02512nas a2200193   4500008004100000022001400041245009200055210006900147260001600216300002200232520181300254100002402067700002202091700002102113700002202134700001902156700002502175856011802200       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://www.neurotechcenter.org/publications/2026/neurorehabilitation-21st-century-new-science-new-strategies-new01902nas a2200241   4500008004100000245011900041210006900160300000800229490000800237520107300245100002401318700001701342700002101359700002501380700001301405700002201418700002301440700002401463700002201487700002101509700001101530856011901541       2025                        eng d00aSoleus H-reflex size versus stimulation rate in the presence of background muscle activity: a methodological study0 aSoleus Hreflex size versus stimulation rate in the presence of b  a2150 v2433 aHoffmann reflex (HR) operant conditioning (HROC) is an important intervention for neurorehabilitation. Current HROC paradigms elicit HRs at low rates (~ 0.2 Hz), minimizing rate-dependent depression (RDD). We investigated the impact of higher stimulation rates on HR size. Fifteen healthy participants maintained low background soleus electromyographic activity (EMG) while standing. Soleus HR and M-wave recruitment curves were obtained at rates of 0.2, 1, and 2 Hz twice, from which Mmax and Hmax were calculated. Seventy-five HRs were collected for each rate at a target M-wave size (~ 10 to 20% of Mmax). HR depression was minimal at higher stimulation rates. The mean HR amplitude was reliable across the two repetitions and three rates, with high intraclass correlation coefficient (ICC) values. HROC could be performed consistently at rates up to 2 Hz with minimal HR depression. Faster rates enable more conditioning trials per session, reducing session duration and/or number, thereby potentially accelerating conditioning and reducing participant burden.1 aBrangaccio, Jodi, A1 aGupta, Disha1 aMojtabavi, Helia1 aHardesty, Russell, L1 aHill, NJ1 aCarp, Jonathan, S1 aGemoets, Darren, E1 aVaughan, Theresa, M1 aNorton, James, JS1 aPerez, Monica, A1 aothers  uhttps://www.neurotechcenter.org/publications/2025/soleus-h-reflex-size-versus-stimulation-rate-presence-background