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

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.