Surgical Neurostimulation for Spinal Cord Injury

Brain Sciences, 2017 · DOI: 10.3390/brainsci7020018 · Published: February 10, 2017

Simple Explanation

Traumatic spinal cord injury (SCI) is a devastating condition leading to various dysfunctions. Current treatments focus on resuscitation, rehabilitation, and symptom management. This review explores neuromodulation strategies like deep brain stimulation (DBS) and spinal cord stimulation (SCS) for SCI, considering their ability to address pain, sensorimotor symptoms, and autonomic dysregulation. Neuromodulation not only holds potential for SCI treatment but also enhances our understanding of spinal cord neurobiology and SCI pathophysiology.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Neurostimulation shows potential for impacting pain, functional motor/sensory recovery, bladder/bowel function, and cardiovascular autonomic dysregulation in SCI patients.
2
DBS with very low frequency stimulation (effectively <0.67 Hz) was most effective in providing analgesia in SCI patients.
3
Combining motor cortex stimulation (MCS) and spinal tDCS in animal models suggests that stimulating proximal and distal to the injury could facilitate functional improvement following SCI.

Research Summary

This review outlines current management strategies for acute and chronic SCI and explores the potential of various neuromodulation techniques in treating pain, sensorimotor deficits, and autonomic dysregulation. While regenerative therapies for chronic SCI are lacking, neuromodulation offers promising avenues for restoring function, harnessing plasticity, and encouraging neuronal regeneration. Despite limited clinical evidence, functional neurosurgery holds potential for SCI treatment by relieving deficits and promoting plastic changes in neural pathways.

Practical Implications

Pain Management

Neurostimulation can provide an alternative approach to manage chronic pain associated with SCI, especially when traditional pharmacotherapy fails.

Motor and Sensory Recovery

Specific stimulation techniques, like combined MCS and tDCS, may promote motor recovery by facilitating neural plasticity around the injury site.

Autonomic Function Restoration

Neuromodulation strategies show promise in addressing bladder, bowel, and cardiovascular autonomic dysfunction, potentially improving the quality of life for SCI patients.

Study Limitations

1
Limited clinical evidence for the efficacy of neuromodulation for locomotor and sensory recovery.
2
Variability in patient responses to neurostimulation interventions makes it difficult to predict outcomes.
3
Potential complications associated with implanted stimulators, impacting quality of life and overall outcomes.

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