Noninvasive Spinal Cord Stimulation: Technical Aspects and Therapeutic Applications

Nardone, Raffaele; Höller, Yvonne; Taylor, Alexandra; Thomschewski, Aljoscha; Orioli, Andrea; Frey, Vanessa; Trinka, Eugen; Brigo, Francesco

doi:10.1111/ner.12332

Cited by 42 publications

(21 citation statements)

References 94 publications

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“…This study suggests that the effects of tACS, as opposed to cerebellar tDCS (Grimaldi and Manto, 2013 ), critically depend on the electrode montage. On the other hand, the after effects of tACS seem to be induced by mechanisms similar to those seen in tDCS and might result from synaptic changes due to long-term potentiation and long-term depression of synaptic transmission (Nardone et al, 2015 ). However, more research is needed to clarify a number of unsolved issues related to tACS.…”

Section: Transcranial Alternating Current Stimulation (Tacs): a Novelmentioning

confidence: 99%

tDCS of the Cerebellum: Where Do We Stand in 2016? Technical Issues and Critical Review of the Literature

Dun

Bodranghien

Mariën

et al. 2016

Front. Hum. Neurosci.

100

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Transcranial Direct Current Stimulation (tDCS) is an up-and-coming electrical neurostimulation technique increasingly used both in healthy subjects and in selected groups of patients. Due to the high density of neurons in the cerebellum, its peculiar anatomical organization with the cortex lying superficially below the skull and its diffuse connections with motor and associative areas of the cerebrum, the cerebellum is becoming a major target for neuromodulation of the cerebellocerebral networks. We discuss the recent studies based on cerebellar tDCS with a focus on the numerous technical and open issues which remain to be solved. Our current knowledge of the physiological impacts of tDCS on cerebellar circuitry is criticized. We provide a comparison with transcranial Alternating Current Stimulation (tACS), another promising transcranial electrical neurostimulation technique. Although both tDCS and tACS are becoming established techniques to modulate the cerebellocerebral networks, it is surprising that their impacts on cerebellar disorders remains unclear. A major reason is that the literature lacks large trials with a double-blind, sham-controlled, and cross-over experimental design in cerebellar patients.

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Section: Transcranial Alternating Current Stimulation (Tacs): a Novelmentioning

confidence: 99%

tDCS of the Cerebellum: Where Do We Stand in 2016? Technical Issues and Critical Review of the Literature

Dun

Bodranghien

Mariën

et al. 2016

Front. Hum. Neurosci.

100

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“…Brain-controlled spinal cord stimulation can potentially be employed for assistive or rehabilitative purposes by patients with lower-limb paralysis. Spinal cord stimulation has been used to neuromodulate the spinal circuitry, supporting motor recovery after lower-limb paralysis (Edgerton and Roy, 2012;Nardone et al, 2015b;Taccola et al, 2018). The first studies in animals evidenced the neuromodulatory properties of dorsal root stimulation of the spine (Budakova, 1972;Grillner and Zangger, 1979).…”

Section: Discussionmentioning

confidence: 99%

“…In this line, magnetic stimulation of the spinal cord presents an alternative modality to neuromodulate the spinal networks non-invasively (Nardone et al, 2015b). In clinical environments, non-invasive magnetic stimulation has been widely used to investigate the central and peripheral nervous systems (Groppa et al, 2012;Nardone et al, 2015a;Rossini et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Non-invasive brain-spine interface: continuous brain control of trans-spinal magnetic stimulation using EEG

Insausti-Delgado

López‐Larraz

Nishimura

et al. 2020

Preprint

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Brain-controlled neuromodulation therapies have emerged as a promising tool to promote functional recovery in patients with motor disabilities. This neuromodulatory strategy is exploited by brain-machine interfaces and could be used for restoring lower limb muscle activity or alleviating gait deficits. Towards a non-invasive approach for leg neurorehabilitation, we present a set-up that combines acquisition of electroencephalographic (EEG) activity to volitionally control trans-spinal magnetic stimulation (ts-MS). We engineered, for the first time, a non-invasive brain-spine interface (BSI) to contingently connect motor cortical activation during leg motor imagery with the activation of leg muscles via ts-MS. This novel brain-controlled stimulation was validated with 10 healthy participants who underwent one session including different ts-MS conditions. After a short screening of their cortical activation during lower limb motor imagery, the participants used the closed-loop system at different stimulation intensities and scored system usability and comfort. We demonstrate the efficiency and robustness of the developed system to remove online stimulation artifacts from EEG regardless of ts-MS intensity used. All the participants reported absence of pain due to ts-MS and good usability. Our results also revealed that ts-MS controlled afferent and efferent intensity-dependent modulation of the nervous system. The here presented system represents a novel non-invasive means to neuromodulate lower limb peripheral nerve activity using brain-controlled spinal stimulation.

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“…Transcutaneous spinal cord stimulation (tcSCS) is a novel form of SCS that delivers superficial stimulation, usually over the skin that overlies the lower thoracic and/or lumbosacral vertebrae [26]. The principles underlying tcSCS rely on the physiology of the corticospinal pathways in the spinal cord that can produce excitability changes in the different neural populations of the spinal circuitry [27,28]. Central pattern generators (CPGs) are pools of neurons able to elicit rhythmic and coordinated movements without the contribution of supraspinal centers.…”

Section: Transcutaneous Spinal Cord Stimulation (Tcscs)mentioning

confidence: 99%

Noninvasive Modalities Used in Spinal Cord Injury Rehabilitation

Barroso¹,

Pascual-Valdunciel²,

Torricelli³

et al. 2019

Spinal Cord Injury Therapy [Working Title]

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In the past three decades, research on plasticity after spinal cord injury (SCI) has led to a gradual shift in SCI rehabilitation: the former focus on learning compensatory strategies changed to functional neurorecovery, that is, promoting restoration of function through the use of affected limbs. This paradigm shift contributed to the development of technology-based interventions aiming to promote neurorecovery through repetitive training. This chapter presents an overview of a range of noninvasive modalities that have been used in rehabilitation after SCI. Among others, we present repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), surface electrical stimulation tools such as transcutaneous electrical spinal cord stimulation (tcSCS), transcutaneous electrical nerve stimulation (TENS), and functional electrical stimulation (FES), as well as its integration with cycling training and assistive robotic devices. The most recent results attained and the potential relevance of these new techniques to strengthen the efficacy of the residual neuronal pathways and improve spasticity are also presented. Future efforts toward the widespread clinical application of these modalities include more advances in the technology, together with the knowledge obtained from basic research and clinical trials. This can ultimately lead to novel customized interventions that meet specific needs of SCI patients.

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Noninvasive Spinal Cord Stimulation: Technical Aspects and Therapeutic Applications

Cited by 42 publications

References 94 publications

tDCS of the Cerebellum: Where Do We Stand in 2016? Technical Issues and Critical Review of the Literature

tDCS of the Cerebellum: Where Do We Stand in 2016? Technical Issues and Critical Review of the Literature

Non-invasive brain-spine interface: continuous brain control of trans-spinal magnetic stimulation using EEG

Noninvasive Modalities Used in Spinal Cord Injury Rehabilitation

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