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Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review

Spinal cord injury (SCI) is a debilitating condition that can significantly affect an individual’s life, causing paralysis, autonomic dysreflexia, and chronic pain. Transspinal stimulation (TSS) is a non-invasive form of neuromodulation that activates the underlying neural circuitries of the spinal...

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Autores principales: Rehman, Muhammad Uzair, Sneed, Dustin, Sutor, Tommy W., Hoenig, Helen, Gorgey, Ashraf S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917510/
https://www.ncbi.nlm.nih.gov/pubmed/36769503
http://dx.doi.org/10.3390/jcm12030854
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author Rehman, Muhammad Uzair
Sneed, Dustin
Sutor, Tommy W.
Hoenig, Helen
Gorgey, Ashraf S.
author_facet Rehman, Muhammad Uzair
Sneed, Dustin
Sutor, Tommy W.
Hoenig, Helen
Gorgey, Ashraf S.
author_sort Rehman, Muhammad Uzair
collection PubMed
description Spinal cord injury (SCI) is a debilitating condition that can significantly affect an individual’s life, causing paralysis, autonomic dysreflexia, and chronic pain. Transspinal stimulation (TSS) is a non-invasive form of neuromodulation that activates the underlying neural circuitries of the spinal cord. Application of TSS can be performed through multiple stimulation protocols, which may vary in the electrodes’ size or position as well as stimulation parameters, and which may influence the response of motor functions to the stimulation. Due to the novelty of TSS, it is beneficial to summarize the available evidence to identify the range of parameters that may provide the best outcomes for motor response. The PubMed and Google Scholar databases were searched for studies examining the effects of TSS on limb motor function. A literature search yielded 34 studies for analysis, in which electrode placement and stimulation parameters varied considerably. The stimulation protocols from each study and their impact on limb motor function were summarized. Electrode placement was variable based on the targeted limb. Studies for the upper limbs targeted the cervical enlargement with anatomical placement of the cathode over the cervical vertebral region. In lower-limb studies, the cathode(s) were placed over the thoracic and lumbar vertebral regions, to target the lumbar enlargement. The effects of carrier frequency were inconclusive across the studies. Multisite cathodal placements yielded favorable motor response results compared to single-site placement. This review briefly summarized the current mechanistic evidence of the effect of TSS on motor response after SCI. Our findings indicate that optimization of stimulation parameters will require future randomized controlled studies to independently assess the effects of different stimulation parameters under controlled circumstances.
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spelling pubmed-99175102023-02-11 Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review Rehman, Muhammad Uzair Sneed, Dustin Sutor, Tommy W. Hoenig, Helen Gorgey, Ashraf S. J Clin Med Review Spinal cord injury (SCI) is a debilitating condition that can significantly affect an individual’s life, causing paralysis, autonomic dysreflexia, and chronic pain. Transspinal stimulation (TSS) is a non-invasive form of neuromodulation that activates the underlying neural circuitries of the spinal cord. Application of TSS can be performed through multiple stimulation protocols, which may vary in the electrodes’ size or position as well as stimulation parameters, and which may influence the response of motor functions to the stimulation. Due to the novelty of TSS, it is beneficial to summarize the available evidence to identify the range of parameters that may provide the best outcomes for motor response. The PubMed and Google Scholar databases were searched for studies examining the effects of TSS on limb motor function. A literature search yielded 34 studies for analysis, in which electrode placement and stimulation parameters varied considerably. The stimulation protocols from each study and their impact on limb motor function were summarized. Electrode placement was variable based on the targeted limb. Studies for the upper limbs targeted the cervical enlargement with anatomical placement of the cathode over the cervical vertebral region. In lower-limb studies, the cathode(s) were placed over the thoracic and lumbar vertebral regions, to target the lumbar enlargement. The effects of carrier frequency were inconclusive across the studies. Multisite cathodal placements yielded favorable motor response results compared to single-site placement. This review briefly summarized the current mechanistic evidence of the effect of TSS on motor response after SCI. Our findings indicate that optimization of stimulation parameters will require future randomized controlled studies to independently assess the effects of different stimulation parameters under controlled circumstances. MDPI 2023-01-20 /pmc/articles/PMC9917510/ /pubmed/36769503 http://dx.doi.org/10.3390/jcm12030854 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rehman, Muhammad Uzair
Sneed, Dustin
Sutor, Tommy W.
Hoenig, Helen
Gorgey, Ashraf S.
Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review
title Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review
title_full Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review
title_fullStr Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review
title_full_unstemmed Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review
title_short Optimization of Transspinal Stimulation Applications for Motor Recovery after Spinal Cord Injury: Scoping Review
title_sort optimization of transspinal stimulation applications for motor recovery after spinal cord injury: scoping review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917510/
https://www.ncbi.nlm.nih.gov/pubmed/36769503
http://dx.doi.org/10.3390/jcm12030854
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