The effects of transcutaneous spinal cord stimulation delivered with and without high-frequency modulation on spinal and corticospinal excitability.

Autor: Massey S; Department of Medical Physics & Biomedical Engineering, University College London, London, UK.; Aspire Centre for Rehabilitation Engineering and Assistive Technology, UCL Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, London, UK., Konig D; Department of Medical Physics & Biomedical Engineering, University College London, London, UK., Upadhyay P; Department of Medical Physics & Biomedical Engineering, University College London, London, UK., Evcil ZB; Department of Medical Physics & Biomedical Engineering, University College London, London, UK., Melin R; Department of Medical Physics & Biomedical Engineering, University College London, London, UK., Fatima M; Department of Medical Physics & Biomedical Engineering, University College London, London, UK., Hannah R; Centre for Human and Applied Physiological Sciences, Kings College London, London, UK., Duffell L; Department of Medical Physics & Biomedical Engineering, University College London, London, UK.; Aspire Centre for Rehabilitation Engineering and Assistive Technology, UCL Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, London, UK.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Mar; Vol. 48 (3), pp. 297-308. Date of Electronic Publication: 2023 Oct 16.
DOI: 10.1111/aor.14660
Abstrakt: Transcutaneous spinal cord stimulation (TSCS) has been shown to improve motor recovery in people with spinal cord injury (SCI). Some groups deliver TSCS modulated with a kHz-frequency (TSCS-kHz); the intensity used for TSCS-kHz is usually set based on the motor threshold for TSCS, even though TSCS-kHz threshold is considerably higher than TSCS. As a result, TSCS-kHz interventions tend to be delivered at low intensities with respect to the motor threshold (~40%). In this study, we compared the effects of sub-threshold TSCS and TSCS-kHz, when delivered at similar intensity relative to their own motor threshold. Experiment I compared the after-effects of 20 min of sub-threshold (40% threshold) TSCS and TSCS-kHz on spinal and corticospinal excitability in able-bodied participants. Experiment II assessed the dose-response relationship of delivering short (10-pulse) trains of TSCS and TSCS-kHz at three different current intensities relative to the threshold (40%, 60%, and 80%). Experiment I found that 20 min of TSCS-kHz at a 40% threshold decreased posterior root reflex amplitude (p < 0.05), whereas TSCS did not. In experiment II, motor-evoked potential (MEP) amplitude increased following short trains of TSCS and TSCS-kHz of increasing intensity. MEP amplitude was significantly greater for TSCS-kHz compared with TSCS when delivered at 80% of the threshold (p < 0.05). These results suggest that TSCS and TSCS-kHz have different effects when delivered at similar intensity relative to their own threshold; both for immediate effects on corticospinal excitability and following prolonged stimulation on spinal excitability. These different effects may be utilized for optimal rehabilitation in people with SCI.
(© 2023 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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