Neural stimulation for spinal spasticity

Kanaka, T.S.; Kumar, Manjit

doi:10.1038/sc.1990.53

Cited by 11 publications

(5 citation statements)

References 11 publications

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“…Kanaka and Kumar created a customized epidural spinal cord stimulator system and implanted five patients with spasticity of varying cause. The system remained externalized and the patients responded well.…”

Section: Scs For Spasticity: Review Of the Literaturementioning

confidence: 99%

Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions

Nagel

Wilson

Johnson

et al. 2017

Neuromodulation: Technology at the Neural Interface

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Section: Scs For Spasticity: Review Of the Literaturementioning

confidence: 99%

Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions

Nagel

Wilson

Johnson

et al. 2017

Neuromodulation: Technology at the Neural Interface

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“…At the macro- and microscale, a wide variety of cells, including MSCs, have been shown to respond to stress and strain. − In fact, mechanical stimulation is a common strategy in tissue engineering of cartilage and ligament, for example. − This is because mechanical alterations in cell morphology lead to changes in cell signaling and gene transcription. Indeed, not only mechanical load patterns but also electrical and electromagnetic stimulation patterns have been shown to be efficacious in neural and bone regeneration. − …”

mentioning

confidence: 99%

Osteogenesis of Mesenchymal Stem Cells by Nanoscale Mechanotransduction

et al. 2013

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It is likely that mesenchymal stem cells will find use in many autologous regenerative therapies. However, our ability to control cell stem growth and differentiation is presently limited, and this is a major hurdle to the clinical use of these multipotent cells especially when considering the desire not to use soluble factors or complex media formulations in culture. Also, the large number of cells required to be clinically useful is currently a hurdle to using materials-based (stiffness, chemistry, nanotopography, etc.) culture substrates. Here we give a first demonstration of using nanoscale sinusoidal mechanotransductive protocols (10-14 nm displacements at 1 kHz frequency), "nanokicking", to promote osteoblastogenesis in human mesenchymal stem cell cultures. On the basis of application of the reverse piezo effect, we use interferometry to develop the optimal stem cell stimulation conditions, allowing delivery of nanoscale cues across the entire surface of the Petri dishes used. A combination of immunofluorescence, PCR, and microarray has then been used to demonstrate osteoblastogenesis, and the arrays implicate RhoA as central to osteoblastic differentiation in agreement with materials-based strategies. We validate this with pharmacological inhibition of RhoA kinase. It is easy to envisage such stimulation protocols being up-scaled to form large-scale osteoblast bioreactors as standard cell culture plates and incubators are used in the protocol.

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“…Electrical stimulation, both in the peripheral and central nervous system, has been previously used for the reduction of spasticity. This included stimulation of the spastic muscles (61), muscles antagonistic to the spastic ones (2), and stimu-lation of the dorsal columns of the spinal cord through epidurally placed electrodes (36). In the first case, reduction of spasticity could be due to the electrical stimulation of the cutaneous afferents (4,14), which is thought to induce synaptic plasticity (e.g., long-term potentiation and depression) in the spinal circuitry (13,14).…”

Section: Discussionmentioning

confidence: 99%

Modulation of motoneuronal firing behavior after spinal cord injury using intraspinal microstimulation current pulses: a modeling study

Elbasiouny¹,

Mushahwar²

2007

Journal of Applied Physiology

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We simulated the effects of delivering focal electrical stimuli to the central nervous system to modulate the firing rate of neurons and alleviate motor disorders. Application of these stimuli to the spinal cord to reduce the increased excitability of motoneurons and resulting spasticity after spinal cord injury (SCI) was examined by means of a morphologically detailed computer model of a spinal motoneuron. High-frequency sinusoidal and rectangular pulses as well as biphasic charge-balanced and charge-imbalanced pulses were examined. Our results suggest that suprathreshold high-frequency sinusoidal or rectangular current pulses could inactivate the Na+ channels in the soma and initial segment, and block action potentials from propagating through the axon. Subthreshold biphasic charge-imbalanced pulses reduced the motoneuronal firing rate significantly (up to approximately 25% reduction). The reduction in firing rate was achieved through stimulation-induced hyperpolarization generated in the first node of Ranvier. Because of their low net DC current, these pulses could be tolerated safely by the tissue. To deliver charge-imbalanced pulses with the lowest net DC current and induce the largest reduction in motoneuronal firing rate, we studied the effect of various charge-imbalanced pulse parameters. Short pulse durations were found to induce the largest reduction in firing rate for the same net DC level. Subthreshold high-frequency sinusoidal and rectangular current pulses and low-frequency biphasic charge-balanced pulses, on the other hand, were ineffective in reducing the motoneuronal firing rate. In conclusion, the proposed electrical stimulation paradigms could provide potential rehabilitation interventions for suppressing the excitability of neurons to reduce the severity of motor disorders after injury to the central nervous system.

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Neural stimulation for spinal spasticity

Cited by 11 publications

References 11 publications

Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions

Spinal Cord Stimulation for Spasticity: Historical Approaches, Current Status, and Future Directions

Osteogenesis of Mesenchymal Stem Cells by Nanoscale Mechanotransduction

Modulation of motoneuronal firing behavior after spinal cord injury using intraspinal microstimulation current pulses: a modeling study

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