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Review Article | DOI: https://doi.org/10.31579/2690-1897/273
Grodno State Medical University, Gorkogo St, Grodno, Republic of Belarus
*Corresponding Author: Elizaveta I Bon, Candidate of biological science, Assistant professor of pathophysiology department named D. A. Maslakov, Grodno State Medical University; Grodno State Medical University, 80 Gorky St,230009, Grodno, Belarus.
Citation: Bon E. I., Maksimovich N.Ye., Sokol V.A., Lichvan N.V., (2025), Mechanisms of Locomotion, J, Surgical Case Reports and Images, 8(8); DOI:10.31579/2690-1897/273
Copyright: © 2025, Elizaveta I Bon. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 03 September 2025 | Accepted: 12 September 2025 | Published: 16 September 2025
Keywords: locomotion; spinal generator; motoneurons
The activity pattern of various limb muscles during locomotion is primarily determined by the operation of the spinal generator. The flexor and extensor half-centers activate corresponding motoneurons of flexor and extensor muscles. It can be assumed that motoneurons of biarticular muscles receive activating inputs from both half-centers, but a stronger influence from the flexor half-center, which explains their predominant activity during the flexion phase at low locomotion intensity. As for the motoneurons of the extensor digitorum brevis and extensor digiti quinti, their connection to the half-centers is likely organized in a more complex manner. During locomotion in mesencephalic cats, as expected, individual α-motoneurons generate bursts of impulses in one movement phase and remain inactive in the other. In steady-state locomotion, the average inter-spike interval within a burst range from 25 to 40 ms. Only at the beginning or end of a motor episode can this interval increase.
Locomotion in a broad sense is understood as a set of coordinated movements by means of which animals actively move in space. In four-legged mammals, for example, various types of locomotion are observed: walking, running, galloping, jumping, climbing, crawling, swimming, and others [1].
During locomotion, the central nervous system of the animal is faced with the need to solve the following main tasks:
In this article, the nervous control of rhythmic limb movements during terrestrial locomotion of four-legged mammals (cats, dogs, rabbits), mainly during walking and running, will be considered, i.e. some mechanisms of the nervous system's solution of the second and third tasks will be touched upon. Therefore, in the following, the term locomotion will be used in a narrower sense - to denote coordinated stereotyped movements of the limbs during walking and running. Information on the kinematics of locomotor movements of the limbs in vertebrates and on the activity of various muscles underlying these movements can be found in literature reviews by Grillner, Schick, and Orlovsky. They also review the neural mechanisms of vertebrate locomotion. Stein's review analyzes numerous data on the neural control of locomotion not only in vertebrates but also in invertebrates. To facilitate consideration of the mechanisms of neural control of locomotion, the general scheme of the organization of the control system of these movements will be outlined first, followed by the mechanisms of functioning of its individual links. In this article, the nervous control of rhythmic limb movements during terrestrial locomotion of four-legged mammals (cats, dogs, rabbits), mainly during walking and running, will be considered, i.e. some mechanisms of the nervous system's solution of the second and third tasks will be touched upon. Therefore, in the following, the term locomotion will be used in a narrower sense - to denote coordinated stereotyped movements of the limbs during walking and running. Information on the kinematics of locomotor movements of the limbs in vertebrates and on the activity of various muscles underlying these movements can be found in literature reviews by Grillner, Schick, and Orlovsky. They also review the neural mechanisms of vertebrate locomotion. Stein's review analyzes numerous data on the neural control of locomotion not only in vertebrates but also in invertebrates.
To facilitate consideration of the mechanisms of neural control of locomotion, the general scheme of the organization of the control system of these movements will be outlined first, followed by the mechanisms of functioning of its individual links.
Currently, the control system for locomotor movements is presented as follows:
Tonic Control of Spinal Locomotor Centers
Decorticate, thalamic, and hypothalamic animals (with the caudal hypothalamus preserved) demonstrate the ability for spontaneous locomotion in acute experiments. Intact animals under light anesthesia also exhibit spontaneous locomotor activity. However, decerebrated cats, in which the caudal hypothalamus remains rostral to the transection site, are incapable of spontaneous locomotion in acute experiments. Voluntary locomotion is also impossible in non-anesthetized cats with lesioned caudal hypothalamus, though this ability recovers after several weeks.
In chronic experiments, mesencephalic cats (with brainstem transection extending from the anterior edge of the superior colliculi to the posterior border of the mammillary bodies) and animals with intercollicular decerebration also show restored spontaneous locomotion [7]. Animals with transections at lower levels display no spontaneous locomotor activity in either acute or chronic phases [8]. These experiments indicate that structures in the caudal hypothalamus and midbrain play a key role in initiating and maintaining locomotion [9]. Electrical stimulation experiments of various brainstem regions have further localized the structures responsible for activating the spinal locomotor generator. Tonic stimulation of the *nucleus subtalamicus* in intact and decerebrated animals was found to elicit locomotor movements. This region was termed the hypothalamic locomotor region (HLR).
In acute experiments, electrical stimulation of an area ventral to the inferior colliculi—approximately corresponding to the *nucleus cuneiformis*—induces locomotor movements in mesencephalic cats. In intact cats with lesioned HLR, stimulation of this mesencephalic locomotor region (MLR) also triggers locomotion. In thalamic cats, MLR lesions do not prevent spontaneous or HLR-stimulated locomotion, though their spontaneous motor activity is significantly reduced. The optimal stimulation frequency for evoking locomotion is 30–60 Hz. Increasing current intensity results in more vigorous locomotion, even transitioning from walking to galloping.
However, HLR and MLR are not functionally equivalent. Animals with intact HLR exhibit spontaneous locomotion, and after immobilization, rhythmic activity is recorded in motor nerves (**fictive locomotion**). In the absence of HLR (e.g., in mesencephalic cats during acute experiments), spontaneous locomotion does not occur—movement is only elicited by MLR stimulation, and no fictive locomotion is observed.
The functional distinctions between HLR and MLR are further evident in stimulation experiments on hypothalamic cats:
The underlying mechanisms remain incompletely understood. A partial explanation lies in the stronger tonic descending drive in thalamic animals compared to mesencephalic cats, which provides greater activation of spinal locomotor centers.
Alternative Locomotion Pathways In mesencephalic cats, locomotion can also be elicited by stimulating pyramidal tract fibers at the pontine level (provided the bulbar pyramids are transected beforehand). Notably, lesioning the most effective part of the MLR in such cases does *not* prevent locomotion. These findings suggest that the pyramidal tract, HLR, and MLR are facultative for locomotion: disabling any two of them still allows locomotion to be evoked by stimulating the third. Moreover, their effects are additive.
Locomotor activity can also be induced by:
The "Locomotor Strip"
Microstimulation studies revealed that in cats, the MLR extends caudally as a locomotor strip, reaching the C1 spinal segment. Stimulation of this strip (10–15 μA current) evokes locomotion.
The strip’s trajectory does not fully overlap with any known descending tract. It is likely associated with the locus coeruleus (*n. coeruleus*), whose noradrenergic neurons project to the spinal cord.
Synaptic Mechanisms
MLR stimulation induces transsynaptic activation of other descending systems. For example, reticulospinal neurons can be monosynaptically activated by MLR stimulation. The critical role of MLR’s synaptic connections is underscored by experiments where a brainstem transection at A-2 (Horsley-Clarke coordinates) — sparing the MLR itself — *completely blocks* locomotion. This implies that structures *rostral* to the MLR are essential for initiating locomotion in mesencephalic cats.
Direct Hypothalamospinal Pathway
Kuypers and Maisky discovered a direct descending pathway from the caudal hypothalamus to the spinal cord, originating in the *zona incerta*. Given its proximity to HLR, this tract may mediate spinal locomotor activation during HLR stimulation. Integrated Network Activation Stimulation of both HLR and the transected bulbar pyramids triggers transsynaptic activation of brainstem descending systems. This aligns with known extensive connections between:
Supporting evidence includes monosynaptic activation of pontomedullary reticulospinal neurons during HLR stimulation.
Thus, the corticofugal tract, hypothalamic locomotor region (HLR), and mesencephalic locomotor region (MLR) should be considered input nodes for descending systems that directly activate spinal locomotor centers. According to a widely accepted (though not yet definitively proven) hypothesis, these descending systems are **monoaminergic tracts**—supported by extensive indirect evidence.
Monoaminergic Systems and Spinal Locomotion
The cell bodies of monoaminergic neurons are located in the brainstem (pons and medulla), with their axons projecting to the spinal cord. To simulate their physiological effects, animals are typically administered precursors of norepinephrine (NE) and serotonin (5-HT) synthesis, which are believed to increase neurotransmitter release from monoaminergic terminals.
- L-DOPA induces a characteristic reorganization of spinal reflexes, similar to that observed in:
1) Hypothalamic animals with spontaneous locomotion,
2) Mesencephalic animals during MLR stimulation.
Pharmacological Modulation of Locomotion
- NE receptor blockers:
- 5-HTP (5-hydroxytryptophan, a serotonin precursor):
While there is strong evidence that noradrenergic (and likely serotonergic) descending systems activate spinal locomotor centers during locomotion, the primary role of NE has been questioned:
The data suggest that:
This aligns with the view that multiple parallel pathways ensure robust locomotor control, with redundancy in neuromodulatory activation.
Interestingly, L-DOPA enhances rhythmic discharges in extensor nerves while reducing their amplitude in flexor nerves in immobilized, lightly anesthetized rabbits. In contrast, 5-HTP exerts the opposite effect. This suggests that:
Potential Role of Fast-Conducting Descending Pathways
The contribution of tonic activation in fast-conducting descending systems (e.g., **rubro-, vestibulo-, and reticulospinal tracts**) cannot be ruled out, as their activity increases during locomotion. Notably:
- The dorsolateral reticulospinal system (comprising thin myelinated fibers) elicits effects similar to L-DOPA and 5-HTP.
- Key difference: Unlike monoaminergic agents, its activation does not induce late, prolonged discharges in motor nerves upon stimulation of group II afferents.
Spinal Mechanisms of Monoaminergic Action
The precise spinal mechanisms remain unclear:
Plasticity in Chronic Spinal Animals
A comparable disinhibition mechanism may operate in chronic spinal animals:
Spinal locomotor centers are also strongly influenced by nonspecific afferent inputs:
Summary of Key Findings
Activating and Inhibitory Control of Locomotion
Potentiation of Locomotor Rhythm by Afferent Inputs
The most pronounced activating effects arise from stimulation of thin, high-threshold afferents [10]. These nonspecific afferent inputs exhibit effective summation with descending monoaminergic activation:
In both decerebrated and spinal animals (after L-DOPA administration), nonspecific peripheral stimulation increases the intensity and frequency of the locomotor rhythm [11].
Proposed mechanisms:
*Primary hypothesis*: Afferent input, like descending monoaminergic fibers, may inhibit inhibitory spinal interneurons, indirectly disinhibiting the locomotor generator.
*Alternative*: Direct excitatory effects on generator neurons cannot be ruled out [12].
Termination of Locomotion: Known Inhibitory Mechanisms
For effective locomotor control, the system must initiate, sustain, and halt movement. However, data on locomotion suppression remain sparse.
Documented inhibitory methods include:
Mechanical pressure on the dorsolumbar/sacral region.
Low-frequency (3–4 Hz) photic stimulation in lightly anesthetized, immobilized intact rabbits (suppresses rhythmic motor nerve discharges).
Stimulation of specific pontomedullary areas during MLR-induced locomotion.
Thalamic Modulation of Locomotion
Grossman’s findings:
Stimulation of nonspecific thalamic nuclei inhibits HLR-induced locomotion without causing atonia or spasticity, suggesting a locomotion-specific inhibitory pathway.
Critical Knowledge Gaps
While progress has been made in understanding locomotor initiation, the mechanisms underlying its precise termination require urgent investigation.
Key questions:
How do pontomedullary and thalamic inhibitory signals integrate with spinal circuits?
Do afferent and descending inhibitory pathways converge on shared spinal interneurons?
Spinal Locomotor Generator Of A Single Limb: Organization Of Motor Output
1. Brown's Hypothesis and Basic Organization
The spinal locomotor generator is conceptualized based on Brown's hypothesis [13], which proposes that:
2. Central Locomotor Program in Fictive Locomotion
Studies in immobilized thalamic cats during fictive locomotion reveal [14]:
3. Afferent Modulation in Intact and Mesencephalic Cats
4. Intensity vs. Frequency Dissociation
- Increased fictive locomotion intensity does not always raise step-cycle frequency.
- Explanation:
5. Complex Activation Patterns in Multiarticular Muscles
Muscles with dual functions (e.g., m. semitendinosus, m. peroneus tertius) exhibit intensity-dependent programming:
- High-intensity locomotion:
6. Digit Flexors: Phase-Shifting Activation
- Extensor digitorum brevis & digiti quinti (physiological digit flexors):
7. Consistency Across Preparations
Patterns observed in fictive locomotion align with data from:
Thus, the activity pattern of various limb muscles during locomotion is primarily determined by the operation of the spinal generator. The flexor and extensor half-centers activate corresponding motoneurons of flexor and extensor muscles. It can be assumed that motoneurons of biarticular muscles receive activating inputs from both half-centers, but a stronger influence from the flexor half-center, which explains their predominant activity during the flexion phase at low locomotion intensity. As for the motoneurons of the extensor digitorum brevis and extensor digiti quinti, their connection to the half-centers is likely organized in a more complex manner. During locomotion in mesencephalic cats, as expected, individual α-motoneurons generate bursts of impulses in one movement phase and remain inactive in the other. In steady-state locomotion, the average inter-spike interval within a burst range from 25 to 40 ms. Only at the beginning or end of a motor episode can this interval increase. The average inter-spike interval characteristic of a given neuron shows little dependence on locomotion intensity. An increase in movement intensity is primarily accompanied by the recruitment of new motoneurons. Further studies have revealed that the impulse burst of an individual motoneuron usually begins with one or two short inter-spike intervals (≤10 ms), followed by impulses with intervals of 25-40 ms.With an increase in the locomotor rhythm frequency, a shortening of the impulse burst is observed, but the described structure of inter-spike intervals is preserved. Stimulation of individual motor axons has shown that the maximum tension developed by a motor unit is achieved precisely with this structure of inter-spike intervals in the stimulating series. Moreover, the magnitude of the developed tension does not depend on the duration of the stimulating series. Thus, the initial high-frequency discharges ensure rapid tension development, while subsequent ones maintain it at a constant level. This organization of motoneuron discharge is likely particularly important during fast locomotion, when the extension phase lasts only 65 ms. An analogous discharge pattern of motoneurons is also observed during fictive locomotion in spinal animals. This indicates that the described activity characteristics of motoneurons are independent of afferent influences and are likely associated with specific features of the impulse patterns generated by the central pattern generator neurons. However, it cannot be ruled out that recurrent inhibition mechanisms or intrinsic properties of motoneurons may also contribute to the formation of such discharge patterns.
Numerous studies have demonstrated α-γ coactivation during locomotion - the simultaneous activation of α-motoneurons and homonymous γ-motoneurons. During spontaneous locomotion in decorticated cats, γ-activation typically precedes α-activation. In cases of limb deafferentation, γ-activation can occur even in the absence of α-activation, indicating that γ-motoneurons are more sensitive to central commands compared to α-motoneurons.
Fusimotor activation involves both static and dynamic γ-motoneurons. However, the ratio of static to dynamic γ-motoneuron activation differs between flexor and extensor muscles. In flexor muscles, the static effect of γ-motoneurons on muscle spindle sensory endings predominates and masks the dynamic effect. In extensor muscles, along with the static effect, a pronounced dynamic action is observed. In terms of impulse activity patterns, γ-motoneurons differ significantly from α-motoneurons. During locomotion in decorticated, mesencephalic, and spinal cats, the discharge frequency of γ-motoneurons shows strong dependence on movement intensity: higher locomotion intensity corresponds to higher discharge frequencies. This in turn leads to increased firing rates of muscle spindle afferents. Although α-motoneurons have a mechanism of recurrent inhibition, its role and dynamics (tonic and phasic changes) during locomotion remain incompletely understood. It is known that:
Although the reflex action of Ia afferents weakens during activation of spinal locomotor centers, it can be assumed that afferent input plays a key role in suppressing recurrent inhibition: in spinal cats after DOPA administration; during locomotion in mesencephalic animals.
This is supported by data showing that:
Most Renshaw cells exhibit burst activity during fictive locomotion: bursts occur in a specific phase of locomotion at a frequency of 5–15 imp/s; in the opposite phase, the neurons are inactive.
Studies of recurrent IPSPs in motoneurons have shown that during fictive locomotion, phasic inhibition of Renshaw cells is absent; the observed fluctuations in IPSP amplitudes may be associated with changes in membrane potential during periodic burst activity of motoneurons.
Thus, during fictive locomotion in thalamic cats, the efficacy of recurrent inhibition of α-motoneurons remains unchanged. However, the question of possible tonic changes in the efficacy of recurrent inhibition in thalamic animals compared to spinal ones remains open [18]. It is known that γ-motoneurons also undergo recurrent inhibition from Renshaw cells. This phenomenon has been described in spinal cats after DOPA administration. However, there is a lack of data in the literature: on changes in the efficacy of recurrent inhibition of γ-motoneurons following DOPA administration; on its dynamics during locomotion. The question of modulation of recurrent inhibition in Ia interneurons during locomotion also remains unresolved. Feldman and Orlovsky, in studies on four Ia interneurons in mesencephalic cats, found that:
These data suggest possible selectivity in the modulation of recurrent inhibition across different neuronal populations during motor activity.
1. Membrane Potentials of Motoneurons During Locomotion
Intracellular recordings of α-motoneuron activity during fictive locomotion revealed:
In spinal animals after DOPA administration:
2. Role of Renshaw Cells in Locomotor Switching
The obtained data suggest that phasic activity of Renshaw cells may participate in switching between flexor and extensor motoneurons. This is supported by the ability of ventral root stimulation to induce a switch from flexor to extensor activity [20].
3. Evolution of Brown’s Hypothesis
The original concept by Brown proposed:
Further developments:
- Three groups of interneurons were identified in the lateral intermediate zone and ventral horns:
- Interneurons of Groups I and II were identified as Brown’s half-centers
- Proposed organization:
4. Modern Views on the Neural Organization of the Generator
Subsequent studies confirmed and expanded these concepts:
- During real (mesencephalic cats) and fictive locomotion (spinal and thalamic cats), the following were identified:
- Main groups of rhythmic interneurons:
Key features:
These findings support the concept of a distributed interneuron network as the basis of the spinal locomotor generator, where activity coordination is ensured by complex interactions between different neuronal populations.
1. Topographic Distribution of Rhythmically Active Interneurons
Studies have revealed that neurons altering their activity during fictive or real (after deafferentation) locomotion are predominantly localized in the same spinal cord regions where Jankowska et al. previously identified interneurons responding to late discharges upon stimulation of group I afferents (Ia afferents). Key observations:
2. Principles of Afferent Input Organization
These findings highlight the structured yet flexible organization of the spinal locomotor network, where distinct interneuron populations integrate specific afferent inputs to coordinate locomotor output. The differential recruitment of interneurons based on their afferent connectivity further supports the distributed and hierarchical nature of the central pattern generator (CPG) for locomotion.
3. Contralateral Influences
Characteristic response patterns to contralateral stimulation:
At the same time, both groups contain units with the opposite type of response
4. Data from Studies on Decorticated Rabbits [24]
Research on spontaneous fictive locomotion in immobilized decorticated rabbits revealed a proposed dorsoventral organization:
However, it should be noted that such strict stratification has not yet been confirmed in other experimental models.
Summary of Findings
The obtained data emphasize the complex yet orderly organization of interneuron networks in the spinal locomotor generator, where:
1. Confirmation of the Half-Center Concept
The body of experimental data generally supports the hypothesis of flexor and extensor half-centers while revealing additional aspects of their organization:
These findings highlight the dynamic and hierarchical nature of spinal locomotor circuits, where both intrinsic rhythm-generating mechanisms and afferent/descending modulation shape locomotor output. The presence of species-specific adaptations further suggests evolutionary flexibility in the organization of central pattern generators (CPGs).
2. Heterogeneity of Temporal Characteristics
Differences in the temporal parameters of interneuron activation may be explained by:
3. Mechanisms of Half-Center Switching
Modern data refine Brown’s original hypothesis:
A. Critique of the Passive Fatigue Concept
- Activity switching is likely an active process
- The primary mechanism may involve presynaptic inhibition:
B. Experimental Evidence [25]
4. Future Research Directions
Key areas requiring clarification:
Current evidence positions the spinal locomotor generator as a self-regulating system where:
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Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
