For individuals with motor complete spinal cord injury (SCI), previous works have shown that spared motor neurons below the injury level can still be voluntarily controlled. In this study, we investigated the behavior of these neurons after SCI by analyzing neural and spatial properties of individual motor units using high-density surface electromyography (HDsEMG) and ultrasound imaging. The dataset for this study is based on motor unit data from our previous work (Oliveira et al. Brain 147: 3583-3595, 2024). Eight participants with chronic motor complete SCI and twelve uninjured controls attempted multiple hand movements, guided by a virtual hand, while we recorded forearm muscle activity. We analyzed the common synaptic input to motor neurons with a factorization method and found two dominant motor unit modes in both the SCI and control groups. Each mode was strongly correlated with the virtual hand's flexion or extension movements. The delay between flexion and extension movements and the motor unit modes was similar between groups, suggesting preserved common input to motor neurons after SCI. We classified motor units into task-modulated or nonmodulated (i.e., tonic or irregularly firing) based on their discharge patterns and phase difference with virtual hand kinematics and found a higher proportion of nonmodulated motor units in the SCI group. At the motor unit action potential level, we found larger motor unit territories after SCI. Finally, we observed distinct movements of paralyzed muscles with concurrent HDsEMG and ultrasound imaging, indicating the presence of highly functional motor units with distinct spared territories after SCI.NEW & NOTEWORTHY Here, we observed a similar pattern of motor unit activation during attempted hand movements in individuals with complete SCI, who cannot move their fingers, and in a control group, who performed the prescribed movements. Despite differences in individual motor unit behavior between these groups, such as a higher proportion of nonmodulated motor units in SCI, movement intention can still be decoded from paralyzed muscles.
Keywords: high-density surface electromyography; motor neuron; motor unit; spinal cord injury.