Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation

Transcutaneous spinal cord stimulation (TSCS) has demonstrated potential to beneficially modulate spinal cord motor and autonomic circuitry. We are interested in pairing cervical TSCS with other forms of nervous system stimulation to enhance synaptic plasticity in circuits serving hand function. We...

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Autores principales:	Jaclyn R. Wecht, William M. Savage, Grace O. Famodimu, Gregory A. Mendez, Jonah M. Levine, Matthew T. Maher, Joseph P. Weir, Jill M. Wecht, Jason B. Carmel, Yu-Kuang Wu, Noam Y. Harel
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	spinal cord stimulation cervical spinal cord injury motor evoked potentials Medicine R
Acceso en línea:	https://doaj.org/article/f50240a5f8684cb989cf8535556fe2eb
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spelling	oai:doaj.org-article:f50240a5f8684cb989cf8535556fe2eb2021-11-25T18:01:34ZPosteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation10.3390/jcm102253042077-0383https://doaj.org/article/f50240a5f8684cb989cf8535556fe2eb2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5304https://doaj.org/toc/2077-0383Transcutaneous spinal cord stimulation (TSCS) has demonstrated potential to beneficially modulate spinal cord motor and autonomic circuitry. We are interested in pairing cervical TSCS with other forms of nervous system stimulation to enhance synaptic plasticity in circuits serving hand function. We use a novel configuration for cervical TSCS in which the anode is placed anteriorly over ~C4–C5 and the cathode posteriorly over ~T2–T4. We measured the effects of single pulses of TSCS paired with single pulses of motor cortex or median nerve stimulation timed to arrive at the cervical spinal cord at varying intervals. In 13 participants with and 15 participants without chronic cervical spinal cord injury, we observed that subthreshold TSCS facilitates hand muscle responses to motor cortex stimulation, with a tendency toward greater facilitation when TSCS is timed to arrive at cervical synapses simultaneously or up to 10 milliseconds after cortical stimulus arrival. Single pulses of subthreshold TSCS had no effect on the amplitudes of median H-reflex responses or F-wave responses. These findings support a model in which TSCS paired with appropriately timed cortical stimulation has the potential to facilitate convergent transmission between descending motor circuits, segmental afferents, and spinal motor neurons serving the hand. Studies with larger numbers of participants and repetitively paired cortical and spinal stimulation are needed.Jaclyn R. WechtWilliam M. SavageGrace O. FamodimuGregory A. MendezJonah M. LevineMatthew T. MaherJoseph P. WeirJill M. WechtJason B. CarmelYu-Kuang WuNoam Y. HarelMDPI AGarticlespinal cord stimulationcervical spinal cord injurymotor evoked potentialsMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5304, p 5304 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	spinal cord stimulation cervical spinal cord injury motor evoked potentials Medicine R
spellingShingle	spinal cord stimulation cervical spinal cord injury motor evoked potentials Medicine R Jaclyn R. Wecht William M. Savage Grace O. Famodimu Gregory A. Mendez Jonah M. Levine Matthew T. Maher Joseph P. Weir Jill M. Wecht Jason B. Carmel Yu-Kuang Wu Noam Y. Harel Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation
description	Transcutaneous spinal cord stimulation (TSCS) has demonstrated potential to beneficially modulate spinal cord motor and autonomic circuitry. We are interested in pairing cervical TSCS with other forms of nervous system stimulation to enhance synaptic plasticity in circuits serving hand function. We use a novel configuration for cervical TSCS in which the anode is placed anteriorly over ~C4–C5 and the cathode posteriorly over ~T2–T4. We measured the effects of single pulses of TSCS paired with single pulses of motor cortex or median nerve stimulation timed to arrive at the cervical spinal cord at varying intervals. In 13 participants with and 15 participants without chronic cervical spinal cord injury, we observed that subthreshold TSCS facilitates hand muscle responses to motor cortex stimulation, with a tendency toward greater facilitation when TSCS is timed to arrive at cervical synapses simultaneously or up to 10 milliseconds after cortical stimulus arrival. Single pulses of subthreshold TSCS had no effect on the amplitudes of median H-reflex responses or F-wave responses. These findings support a model in which TSCS paired with appropriately timed cortical stimulation has the potential to facilitate convergent transmission between descending motor circuits, segmental afferents, and spinal motor neurons serving the hand. Studies with larger numbers of participants and repetitively paired cortical and spinal stimulation are needed.
format	article
author	Jaclyn R. Wecht William M. Savage Grace O. Famodimu Gregory A. Mendez Jonah M. Levine Matthew T. Maher Joseph P. Weir Jill M. Wecht Jason B. Carmel Yu-Kuang Wu Noam Y. Harel
author_facet	Jaclyn R. Wecht William M. Savage Grace O. Famodimu Gregory A. Mendez Jonah M. Levine Matthew T. Maher Joseph P. Weir Jill M. Wecht Jason B. Carmel Yu-Kuang Wu Noam Y. Harel
author_sort	Jaclyn R. Wecht
title	Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation
title_short	Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation
title_full	Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation
title_fullStr	Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation
title_full_unstemmed	Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation
title_sort	posteroanterior cervical transcutaneous spinal cord stimulation: interactions with cortical and peripheral nerve stimulation
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/f50240a5f8684cb989cf8535556fe2eb
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Posteroanterior Cervical Transcutaneous Spinal Cord Stimulation: Interactions with Cortical and Peripheral Nerve Stimulation

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