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Short-term effect of Transcutaneous Spinal Cord Stimulation in patients with multiple sclerosis: a randomized
Eira Lotta Spieker1,2,3, Marie Hoffmann1, Carolin Otto1
1Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Frontiers in Neurology
|September 8, 2025
Summary
Transcutaneous spinal cord stimulation (tSCS) showed a small, nonsignificant effect on leg spasticity in progressive multiple sclerosis. Improved spasticity did not directly lead to better gait performance in patients with PPMS and SPMS.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Gait deficits and leg spasticity are common in Primary and Secondary Progressive Multiple Sclerosis (PPMS and SPMS).
- Transcutaneous spinal cord stimulation (tSCS) is explored as a potential therapy to reduce spinal hyperexcitability and alleviate these symptoms.
- A clinical crossover study was conducted to evaluate tSCS effects on spasticity and gait in PPMS and SPMS patients.
Purpose of the Study:
- To assess the therapeutic effects of tSCS on leg spasticity and gait in patients with PPMS and SPMS.
- To determine if tSCS can reduce spinal hyperexcitability and improve motor function post-stimulation.
- To compare the efficacy of tSCS against a sham intervention in a randomized, controlled setting.
Main Methods:
- A single-center, randomized, sham-controlled clinical crossover study involving 16 participants with PPMS and SPMS.
- Participants received both tSCS and sham interventions on separate days, with blinding for patients and examiners.
- Primary outcome was the Modified Ashworth Scale (MAS) for spasticity; secondary outcomes included gait assessments, kinematics via inertial sensors, and PRM-reflexes via EMG.
Main Results:
- Transcutaneous spinal cord stimulation (tSCS) demonstrated a small, statistically nonsignificant effect on bilateral leg spasticity (MAS sum score, p=0.12).
- While more patients improved with tSCS (10/16) than sham (7/16), the overall effect size was small ( -0.25).
- Negligible effects were observed for tSCS on clinical gait tests, kinematic parameters, and PRM-reflexes.
Conclusions:
- Transcutaneous spinal cord stimulation (tSCS) exhibited a minor, non-significant impact on reducing spasticity in patients with progressive multiple sclerosis.
- The observed reduction in spasticity did not immediately translate into measurable improvements in gait performance.
- Further research may be needed to optimize tSCS parameters or patient selection for potential therapeutic benefits.
