Neurophysiological Effect of Transcutaneous Electrical Spinal Cord Stimulation in Chronic Complete Spinal Cord Injury

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Spinal Cord Injury Research

Background:

• Transcutaneous electrical spinal cord stimulation combined with activity-based therapy (TESCS-ABT) shows promise for spinal cord injury (SCI) rehabilitation.
• Effectiveness of TESCS-ABT in chronic complete SCI is underexplored, despite potential neurological incompleteness.
• This study investigated TESCS-ABT's neurophysiological effects and functional translation in chronic complete SCI.

Purpose of the Study:

• To investigate the neurophysiological effects of TESCS-ABT in individuals with chronic complete SCI.
• To assess if observed neurophysiological changes translate into functional improvements.
• To explore the potential limitations and mechanisms of TESCS-ABT in this population.

Main Methods:

• Prospective, single-arm, open-label trial with nine participants with chronic complete SCI.
• Two-phase intervention: 6 weeks of FES-conditioning followed by 16 weeks of TESCS-ABT.
• Neurophysiological, neurological, and functional assessments at multiple timepoints.

Main Results:

• Increased synchronized neural signals in high-frequency bands observed in all participants.
• Limited improvements in corticospinal and spinal excitability.
• Neurophysiological changes did not consistently correlate with significant strength or functional improvements.

Conclusions:

• TESCS-ABT's neurophysiological effects in chronic complete SCI are contingent on residual supraspinal connectivity.
• This population shows a more restricted response compared to individuals with incomplete SCI.
• Findings guide future research for optimizing TESCS-ABT and identifying suitable candidates.