Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review

Abstract

Spinal cord injury (SCI) is one of the most debilitating injuries in the world. Complications after SCI, such as respiratory issues, bowel/bladder incontinency, pressure ulcers, autonomic dysreflexia, spasticity, pain, etc., lead to immense suffering, a remarkable reduction in life expectancy, and even premature death. Traditional rehabilitations for people with SCI are often insignificant or ineffective due to the severity and complexity of the injury. However, the recent development of noninvasive electrical neuromodulation treatments to the spinal cord have shed a ray of hope for these individuals to regain some of their lost functions, a reduction in secondary complications, and an improvement in their life quality. For this review, 250 articles were screened and about 150 were included to summarize the two most promising noninvasive spinal cord electrical stimulation methods of SCI rehabilitation treatment, namely, trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS). Both treatments have demonstrated good success in not only improving the sensorimotor function, but also autonomic functions. Due to the noninvasive nature and lower costs of these treatments, in the coming years, we expect these treatments to be integrated into regular rehabilitation therapies worldwide.

Current Trends in Nanotheranostics: A Concise Review on Bioimaging and Smart Wearable Technology

“…Electroceutical are categorized as therapeutics targeting neural circuits of the internal organs 141 . Treatment examples include vagus nerve stimulation 142 , spinal cord stimulation 143 , cochlear 143 and retinal 144 stimulation through biocompatible implants. This approach is extended in targeting chronic lung disorders 145 , hypertension 146 , diabetes and gastrointestinal diseases 147 .…”

A Current Monitoring and Over-Current Detection Circuit for Safe Electrical Stimulation

“…It has been reported that the safety limits and the patient's comfort level have a direct correlation to charge injection density (C/cm 2 ), electrode material, and stimulation protocols [5], [13], [14]. These factors combined with individual variances between patients require the current threshold to be programmable.…”

“…1b, resulting in over-current stimulation. It has been reported in the literature that over-current stimulation leads to discomfort, pain, or even tissue damage [5], [6]. Therefore, a safety mechanism is an indispensable functional block in a muscular stimulator to cope with over-current stimulation.…”

An easy-to-build transcutaneous electrical stimulator for spinal cord stimulation therapy

“…2 Recent studies found that, in case of a disruption of the connection between the brain and the spinal cord, resulting from an injury or disease, motor tasks can be enabled by TESCS to the cervical and/or lumbosacral segments of the spinal cord. 7,8 Modi cation of spasticity by tonic TESCS was also demonstrated in individuals with spinal cord injury. 9 In a recent study, it has also been demonstrated that TESCS can induce rhythmic activities of legs in robotic orthosis driven body-weight support system in upright position in people with complete spinal cord injury.…”