Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications

Transcutaneous spinal cord stimulation (tSCS) is a promising intervention that can benefit spasticity control and augment voluntary movement in spinal cord injury (SCI) and multiple sclerosis. Current applications require expert knowledge and rely on the thorough visual analysis of electromyographic...

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Autores principales:	Christina Salchow-Hömmen, Thomas Schauer, Philipp Müller, Andrea A. Kühn, Ursula S. Hofstoetter, Nikolaus Wenger
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	automation electromyography noninvasive Parkinson’s disease posterior root-muscle reflexes spasticity Medicine R
Acceso en línea:	https://doaj.org/article/a602f864a56c40b3b0a6bc3ad31d8f5b
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spelling	oai:doaj.org-article:a602f864a56c40b3b0a6bc3ad31d8f5b2021-11-25T18:03:06ZAlgorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications10.3390/jcm102254642077-0383https://doaj.org/article/a602f864a56c40b3b0a6bc3ad31d8f5b2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5464https://doaj.org/toc/2077-0383Transcutaneous spinal cord stimulation (tSCS) is a promising intervention that can benefit spasticity control and augment voluntary movement in spinal cord injury (SCI) and multiple sclerosis. Current applications require expert knowledge and rely on the thorough visual analysis of electromyographic (EMG) responses from lower-limb muscles to optimize attainable treatment effects. Here, we devised an automated tSCS setup by combining an electrode array placed over low-thoracic to mid-lumbar vertebrae, synchronized EMG recordings, and a self-operating stimulation protocol to systematically test various stimulation sites and amplitudes. A built-in calibration procedure classifies the evoked responses as reflexes or direct motor responses and identifies stimulation thresholds as recommendations for tSCS therapy. We tested our setup in 15 individuals (five neurologically intact, five SCI, and five Parkinson’s disease) and validated the results against blinded ratings from two clinical experts. Congruent results were obtained in 13 cases for electrode positions and in eight for tSCS amplitudes, with deviations of a maximum of one position and 5 to 10 mA in amplitude in the remaining cases. Despite these minor deviations, the calibration found clinically suitable tSCS settings in 13 individuals. In the remaining two cases, the automatic setup and both experts agreed that no reflex responses could be detected. The presented technological developments may facilitate the dissemination of tSCS into non-academic environments and broaden its use for diagnostic and therapeutic purposes.Christina Salchow-HömmenThomas SchauerPhilipp MüllerAndrea A. KühnUrsula S. HofstoetterNikolaus WengerMDPI AGarticleautomationelectromyographynoninvasiveParkinson’s diseaseposterior root-muscle reflexesspasticityMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5464, p 5464 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	automation electromyography noninvasive Parkinson’s disease posterior root-muscle reflexes spasticity Medicine R
spellingShingle	automation electromyography noninvasive Parkinson’s disease posterior root-muscle reflexes spasticity Medicine R Christina Salchow-Hömmen Thomas Schauer Philipp Müller Andrea A. Kühn Ursula S. Hofstoetter Nikolaus Wenger Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications
description	Transcutaneous spinal cord stimulation (tSCS) is a promising intervention that can benefit spasticity control and augment voluntary movement in spinal cord injury (SCI) and multiple sclerosis. Current applications require expert knowledge and rely on the thorough visual analysis of electromyographic (EMG) responses from lower-limb muscles to optimize attainable treatment effects. Here, we devised an automated tSCS setup by combining an electrode array placed over low-thoracic to mid-lumbar vertebrae, synchronized EMG recordings, and a self-operating stimulation protocol to systematically test various stimulation sites and amplitudes. A built-in calibration procedure classifies the evoked responses as reflexes or direct motor responses and identifies stimulation thresholds as recommendations for tSCS therapy. We tested our setup in 15 individuals (five neurologically intact, five SCI, and five Parkinson’s disease) and validated the results against blinded ratings from two clinical experts. Congruent results were obtained in 13 cases for electrode positions and in eight for tSCS amplitudes, with deviations of a maximum of one position and 5 to 10 mA in amplitude in the remaining cases. Despite these minor deviations, the calibration found clinically suitable tSCS settings in 13 individuals. In the remaining two cases, the automatic setup and both experts agreed that no reflex responses could be detected. The presented technological developments may facilitate the dissemination of tSCS into non-academic environments and broaden its use for diagnostic and therapeutic purposes.
format	article
author	Christina Salchow-Hömmen Thomas Schauer Philipp Müller Andrea A. Kühn Ursula S. Hofstoetter Nikolaus Wenger
author_facet	Christina Salchow-Hömmen Thomas Schauer Philipp Müller Andrea A. Kühn Ursula S. Hofstoetter Nikolaus Wenger
author_sort	Christina Salchow-Hömmen
title	Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications
title_short	Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications
title_full	Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications
title_fullStr	Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications
title_full_unstemmed	Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications
title_sort	algorithms for automated calibration of transcutaneous spinal cord stimulation to facilitate clinical applications
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a602f864a56c40b3b0a6bc3ad31d8f5b
work_keys_str_mv	AT christinasalchowhommen algorithmsforautomatedcalibrationoftranscutaneousspinalcordstimulationtofacilitateclinicalapplications AT thomasschauer algorithmsforautomatedcalibrationoftranscutaneousspinalcordstimulationtofacilitateclinicalapplications AT philippmuller algorithmsforautomatedcalibrationoftranscutaneousspinalcordstimulationtofacilitateclinicalapplications AT andreaakuhn algorithmsforautomatedcalibrationoftranscutaneousspinalcordstimulationtofacilitateclinicalapplications AT ursulashofstoetter algorithmsforautomatedcalibrationoftranscutaneousspinalcordstimulationtofacilitateclinicalapplications AT nikolauswenger algorithmsforautomatedcalibrationoftranscutaneousspinalcordstimulationtofacilitateclinicalapplications
_version_	1718411697840979968

Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications

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