Transcutaneous spinal cord stimulation induces temporary attenuation of spasticity in individuals with spinal cord injury.

@article{Hofstoetter2019TranscutaneousSC,
  title={Transcutaneous spinal cord stimulation induces temporary attenuation of spasticity in individuals with spinal cord injury.},
  author={Ursula S. Hofstoetter and Brigitta Freundl and Simon M. Danner and Matthias J. Krenn and Winfried Mayr and H. Binder and Karen Minassian},
  journal={Journal of neurotrauma},
  year={2019}
}
Epidural spinal cord stimulation (SCS) is currently regarded as a breakthrough procedure for enabling movement after spinal cord injury (SCI), yet one of its original applications was for spinal spasticity. An emergent method that activates similar target neural structures noninvasively is transcutaneous SCS. Its clinical value for spasticity control would depend on inducing carry-over effects, because the surface-electrode-based approach cannot be applied chronically. We evaluated single… 

Efficacy of Transcutaneous Spinal Stimulation versus Whole Body Vibration for Spasticity Reduction in Persons with Spinal Cord Injury

TLDR
Transcutaneous spinal stimulation and whole-body vibration are feasible physical therapeutic interventions for the reduction of spasticity, with persistent effects.

Immediate Effects of Transcutaneous Spinal Cord Stimulation on Motor Function in Chronic, Sensorimotor Incomplete Spinal Cord Injury

TLDR
Investigating the immediate effects during single-sessions of tonic tSCS on ankle control, spinal excitability, and locomotion in ten individuals with chronic, sensorimotor iSCI found the three with the lowest as well as the one with the highest walking function scores showed positive stimulation effects, including increased maximum walking speed, or more continuous and faster stepping at a self-selected speed.

High-Frequency Stimulation Does Not Improve Comfort of Transcutaneous Spinal Cord Stimulation

TLDR
High-frequency tSCS is equally as comfortable as conventional stimulation at amplitudes required to stimulate spinal dorsal roots, and is less efficient in recruiting neural activity in spinal roots.

Transcutaneous Spinal Cord Stimulation Enhances Quadriceps Motor Evoked Potential in Healthy Participants: A Double-Blind Randomized Controlled Study

TLDR
The main aim of the present study is to quantify the effect of a single session of tSCS on lower limb motor evoked potentials (MEPs) in healthy participants to reflect optimal excitation of this motor response at the interneuronal or motoneuronal level.

Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review

TLDR
The two most promising noninvasive spinal cord electrical stimulation methods of SCI rehabilitation treatment, namely, trans-spinal direct current stimulation (tsDCS) and trans-Spinal pulsed current stimulating (tsPCS) are summarized.

Voluntary Modulation of Evoked Responses Generated by Epidural and Transcutaneous Spinal Stimulation in Humans with Spinal Cord Injury

TLDR
The results suggest that descending commands combined with spinal stimulation may increase activity of inhibitory interneuronal circuitry within spinal sensorimotor networks in individuals with SCI, which may be relevant in the context of regaining functional motor outcomes.

Transcutaneous Spinal Cord Stimulation Enhances Walking Performance and Reduces Spasticity in Individuals with Multiple Sclerosis

TLDR
The results suggest that transcutaneous lumbar SCS can serve as a clinically accessible method without known side effects that holds the potential for substantial clinical benefit across the disability spectrum of MS.

Influence of Spine Curvature on the Efficacy of Transcutaneous Lumbar Spinal Cord Stimulation

TLDR
Spinal flexion reduced the capacity of the stimulation to activate afferent fibers and led to the co-activation of motor fibers in the anterior roots, which recommended applying transcutaneous spinal cord stimulation in body positions that allow individuals to maintain a neutral or extended spine.

Effect of Cervical Transcutaneous Spinal Cord Stimulation on Sensorimotor Cortical Activity during Upper-Limb Movements in Healthy Individuals

TLDR
It is demonstrated that a single 10 min session of tSCS delivered to the cervical region of the spine was not sufficient to induce consistent changes in sensorimotor cortical activity among the entire cohort, suggesting that under high intensities there may be an inhibitory effect at the cortical level.

Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications

TLDR
An automated tSCS setup is devised by combining an electrode array placed over low-thoracic to mid-lumbar vertebrae, synchronized EMG recordings, and a self-operating stimulation protocol to systematically test various stimulation sites and amplitudes.
...

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