Modulation of spinal neuronal excitability by spinal direct currents and locomotion after spinal cord injury

Hubli, Michéle; Dietz, Volker; Schrafl-Altermatt, Miriam; Bolliger, Marc

doi:10.1016/j.clinph.2012.11.021

Cited by 96 publications

(121 citation statements)

References 43 publications

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“…It has been used in patients with spinal cord injury (Hubli et al, 2013) and with restless leg syndrome (Heide et al, 2014). The technique appears to influence ascending and descending spinal pathways and to modify the excitability of various spinal reflexes in humans and animals (for a review see Priori et al, 2014).…”

Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Antal

Alekseichuk

Bikson

et al. 2017

Clinical Neurophysiology

931

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Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1–2 mA and during tACS at higher peak-to-peak intensities above 2 mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity ‘conventional’ TES defined as <4 mA, up to 60 min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3–13 A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10 mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6–7, 2016 and were refined thereafter by email correspondence.

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Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Antal

Alekseichuk

Bikson

et al. 2017

Clinical Neurophysiology

931

728

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“…Note that one session of T11 anodal transcutaneous spinal DCS increased long‐latency plantar–TA cutaneous reflex activity, similar to a previous study (Hubli et al . ). D , schematic diagram of the T11 anodal transcutaneous spinal DCS electrode (black arrow) in relation to the vertebral level, spinal segments and motoneuronal pools innervating key lower limb muscles.…”

Section: Measurement Of Cutaneous Lower Limb Hyperreflexia As a Charamentioning

confidence: 97%

“…C ) and individuals with motor complete SCI (Hubli et al . ), following application at the T11 vertebral level. In contrast, five 20‐min sessions of anodal transcutaneous spinal DCS delivered to the T10–T12 ‘thoracic spinal cord’ lead to long‐term inhibition of muscle hypertonia, albeit for people with hereditary spastic paraplegia (Ardolino et al .…”

Section: Measurement Of Cutaneous Lower Limb Hyperreflexia As a Charamentioning

confidence: 99%

Non‐invasive spinal direct current simulation for spasticity therapy following spinal cord injury: mechanistic insights contributing to long‐term treatment effects

Gómez-Soriano

Megía-García

Serrano-Muñóz

et al. 2019

The Journal of Physiology

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“…Hubli et al. applied tsDCS or locomotor activity to determine whether the excitability of spinal neuronal circuitries underlying locomotion can be modulated after motor complete SCI . Spinal reflexes (SRs), as evoked by non‐noxious electrical stimulation of the tibial nerve, were assessed before, immediately after, and 20 min after four different interventions (anodal, cathodal, sham tsDCS, or locomotion) in subjects with motor complete SCI and healthy subjects.…”

Section: Principal Findings and Clinical Applicationsmentioning

confidence: 99%

Noninvasive Spinal Cord Stimulation: Technical Aspects and Therapeutic Applications

Nardone

Höller

Taylor

et al. 2015

Neuromodulation: Technology at the Neural Interface

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Modulation of spinal neuronal excitability by spinal direct currents and locomotion after spinal cord injury

Cited by 96 publications

References 43 publications

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Non‐invasive spinal direct current simulation for spasticity therapy following spinal cord injury: mechanistic insights contributing to long‐term treatment effects

Noninvasive Spinal Cord Stimulation: Technical Aspects and Therapeutic Applications

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