Spinal cord stimulation for the restoration of bladder function after spinal cord injury

Steadman, Casey J.; Grill, Warren M.

doi:10.1049/htl.2020.0026

Cited by 20 publications

(4 citation statements)

References 95 publications

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“…Transcutaneous electrical nerve stimulation (TENS), stimulation of specific brain regions, and epidural electrical stimulation of the spinal cord have all been used ( 55 – 57 ). These nerve stimulators can be minimally invasive by transcutaneous implantation of electrodes ( 58 , 59 ) or a surgical approach which allows for direct implantation of spinal cord stimulators ( 60 , 61 ). Even though there have been effective results in clinical trials, there are complications because of the invasive quality of spinal cord stimulation implantation.…”

Section: Types Of Pharmacological and Procedural Therapies For Sci Painmentioning

confidence: 99%

Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain

et al. 2022

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Spinal cord injury (SCI) is a complex neurophysiological disorder, which can result in many long-term complications including changes in mobility, bowel and bladder function, cardiovascular function, and metabolism. In addition, most individuals with SCI experience some form of chronic pain, with one-third of these individuals rating their pain as severe and unrelenting. SCI-induced chronic pain is considered to be “high impact” and broadly affects a number of outcome measures, including daily activity, physical and cognitive function, mood, sleep, and overall quality of life. The majority of SCI pain patients suffer from pain that emanates from regions located below the level of injury. This pain is often rated as the most severe and the underlying mechanisms involve injury-induced plasticity along the entire neuraxis and within the peripheral nervous system. Unfortunately, current therapies for SCI-induced chronic pain lack universal efficacy. Pharmacological treatments, such as opioids, anticonvulsants, and antidepressants, have been shown to have limited success in promoting pain relief. In addition, these treatments are accompanied by many adverse events and safety issues that compound existing functional deficits in the spinally injured, such as gastrointestinal motility and respiration. Non-pharmacological treatments are safer alternatives that can be specifically tailored to the individual and used in tandem with pharmacological therapies if needed. This review describes existing non-pharmacological therapies that have been used to treat SCI-induced pain in both preclinical models and clinical populations. These include physical (i.e., exercise, acupuncture, and hyper- or hypothermia treatments), psychological (i.e., meditation and cognitive behavioral therapy), and dietary interventions (i.e., ketogenic and anti-inflammatory diet). Findings on the effectiveness of these interventions in reducing SCI-induced pain and improving quality of life are discussed. Overall, although studies suggest non-pharmacological treatments could be beneficial in reducing SCI-induced chronic pain, further research is needed. Additionally, because chronic pain, including SCI pain, is complex and has both emotional and physiological components, treatment should be multidisciplinary in nature and ideally tailored specifically to the patient.

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Section: Types Of Pharmacological and Procedural Therapies For Sci Painmentioning

confidence: 99%

Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain

et al. 2022

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“…Long-term epidural stimulation after chronic complete spinal cord injury can enable volitional movement in the absence of stimulation. Debilitating neurogenic bladder and bowel incontinence may respond to novel treatments such as sacral anterior root stimulation 31 32…”

Section: Futurementioning

confidence: 99%

Spontaneous spinal cord infarction: a practical approach

et al. 2022

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Spontaneous spinal cord infarction is significantly less common than cerebrovascular disease. Because of the tight anatomical distribution of pathways in the cord, small spinal cord infarcts usually give more obvious symptoms and signs than similar lesions in the brain. Large epidemiological stroke studies have generally not included spinal cord stroke and so the incidence of vascular syndromes in the spinal cord is unknown. Management and prevention strategies for spontaneous spinal cord infarcts stem from small case series and case reports. Patient outcomes from spinal cord infarction are better with prompt recognition, timely management and prevention of associated medical complications arising from paraplegia, tetraplegia, neurogenic bladder and bowel dysfunction. The process of rehabilitation following spinal cord infarction is an evolving area.

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“…Other applications have focused on hybrid muscle stimulation and robotic assistance for control of upper limb movement [3 ▪ ], spinal stimulation for restoration of bladder [4 ▪ ], locomotor, and other functions after SCI [5–7].…”

Section: Neuromodulatory Approaches To Augmenting Brain and Spinal Co...mentioning

confidence: 99%

Combined neuromodulatory approaches in the central nervous system for treatment of spinal cord injury

Noga

Guest

2021

Current Opinion in Neurology

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Purpose of reviewTo report progress in neuromodulation following spinal cord injury (SCI) using combined brain and spinal neuromodulation. Neuromodulation refers to alterations in neuronal activity for therapeutic purposes. Beneficial effects are established in disease states such as Parkinson's Disease (PD), chronic pain, epilepsy, and SCI. The repertoire of neuromodulation and bioelectric medicine is rapidly expanding. After SCI, cohort studies have reported the benefits of epidural stimulation (ES) combined with training. Recently, we have explored combining ES with deep brain stimulation (DBS) to increase activation of descending motor systems to address limitations of ES in severe SCI. In this review, we describe the types of applied neuromodulation that could be combined in SCI to amplify efficacy to enable movement. These include ES, mesencephalic locomotor region (MLR) -DBS, noninvasive transcutaneous stimulation, transcranial magnetic stimulation, paired-pulse paradigms, and neuromodulatory drugs. We examine immediate and longer-term effects and what is known about: (1) induced neuroplastic changes, (2) potential safety concerns; (3) relevant outcome measures; (4) optimization of stimulation; (5) therapeutic limitations and prospects to overcome these.Recent findings DBS of the mesencephalic locomotor region is emerging as a potential clinical target to amplify supraspinal command circuits for locomotion. SummaryCombinations of neuromodulatory methods may have additive value for restoration of function after spinal cord injury.

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Spinal cord stimulation for the restoration of bladder function after spinal cord injury

Cited by 20 publications

References 95 publications

Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain

Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain

Spontaneous spinal cord infarction: a practical approach

Combined neuromodulatory approaches in the central nervous system for treatment of spinal cord injury

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