Transvertebral direct current stimulation paired with locomotor training in chronic spinal cord injury: A case study

Powell, Elizabeth; Carrico, Cheryl; Raithatha, Ravi; Salyers, Emily; Ward, Andrea B.; Sawaki, Lumy

doi:10.3233/nre-151292

Cited by 16 publications

(18 citation statements)

References 41 publications

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“…Trans-spinal direct current stimulation (tsDCS) is a new neuromodulatory technique utilizing polarization phenomena. Despite numerous unknowns with respect to physiological mechanisms and neuronal interactions within spinal networks, tsDCS has been increasingly used over recent years in the rehabilitation of patients following neurological injuries (23,40,49) or as an addition to physical training in sport (8,13). To date, it has been shown in both animals and humans that trans-spinally applied constant current can modify the effectiveness of synaptic actions of descending pathways (1, 2), ascending tracts (52,53), or local interneuronal circuits (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Motoneuron firing properties are modified by trans-spinal direct current stimulation in rats

Bączyk¹,

Drzymała‐Celichowska²,

Mrówczyński³

et al. 2019

Journal of Applied Physiology

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Spinal polarization evoked by direct current stimulation [trans-spinal direct current stimulation (tsDCS)] is a novel method for altering spinal network excitability; however, it remains not well understood. The aim of this study was to determine whether tsDCS influences spinal motoneuron activity. Twenty Wistar rats under general pentobarbital anesthesia were subjected to 15 min anodal ( n = 10) or cathodal ( n = 10) tsDCS of 0.1 mA intensity, and the electrophysiological properties of their motoneurons were intracellularly measured before, during, and after direct current application. The major effects of anodal intervention included increased minimum firing frequency and the slope of the frequency-current ( f-I) relationship, as well as decreased rheobase and currents evoking steady-state firing (SSF). The effects of cathodal polarization included decreased maximum SSF frequency, decreased f-I slope, and decreased current evoking the maximum SSF. Notably, the majority of observed effects appeared immediately after the current onset, developed during polarization, and outlasted it for at least 15 min. Moreover, the effects of anodal polarization were generally more pronounced and uniform than those evoked by cathodal polarization. Our study is the first to present polarity-dependent, long-lasting changes in spinal motoneuron firing following tsDCS, which may aid in the development of more safe and accurate application protocols in medicine and sport. NEW & NOTEWORTHY Trans-spinal direct current stimulation induces significant polarity-dependent, long-lasting changes in the threshold and firing properties of spinal motoneurons. Anodal polarization potentiates motoneuron firing whereas cathodal polarization acts mainly toward firing inhibition. The alterations in rheobase and rhythmic firing properties are not restricted to the period of current application and can be observed long after the current offset.

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Section: Introductionmentioning

confidence: 99%

Motoneuron firing properties are modified by trans-spinal direct current stimulation in rats

Bączyk¹,

Drzymała‐Celichowska²,

Mrówczyński³

et al. 2019

Journal of Applied Physiology

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“…In the last years, studies have aimed at developing transcutaneous spinal direct current stimulation (tsDCS) as a non-invasive technique to modulate spinal cord function in humans. Most of these studies have focused on the after-effects of tsDCS on motor-related functions (Cogiamanian et al , 2011; Lim & Shin, 2011; Lamy et al , 2012; Hubli et al , 2013; Bocci et al , 2014; Knikou et al , 2015; Perrotta et al , 2016; Donges et al , 2017; Winkler et al , 2010; Powell et al , 2016). In contrast, although invasive electrical stimulation of the spinal cord (SCS) using epidural electrodes is extensively used as a mean to reduce pain in patients with chronic neuropathic radicular pain (Nizard et al , 2012; Deer et al , 2014), very few experiments have been conducted to assess the possible effects of tsDCS on the spinal transmission and processing of nociceptive inputs.…”

Section: Introductionmentioning

confidence: 99%

Anodal Transcutaneous Spinal Direct Current Stimulation (tsDCS) Selectively Inhibits the Synaptic Efficacy of Nociceptive Transmission at Spinal Cord Level

2018

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Recently studies have aimed at developing transcutaneous spinal direct current stimulation (tsDCS) as a non-invasive technique to modulate spinal function in humans. Independent studies evaluating its after-effects on nociceptive or non-nociceptive somatosensory responses have reported comparable effects suggesting that tsDCS impairs axonal conduction of both the spino-thalamic and the medial lemniscus tracts. The present study aimed to better understand how tsDCS affects, in humans, the spinal transmission of nociceptive and non-nociceptive somatosensory inputs. We compared the after-effects of anodal low-thoracic, anodal cervical and sham tsDCS on the perception and brain responses elicited by laser stimuli selectively activating Aδ-thermonociceptors of the spinothalamic system and vibrotactile stimuli selectively activating low threshold Aβ-mechanoreceptors of the lemniscal system, delivered to the hands and feet. Low-thoracic tsDCS selectively and significantly affected the LEP-N2 wave elicited by nociceptive stimulation of the lower limbs, without affecting the LEP-N2 wave elicited by nociceptive stimulation of the upper limbs, and without affecting the SEP-N2 wave elicited by vibrotactile stimulation of either limb. This selective and segmental effect indicates that the neuromodulatory after-effects of tsDCS cannot be explained by anodal blockade of axonal conduction and, instead, are most probably due to a segmental effect on the synaptic efficacy of the local processing and/or transmission of nociceptive inputs in the dorsal horn.

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“…These studies also demonstrated that tsDCS can enhance functional aspects of behaviors such as walking, breathing, and muscle tone. In a recent case study, 24 sessions of cathodal tsDCS combined with robotic locomotor training were found to improve functional outcomes compared with sham treatment sessions for a patient with spinal cord injury (57). Moreover, transcranial DCS has been shown to enhance cognitive and motor functions in healthy individuals, as well as in individuals affected by stroke, psychiatric disorders, or Parkinson's disease (32,39,68).…”

mentioning

confidence: 99%

Transspinal direct current stimulation modulates migration and proliferation of adult newly born spinal cells in mice

Samaddar

Vazquez

Ponkia

et al. 2017

Journal of Applied Physiology

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Direct current electrical fields have been shown to be a major factor in the regulation of cell proliferation, differentiation, migration, and survival, as well as in the maturation of dividing cells during development. During adulthood, spinal cord cells are continuously produced in both animals and humans, and they hold great potential for neural restoration following spinal cord injury. While the effects of direct current electrical fields on adult-born spinal cells cultured ex vivo have recently been reported, the effects of direct current electrical fields on adult-born spinal cells in vivo have not been characterized. Here, we provide convincing findings that a therapeutic form of transspinal direct current stimulation (tsDCS) affects the migration and proliferation of adult-born spinal cells in mice. Specifically, cathodal tsDCS attracted the adult-born spinal cells, while anodal tsDCS repulsed them. In addition, both tsDCS polarities caused a significant increase in cell number. Regarding the potential mechanisms involved, both cathodal and anodal tsDCS caused significant increases in expression of brain-derived neurotrophic factor, while expression of nerve growth factor increased and decreased, respectively. In the spinal cord, both anodal and cathodal tsDCS increased blood flow. Since blood flow and angiogenesis are associated with the proliferation of neural stem cells, increased blood flow may represent a major factor in the modulation of newly born spinal cells by tsDCS. Consequently, we propose that the method and novel findings presented in the current study have the potential to facilitate cellular, molecular, and/or bioengineering strategies to repair injured spinal cords. Our results indicate that transspinal direct current stimulation (tsDCS) affects the migratory pattern and proliferation of adult newly born spinal cells, a cell population which has been implicated in learning and memory. In addition, our results suggest a potential mechanism of action regarding the functional effects of applying direct current. Thus tsDCS may represent a novel method by which to manipulate the migration and cell number of adult newly born cells and restore functions following brain or spinal cord injury.

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Transvertebral direct current stimulation paired with locomotor training in chronic spinal cord injury: A case study

Abstract: This publication was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000117, and the HealthSouth Cardinal Hill Stroke and Spinal Cord Endowment (1215375670).

Cited by 16 publications

References 41 publications

Motoneuron firing properties are modified by trans-spinal direct current stimulation in rats

Motoneuron firing properties are modified by trans-spinal direct current stimulation in rats

Anodal Transcutaneous Spinal Direct Current Stimulation (tsDCS) Selectively Inhibits the Synaptic Efficacy of Nociceptive Transmission at Spinal Cord Level

Transspinal direct current stimulation modulates migration and proliferation of adult newly born spinal cells in mice

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