Posteroanterior cervical transcutaneous spinal stimulation targets ventral and dorsal nerve roots.

Autor: Wu YK; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA., Levine JM; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Wecht JR; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Maher MT; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., LiMonta JM; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Saeed S; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Santiago TM; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Bailey E; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Kastuar S; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA., Guber KS; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Yung L; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA., Weir JP; University of Kansas, 1301 Sunnyside Avenue, Lawrence, KS 66045, USA., Carmel JB; Columbia University, 650 West 168th Street, New York, NY 10032, USA., Harel NY; James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA. Electronic address: noam.harel@mssm.edu.
Jazyk: angličtina
Zdroj: 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.
DOI: 10.1016/j.clinph.2019.11.056
Abstrakt: 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).
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.
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.
Conclusions: Posteroanterior cTSS has the capability to target motor neurons both trans-synaptically via large-diameter afferents and non-synaptically via efferent motor axons.
Significance: Posteroanterior cTSS is well tolerated and easily activates upper extremity muscles in individuals with SCI and ALS.
(Published by Elsevier B.V.)
Databáze: MEDLINE
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