Neural Substrates of Transcutaneous Spinal Cord Stimulation: Neuromodulation across Multiple Segments of the Spinal Cord

J. Clin. Med., 2022 · DOI: https://doi.org/10.3390/jcm11030639 · Published: January 27, 2022

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Transcutaneous spinal cord stimulation (tSCS) is a non-invasive method to modulate the spinal cord and potentially improve sensorimotor rehabilitation. The review explores how tSCS, applied to the cervical or lumbar areas, affects the excitability of spinal networks and whether stimulating multiple sites has synergistic effects. The authors discuss the potential and limitations of using tSCS to engage spinal cord networks, aiming to enhance rehabilitation interventions and improve clinical outcomes after spinal cord injury.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Single-site tSCS can alter excitability across multiple segments of the spinal cord, showing a widespread influence of localized stimulation.
2
Multiple sites of tSCS converge to facilitate spinal reflex and corticospinal networks, indicating a cumulative effect of stimulation.
3
Further mechanistic work is needed to optimize tSCS parameters, improving targeted rehabilitation strategies and clinical outcomes.

Research Summary

This review describes the development of tSCS as a method to modulate the spinal cord and improve sensorimotor recovery after spinal cord injury. The review highlights that single-site tSCS can alter excitability across multiple segments of the spinal cord, and multiple sites of tSCS can converge to facilitate spinal reflex and corticospinal networks. The potential and limitations for engaging cervical and lumbar spinal cord networks through tSCS to enhance rehabilitation are discussed, emphasizing the need for further research.

Practical Implications

Optimizing Rehabilitation Strategies

Further research into the mechanisms of tSCS is crucial for optimizing rehabilitation strategies, allowing for more targeted interventions.

Enhancing Clinical Outcomes

Understanding how different tSCS parameters modulate spinal circuitry can lead to improved clinical outcomes for individuals with spinal cord injuries.

Improving Interlimb Coordination

tSCS may influence coupling between the arms and legs after SCI, potentially improving walking ability and overall mobility.

Study Limitations

1
Further mechanistic work is needed in order to optimize tSCS parameters.
2
The potential interactions between tSCS and such devices have not been explored
3
limited data are available as to the differences in speciﬁc neural substrates recruited by tSCS with and without a carrier frequency

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury