The effects of anodal transcranial direct current stimulation and patterned electrical stimulation on spinal inhibitory interneurons and motor function in patients with spinal cord injury

Exp Brain Res, 2016 · DOI: 10.1007/s00221-016-4561-4 · Published: January 20, 2016

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This study investigates how stimulating the brain and nerves in the leg can affect spinal cord reflexes and ankle movement in people with incomplete spinal cord injury (SCI). The researchers used transcranial direct current stimulation (tDCS) on the brain and patterned electrical stimulation (PES) on a leg nerve. The study found that this combined stimulation increased certain inhibitory reflexes in both healthy individuals and those with SCI. In SCI patients, this increase in inhibitory reflexes was linked to improved ankle movement. These findings suggest that using brain and nerve stimulation together could help improve motor function in people with SCI by making changes in the spinal cord.

Study Duration

Not specified

Participants

11 patients with incomplete SCI and 10 healthy adults

Evidence Level

Level 2: Single-masked, sham-controlled crossover study

Key Findings

1
Simultaneous application of anodal tDCS with PES significantly increased changes in disynaptic reciprocal inhibition and long-latency presynaptic inhibition in both healthy and SCI groups for at least 20 min after the stimulation.
2
In patients with incomplete SCI, anodal tDCS with PES significantly increased the number of ankle movements in 10 s at 20 min after the stimulation.
3
Significant negative relationships were found between changes in RI2ms and RI100ms with the change in the number of ankle movements.

Research Summary

The study investigated the effects of anodal tDCS combined with PES on spinal inhibitory interneurons in patients with chronic incomplete SCI and in healthy individuals. The results showed that the combined stimulation significantly increased disynaptic reciprocal inhibition and long-latency presynaptic inhibition in both groups. In SCI patients, the combined stimulation improved ankle movement, suggesting that this therapy may be useful for neuro-rehabilitation.

Practical Implications

Rehabilitation Strategy

Combining anodal tDCS with PES might be an effective adjuvant therapy for functional recovery of locomotion.

Preparation for Locomotor Training

This method can be used in preparation for locomotor training such as treadmill walking with partial body weight support and robot-assisted locomotor training.

Future Research

Further studies are needed to investigate whether the effects of anodal tDCS combined with PES on spasticity and gait function may induce more pronounced and beneficial clinical effects.

Study Limitations

1
The absence of data regarding the long-term effects on the restoration of the spinal cord and motor function.
2
The study acknowledges the need for future studies to assess the long-term benefits of this technique in improving functional abnormalities and locomotion in the patient population.
3
The effect of noninvasive brain stimulation on reciprocal inhibition

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