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Trans-Spinal Direct Current Stimulation in Spasticity: A Literature Mini-Review.

Maria A Estudillo-Guerra1, Ines Mesia-Toledo1, Noga Rogel2

  • 1Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States.

Frontiers in Stroke
|January 16, 2026
PubMed
Summary

Trans-spinal direct current stimulation (tsDCS) effectively reduced spasticity in neurological conditions. This non-pharmacological neuromodulation approach shows promise for improving motor function and quality of life.

Keywords:
neuromodulationspasticitystroketrans-spinal direct current stimulationtsDCS

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Neuroscience

Background:

  • Spasticity is a common and debilitating condition following neurological injury, significantly impacting patient function and quality of life.
  • Current treatments for spasticity often involve pharmacological interventions with potential side effects, highlighting the need for safe, non-pharmacological alternatives.
  • Trans-spinal direct current stimulation (tsDCS) is an emerging non-invasive neuromodulation technique that targets spinal excitability.

Purpose of the Study:

  • To review current treatment options for spasticity.
  • To evaluate the efficacy of trans-spinal direct current stimulation (tsDCS) as a non-pharmacological treatment for spasticity across various neurological conditions.
  • To explore the potential of tsDCS in modulating spinal pathways for functional improvement.

Main Methods:

  • A literature review was conducted on clinical studies investigating tsDCS for spasticity treatment.
  • Four studies were identified, examining tsDCS in hereditary spastic paraplegia, post-stroke upper extremity spasticity, multiple sclerosis, and spinal cord injury.
  • Spasticity was assessed as a primary or secondary outcome measure.

Main Results:

  • Three of the four studies, where spasticity was the primary outcome, demonstrated a significant decrease in spasticity with active tsDCS compared to sham stimulation.
  • These findings suggest that tsDCS can effectively modulate spinal motor and sensory pathways.
  • Improvements in motor function were observed, indicating tsDCS's potential therapeutic benefits.

Conclusions:

  • Trans-spinal direct current stimulation (tsDCS) shows promise as a safe and effective non-pharmacological treatment for reducing spasticity.
  • The modulation of spinal excitability by tsDCS offers a viable therapeutic option for improving motor function in patients with various neurological conditions.
  • Further research into optimal electrode montages and stimulation parameters for tsDCS is warranted to maximize its clinical utility in spasticity management.