At Verita Neuro, our mission has always been to bring the most promising advancements in spinal cord injury treatment directly to patients. We’re proud to announce the publication of “Time Course of Motor Improvement by Epidural Stimulation After Spinal Cord Injury: An Interim Analysis of a Phase II Trial” on April 5th 2025, a peer-reviewed study authored by members of Verita Neuro’s Medical Board. The authors include Hanna Charles (Chief Growth Officer and Director of Patient Services), Dr. Nasir Majeed (Medical Director and Head of R&D), and Prof. Dr. Guilherme Lepski (Neurosurgeon and Neurosurgical Advisor to Verita Neuro), together with 12 international collaborators.
Below, Hanna shares her commentary on the study’s most promising findings and why this Epidural Stimulation research represents an important step forward in spinal cord injury recovery.
Leading the Future of Neurological Recovery
In the ever-evolving field of neuroinnovation, Verita Neuro stands as a pioneer, pushing the boundaries of what’s possible for individuals living with paralysis. For over a decade, we’ve been at the forefront of neuromodulation treatments, offering our proprietary Epidural Stimulation treatment to spinal cord injury patients from more than 50 countries.
Our mission has always been to restore independence and potential through cutting-edge science, and today we’re proud to share a milestone that validates this work: the publication of our research in the Journal of Central Nervous System Disease.
Conducted in collaboration with the University of São Paulo under the expert guidance of Prof. Dr. Guilherme Lepski, a brilliant Neurosurgeon and key member of Verita Neuro’s Medical Board, this Phase II trial provides compelling evidence of Epidural Stimulation’s power in restoring motor function after spinal cord injury.
Since our inception, we’ve focused on developing and refining Epidural Stimulation. This isn’t just theoretical, it’s a proven modality that has helped hundreds regain independence and quality of life. While traditional rehabilitation often falls short for those with severe injuries, our approach reactivates dormant neural pathways, fostering neuroplasticity and enabling meaningful recovery.
What Is Epidural Stimulation and How Does It Work?
Epidural Stimulation is a neuromodulation treatment that involves the surgical implantation of a small, programmable spinal cord stimulator within the spinal canal. The placement of the electrode varies depending on the patient’s level of injury and in some cases, quadriplegic patients may receive two stimulators to target both upper and lower limb functions.
The device acts as a bridge, amplifying or reactivating signals from the brain to the body below the injury level, helping restore voluntary control and coordination. Once implanted, each patient’s program is personalized through a process known as “mapping,” where our Physical Therapists and Neurorehabiliation Specialists calibrate electrical parameters to elicit optimal muscle responses.
Unlike traditional rehabilitation, which focuses mainly on strengthening existing muscle responses, Epidural Stimulation directly activates spinal cord neural circuits. This encourages neuroplasticity, which is the nervous system’s ability to form new connections, leading to improved movement, control, and sensation.
Following implantation, patients at Verita Neuro typically undergo around 35 days of intensive physiotherapy and mapping to relearn movement and regain autonomy at a pace that aligns with their progress.
This latest Verita Neuro publication is the first of many scientific confirmations that Epidural Stimulation is not only effective but represents the most advanced treatment available worldwide for spinal cord injury recovery.
Inside the Study: A Milestone in Spinal Cord Injury Research
Study Design and Participants
Titled “Time Course of Motor Improvement by Epidural Stimulation After Spinal Cord Injury: An Interim Analysis of a Phase II Trial,” the research involved five male patients aged 32–44, all living with chronic thoracic spinal cord injury (classified ASIA A or B). They had been living with paralysis for an average of 34 months before enrollment.
Under Prof. Lepski’s oversight, the University of São Paulo team implanted the same Epidural Stimulation devices used in Verita Neuro’s clinical practice (Medtronic Intellis generator). Patients then followed a structured rehabilitation program, with stimulation parameters adjusted daily using real-time electromyography feedback.
This is the clinical term for what we refer to as “mapping” at Verita Neuro, where we use electromyography to record muscle activity and refine stimulator settings. Clinicians identify the exact current strength and pulse frequency that produce coordinated, functional movements. This data-driven process ensures each patient’s stimulation pattern is unique to their body’s responses. This research protocol mirrored Verita Neuro’s clinical practice.
Measured Outcomes and Key Results
The primary outcome was motor recovery, measured using the Fugl-Meyer Lower Extremity (FMA-LE) scale. This is a globally recognized neurological scale for evaluating motor recovery, coordination, and reflex control. Scores were measured at baseline (the start of treatment, before implantation) and again at three, six, and twelve months to track recovery over time.
The study’s participants demonstrated significant gains: from 36 ± 9 at baseline to 55 ± 2 at three months, 59 ± 2 at six months, and 64 ± 4 at twelve months. All results were considered statistically significant (P < 0.05). This translates to a 78 percent improvement overall, with motor recovery plateauing around month five at roughly 68 percent above baseline. Increases of this magnitude represent tangible improvements in voluntary movement and quality of life.
Electromyography mapping confirmed heightened voluntary muscle activation, even when stimulation was turned off, suggesting long-term neuroplastic changes.
Secondary outcomes were equally strong: balance improved (Berg Balance Scale, P < 0.001) and spasticity decreased (Modified Ashworth Scale, P < 0.05). No serious adverse events occurred; only transient pain and one self-resolving pressure ulcer were noted.
Predicting Recovery with Mathematical Modelling
What makes this study particularly groundbreaking is its use of mathematical modelling to map each patient’s recovery curve and predict improvement over time. Using the Gompertz three-parameter model, researchers observed rapid motor movement gains in the first two months, averaging around five Fugl-Meyer points per month, before recovery began to stabilize around month five.
This data-driven approach provides clinicians with valuable insight for planning rehabilitation programs. It suggests that intensive rehabilitation efforts are most important within the first six months after implantation, when patients experience the fastest rate of improvement. This interim analysis aligns perfectly with our broader clinical experience at Verita Neuro’s centres in Thailand and Mexico.
It also reinforces that recovery remains possible years after injury, challenging the long-held belief that progress stops after the first year. All patients in the study had been living with paralysis for an average of 34 months before treatment, yet the model held consistently across all five participants.
Real World Impact and Future Directions
At Verita Neuro, we view Epidural Stimulation as more than a treatment; it is a gateway to a fuller life. Our proprietary approach has consistently delivered a wide range of improvements for spinal cord injury patients, such as:
- Return of voluntary movement: Many regain control over limbs that were previously unresponsive.
- Returned ability to stand and take steps: With assistance initially, patients often progress to independent mobility.
- Ability to use upper limbs again: Enhancing daily activities and independence.
Improved strength and stamina: Building endurance for sustained activity. - Increased sensation: Restoring feeling below the injury level.
- Improved body temperature regulation: Addressing common autonomic challenges.
- Stabilizing blood pressure: Reducing risks such as orthostatic hypotension.
- Improved bladder and bowel control: Promoting dignity and health.
- Relief from neuropathic pain: Alleviating chronic discomfort.
Prof. Dr. Guilherme Lepski’s involvement underscores Verita Neuro’s commitment to rigorous, collaborative science. As a renowned Neurosurgeon on our Medical Board, he brings exceptional expertise, ensuring that every Verita Neuro protocol is safe, effective, and grounded in evidence. This partnership with the University of São Paulo exemplifies how academic research and clinical innovation come together to advance patient care.
While this trial is ongoing, with a target of ten participants, the interim findings already reinforce what we observe daily across our international centres: Epidural Stimulation is life changing.
These insights also provide a framework for optimising therapy schedules and understanding patient-specific plateaus. They continue to inform how our medical teams structure rehabilitation programs at Verita Neuro Thailand and Mexico.
Looking ahead, this publication paves the way for broader adoption and deeper research. Our team is now exploring the integration of Epidural Stimulation with regenerative protocols such as LamiSpine, our proprietary stem-cell-based spinal repair treatment, to extend recovery potential beyond current limits.
Every milestone like this brings us closer to redefining what is possible for the 15 million people who are impacted by spinal cord injury, worldwide. As global awareness grows and scientific collaboration expands, we remain committed to translating every discovery into meaningful change. As ever, our goal remains to make the latest scientific innovations available to patients today.
If you are inspired by these advancements or seeking options for yourself or a loved one, Verita Neuro is here to help. Our centres in Thailand and Mexico provide world-class care, drawing patients from across the globe.
References:
- Porceban, M. M., Angelin, L. G., Gabana, E., Prota, C., De Byase, M. E. M., Ferreira, R. J. R., … Charles, H. (2025). Time Course of Motor Improvement by Epidural Stimulation After Spinal Cord Injury: An Interim Analysis of a Phase II Trial. Journal of Central Nervous System Disease. https://journals.sagepub.com/doi/full/10.1177/11795735251379220
PubMed+1 - “Fugl-Meyer Assessment of Motor Recovery after Stroke.” (n.d.). Physio-Pedia. Retrieved from https://www.physio-pedia.com/Fugl-Meyer_Assessment_of_Motor_Recovery_after_Stroke
Physiopedia+1 - Chavarro, P., & Chalif, C. (2017). The use of Gompertz models in growth analyses and new Gompertz-model approach: An addition to the Unified-Richards family. ResearchGate. https://www.researchgate.net/publication/317352708_The_use_of_Gompertz_models_in_growth_analyses_and_new_Gompertz-model_approach_An_addition_to_the_Unified-Richards_family
ResearchGate - World Health Organization (2024, April 16). Spinal cord injury – Fact sheet. https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury
