinal cord, as previous animal studies suggested.</p>1 aThompson, Aiko, K1 aGill, Christina, R1 aFeng, Wuwei1 aSegal, Richard, L  uhttps://neurotechcenter.org/publications/2022/operant-down-conditioning-soleus-h-reflex-people-after-stroke02450nas a2200265   4500008004100000022001400041245007300055210006900128260001200197300001400209490000800223520163500231653001001866653001601876653002101892653001301913653001101926653002001937653002101957100001801978700002401996700002602020700002202046856011602068       2022                        eng d  a1432-110600aSoleus H-reflex modulation during a double-legged drop landing task.0 aSoleus Hreflex modulation during a doublelegged drop landing tas  c04/2022  a1093-11030 v2403 a<p>Muscle spindle afferent feedback is modulated during different phases of locomotor tasks in a way that facilitates task goals. However, only a few studies have studied H-reflex modulation during landing. This study aimed to characterize soleus (SOL) H-reflex modulation during the flight and early landing period of drop landings. Since landing presumably involves a massive increase in spindle afferent firing due to rapid SOL muscle stretching, we hypothesized H-reflex size would decrease near landing reflecting neural modulation to prevent excessive motoneuron excitation. The soleus H-reflex was recorded during drop landings from a 30 cm height in nine healthy adults. Electromyography (SOL, tibialis anterior (TA), medial gastrocnemius, and vastus lateralis), ankle and knee joint motion and ground reaction force were recorded during landings. Tibial nerve stimulation was timed to elicit H-reflexes during the flight and early ground contact period (five 30 ms Bins from 90 ms before to 60 ms after landing). The H-reflexes recorded after landing (0-30 and 30-60 ms) were significantly smaller (21-36% less) than that recorded during the flight periods (90-0 ms before ground contact; P ≤ 0.004). The decrease in H-reflex size not occurring until after ground contact indicates a time-critical modulation of reflex gain during the last 30 ms of flight (i.e., time of tibial nerve stimulation). H-reflex size reduction after ground contact supports a probable neural strategy to prevent excessive reflex-mediated muscle activation and thereby facilitates appropriate musculotendon and joint stiffness.</p>10aAdult10aAnkle Joint10aElectromyography10aH-Reflex10aHumans10aMuscle Spindles10aMuscle, Skeletal1 aLyle, Mark, A1 aMcLeod, Michelle, M1 aPouliot, Bridgette, A1 aThompson, Aiko, K  uhttps://neurotechcenter.org/publications/2022/soleus-h-reflex-modulation-during-double-legged-drop-landing-task02374nas a2200157   4500008004100000022001400041245015700055210006900212260000900281300000800290490000700298520176000305100002202065700002102087856010802108       2020                        eng d  a1664-229500aCan Operant Conditioning of EMG-Evoked Responses Help to Target Corticospinal Plasticity for Improving Motor Function in People With Multiple Sclerosis?0 aCan Operant Conditioning of EMGEvoked Responses Help to Target C  c2020  a5520 v113 a<p>Corticospinal pathway and its function are essential in motor control and motor rehabilitation. Multiple sclerosis (MS) causes damage to the brain and descending connections, and often diminishes corticospinal function. In people with MS, neural plasticity is available, although it does not necessarily remain stable over the course of disease progress. Thus, inducing plasticity to the corticospinal pathway so as to improve its function may lead to motor control improvements, which impact one's mobility, health, and wellness. In order to harness plasticity in people with MS, over the past two decades, non-invasive brain stimulation techniques have been examined for addressing common symptoms, such as cognitive deficits, fatigue, and spasticity. While these methods appear promising, when it comes to motor rehabilitation, just inducing plasticity or having a capacity for it does not guarantee generation of better motor functions. Targeting plasticity to a key pathway, such as the corticospinal pathway, could change what limits one's motor control and improve function. One of such neural training methods is operant conditioning of the motor-evoked potential that aims to train the behavior of the corticospinal-motoneuron pathway. Through up-conditioning training, the person learns to produce the rewarded neuronal behavior/state of increased corticospinal excitability, and through iterative training, the rewarded behavior/state becomes one's habitual, daily motor behavior. This minireview introduces operant conditioning approach for people with MS. Guiding beneficial CNS plasticity on top of continuous disease progress may help to prolong the duration of maintained motor function and quality of life in people living with MS.</p>1 aThompson, Aiko, K1 aSinkjær, Thomas  uhttps://neurotechcenter.org/publications/2020/can-operant-conditioning-emg-evoked-responses-help-target02092nas a2200217   4500008004100000022001400041245009800055210006900153260001200222300001100234490000700245520143300252653001301685653001501698653002301713653002701736653002001763100002201783700002101805856004801826       2015                        eng d  a1089-409800aRestoring walking after spinal cord injury: operant conditioning of spinal reflexes can help.0 aRestoring walking after spinal cord injury operant conditioning   c04/2015  a203-150 v213 a<p>People with incomplete spinal cord injury (SCI) frequently suffer motor disabilities due to spasticity and poor muscle control, even after conventional therapy. Abnormal spinal reflex activity often contributes to these problems. Operant conditioning of spinal reflexes, which can target plasticity to specific reflex pathways, can enhance recovery. In rats in which a right lateral column lesion had weakened right stance and produced an asymmetrical gait, up-conditioning of the right soleus H-reflex, which increased muscle spindle afferent excitation of soleus, strengthened right stance and eliminated the asymmetry. In people with hyperreflexia due to incomplete SCI, down-conditioning of the soleus H-reflex improved walking speed and symmetry. Furthermore, modulation of electromyographic activity during walking improved bilaterally, indicating that a protocol that targets plasticity to a specific pathway can trigger widespread plasticity that improves recovery far beyond that attributable to the change in the targeted pathway. These improvements were apparent to people in their daily lives. They reported walking faster and farther, and noted less spasticity and better balance. Operant conditioning protocols could be developed to modify other spinal reflexes or corticospinal connections; and could be combined with other therapies to enhance recovery in people with SCI or other neuromuscular disorders.</p>10aLearning10aLocomotion10aspinal cord injury10aspinal cord plasticity10aspinal reflexes1 aThompson, Aiko, K1 aWolpaw, Jonathan  uhttp://www.ncbi.nlm.nih.gov/pubmed/2463695402012nas a2200229   4500008004100000022001400041245004900055210004800104260001200152300001100164490000800175520137600183653003401559653001301593653002501606653001901631653002301650653001801673100002201691700002101713856004801734       2015                        eng d  a1875-785500aTargeted neuroplasticity for rehabilitation.0 aTargeted neuroplasticity for rehabilitation  c03/2015  a157-720 v2183 a<p>An operant-conditioning protocol that bases reward on the electromyographic response produced by a specific CNS pathway can change that pathway. For example, in both animals and people, an operant-conditioning protocol can increase or decrease the spinal stretch reflex or its electrical analog, the H-reflex. Reflex change is associated with plasticity in the pathway of the reflex as well as elsewhere in the spinal cord and brain. Because these pathways serve many different behaviors, the plasticity produced by this conditioning can change other behaviors. Thus, in animals or people with partial spinal cord injuries, appropriate reflex conditioning can improve locomotion. Furthermore, in people with spinal cord injuries, appropriate reflex conditioning can trigger widespread beneficial plasticity. This wider plasticity appears to reflect an iterative process through which the multiple behaviors in the individual's repertoire negotiate the properties of the spinal neurons and synapses that they all use. Operant-conditioning protocols are a promising new therapeutic method that could complement other rehabilitation methods and enhance functional recovery. Their successful use requires strict adherence to appropriately designed procedures, as well as close attention to accommodating and engaging the individual subject in the conditioning process.</p>10aactivity-dependent plasticity10aH-Reflex10aoperant conditioning10aRehabilitation10aspinal cord injury10aspinal reflex1 aThompson, Aiko, K1 aWolpaw, Jonathan  uhttp://www.ncbi.nlm.nih.gov/pubmed/2589013602145nas a2200217   4500008004100000022001400041245008500055210006900140260001200209300000700221490000600228520150000234653001301734653002401747653001501771653002301786653002701809100002201836700002101858856004801879       2014                        eng d  a1662-514500aOperant conditioning of spinal reflexes: from basic science to clinical therapy.0 aOperant conditioning of spinal reflexes from basic science to cl  c03/2014  a250 v83 aNew appreciation of the adaptive capabilities of the nervous system, recent recognition that most spinal cord injuries are incomplete, and progress in enabling regeneration are generating growing interest in novel rehabilitation therapies. Here we review the 35-year evolution of one promising new approach, operant conditioning of spinal reflexes. This work began in the late 1970's as basic science; its purpose was to develop and exploit a uniquely accessible model for studying the acquisition and maintenance of a simple behavior in the mammalian central nervous system (CNS). The model was developed first in monkeys and then in rats, mice, and humans. Studies with it showed that the ostensibly simple behavior (i.e., a larger or smaller reflex) rests on a complex hierarchy of brain and spinal cord plasticity; and current investigations are delineating this plasticity and its interactions with the plasticity that supports other behaviors. In the last decade, the possible therapeutic uses of reflex conditioning have come under study, first in rats and then in humans. The initial results are very exciting, and they are spurring further studies. At the same time, the original basic science purpose and the new clinical purpose are enabling and illuminating each other in unexpected ways. The long course and current state of this work illustrate the practical importance of basic research and the valuable synergy that can develop between basic science questions and clinical needs.10aH-Reflex10alearning and memory10aLocomotion10aspinal cord injury10aspinal cord plasticity1 aThompson, Aiko, K1 aWolpaw, Jonathan  uhttp://www.ncbi.nlm.nih.gov/pubmed/2467244102554nas a2200241   4500008004100000022001400041245016400055210006900219260001200288300001200300490000800312520178000320653001302100653001502113653001902128653001602147653001502163100002102178700002202199700002102221700002202242856004802264       2014                        eng d  a1522-159800aOperant conditioning of the soleus H-reflex does not induce long-term changes in the gastrocnemius H-reflexes and does not disturb normal locomotion in humans.0 aOperant conditioning of the soleus Hreflex does not induce longt  c09/2014  a1439-460 v1123 a<p>In normal animals, operant conditioning of the spinal stretch reflex or the H-reflex has lesser effects on synergist muscle reflexes. In rats and people with incomplete spinal cord injury (SCI), soleus H-reflex operant conditioning can improve locomotion. We studied in normal humans the impact of soleus H-reflex down-conditioning on medial (MG) and lateral gastrocnemius (LG) H-reflexes and on locomotion. Subjects completed 6 baseline and 30 conditioning sessions. During conditioning trials, the subject was encouraged to decrease soleus H-reflex size with the aid of visual feedback. Every sixth session, MG and LG H-reflexes were measured. Locomotion was assessed before and after conditioning. In successfully conditioned subjects, the soleus H-reflex decreased 27.2%. This was the sum of within-session (task dependent) adaptation (13.2%) and across-session (long term) change (14%). The MG H-reflex decreased 14.5%, due mainly to task-dependent adaptation (13.4%). The LG H-reflex showed no task-dependent adaptation or long-term change. No consistent changes were detected across subjects in locomotor H-reflexes, EMG activity, joint angles, or step symmetry. Thus, in normal humans, soleus H-reflex down-conditioning does not induce long-term changes in MG/LG H-reflexes and does not change locomotion. In these subjects, task-dependent adaptation of the soleus H-reflex is greater than it is in people with SCI, whereas long-term change is less. This difference from results in people with SCI is consistent with the fact that long-term change is beneficial in people with SCI, since it improves locomotion. In contrast, in normal subjects, long-term change is not beneficial and may necessitate compensatory plasticity to preserve satisfactory locomotion.</p>10aLearning10aplasticity10aRehabilitation10aSpinal Cord10asynergists1 aMakihara, Yukiko1 aSegal, Richard, L1 aWolpaw, Jonathan1 aThompson, Aiko, K  uhttp://www.ncbi.nlm.nih.gov/pubmed/2494421601203nas a2200277   4500008004100000022001400041245009000055210006900145260001200214300001000226490000700236520041500243653001200658653002600670653001300696653001100709653001700720653002100737653002400758653001100782653001600793653002500809100002200834700002100856856004800877       2014                        eng d  a1538-300800aThe simplest motor skill: mechanisms and applications of reflex operant conditioning.0 asimplest motor skill mechanisms and applications of reflex opera  c04/2014  a82-900 v423 aOperant conditioning protocols can change spinal reflexes gradually, which are the simplest behaviors. This article summarizes the evidence supporting two propositions: that these protocols provide excellent models for defining the substrates of learning and that they can induce and guide plasticity to help restore skills, such as locomotion, that have been impaired by spinal cord injury or other disorders.10aAnimals10aConditioning, Operant10aH-Reflex10aHumans10aMotor Skills10aMuscle, Skeletal10aNeuronal Plasticity10aReflex10aSpinal Cord10aSpinal Cord Injuries1 aThompson, Aiko, K1 aWolpaw, Jonathan  uhttp://www.ncbi.nlm.nih.gov/pubmed/24508738