Precision neuromodulation: Promises and challenges of spinal stimulation for multi-modal rehabilitation.

Autor: Bandres MF; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States.; Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States., Gomes JL; Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States., Moreno Romero GN; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States., Twyman AR; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States., McPherson JG; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States.; Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.; Washington University Pain Center, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.; Washington University Program in Neurosciences, Washington University in St. Louis, St. Louis, MO, United States.
Jazyk: angličtina
Zdroj: Frontiers in rehabilitation sciences [Front Rehabil Sci] 2023 Apr 19; Vol. 4, pp. 1135593. Date of Electronic Publication: 2023 Apr 19 (Print Publication: 2023).
DOI: 10.3389/fresc.2023.1135593
Abstrakt: Spinal cord injury results in multiple, simultaneous sensorimotor deficits. These include, but are not limited to, full or partial paralysis of muscles below the lesion, muscle spasms, spasticity, and neuropathic pain. Bowel, bladder, and sexual dysfunction are also prevalent. Yet, the majority of emerging spinal stimulation-based therapies focus on a single issue: locomotor rehabilitation. Despite the enormous potential of these translational advances to transform the lives of people living with spinal cord injury, meaningful recovery in other domains deemed critical priorities remains lacking. Here, we highlight the importance of considering the diverse patterns of neural transmission that underlie clinically similar presentations when developing spinal stimulation-based therapies. We also motivate advancement of multi-modal rehabilitation paradigms, which leverage the dense interconnectivity of sensorimotor spinal networks and the unique ability of electrical stimulation to modulate these networks to facilitate and guide simultaneous rehabilitation across domains.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(© 2023 Bandres, Gomes, Moreno Romero, Twyman and McPherson.)
Databáze: MEDLINE