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Posteroanterior cervical transcutaneous spinal stimulation targets ventral and dorsal nerve roots.
- Source :
-
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2020 Feb; Vol. 131 (2), pp. 451-460. Date of Electronic Publication: 2019 Dec 13. - Publication Year :
- 2020
-
Abstract
- Objective: We aim to non-invasively facilitate activation of spared neural circuits after cervical spinal cord injury (SCI) and amyotrophic lateral sclerosis (ALS). We developed and tested a novel configuration for cervical transcutaneous spinal stimulation (cTSS).<br />Methods: cTSS was delivered via electrodes placed over the midline at ~T2-T4 levels posteriorly and ~C4-C5 levels anteriorly. Electromyographic responses were measured in arm and hand muscles across a range of stimulus intensities. Double-pulse experiments were performed to assess homosynaptic post-activation depression (PAD). Safety was closely monitored.<br />Results: More than 170 cTSS sessions were conducted without major safety or tolerability issues. A cathode-posterior, 2 ms biphasic waveform provided optimal stimulation characteristics. Bilateral upper extremity muscle responses were easily obtained in subjects with SCI and ALS. Resting motor threshold at the abductor pollicis brevis muscle ranged from 5.5 to 51.0 mA. As stimulus intensity increased, response latencies to all muscles decreased. PAD was incomplete at lower stimulus intensities, and decreased at higher stimulus intensities.<br />Conclusions: Posteroanterior cTSS has the capability to target motor neurons both trans-synaptically via large-diameter afferents and non-synaptically via efferent motor axons.<br />Significance: Posteroanterior cTSS is well tolerated and easily activates upper extremity muscles in individuals with SCI and ALS.<br /> (Published by Elsevier B.V.)
- Subjects :
- Adult
Aged
Amyotrophic Lateral Sclerosis rehabilitation
Female
Hand innervation
Hand physiopathology
Humans
Male
Middle Aged
Motor Neurons physiology
Neck physiopathology
Sensory Receptor Cells physiology
Spinal Cord Injuries rehabilitation
Spinal Cord Stimulation adverse effects
Amyotrophic Lateral Sclerosis therapy
Spinal Cord Injuries therapy
Spinal Cord Stimulation methods
Spinal Nerve Roots physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1872-8952
- Volume :
- 131
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 31887616
- Full Text :
- https://doi.org/10.1016/j.clinph.2019.11.056