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Non-invasive Stimulation after Spinal Cord Injury


  • Published: 2012-11-30 : Author: Cell Press
  • Synopsis: Using noninvasive stimulation improved ability of people with spinal cord injuries to use their hands showing promise for treating partially paralyzed due to SCI.

By using noninvasive stimulation, researchers were able to temporarily improve the ability of people with spinal cord injuries to use their hands.

Spinal Cord Injury - (Spinal cord trauma) - Damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the surrounding bones, tissues, or blood vessels. Symptoms of SCI vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and below the injury. How severe symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete). Most spinal cord trauma happens to young, healthy individuals. Men ages 15 - 35 are most commonly affected. The death rate tends to be higher in young children with spinal injuries.

The findings, reported on November 29th in Current Biology, a Cell Press publication, hold promise in treating thousands of people in the United States alone who are partially paralyzed due to spinal cord injury.

"This approach builds on earlier work and highlights the importance of the corticospinal tract - which conducts impulses from the brain's motor cortex to the spinal cord and is a major pathway contributing to voluntary movement - as an important target for intervention after spinal cord injury," said Monica Perez of the University of Pittsburgh.

The researchers tested the new method in 19 people with chronic cervical spinal cord injury and 14 uninjured people.

The treatment was customized to each individual and paired transcranial magnetic stimulation delivered to a specific part of the motor cortex with electrical stimulation to peripheral nerves found in the wrist.

One hundred paired pulses were delivered every 10 seconds for a period of around 20 minutes to produce volleys of neural activity. The timing of arrival of those volleys in the spinal cord was absolutely essential to the treatment's success, the report shows.

After non-invasive stimulation, people with spinal cord injuries showed greater manual dexterity when asked to grasp and manipulate small pegs with their index fingers and thumbs.About This Image: After non-invasive stimulation, people with spinal cord injuries showed greater manual dexterity when asked to grasp and manipulate small pegs with their index fingers and thumbs."This short, noninvasive stimulation protocol has the potential to be used within a clinic setting as part of a rehabilitation technique," said study coauthor Karen Bunday, also of the University of Pittsburgh. "When pulses from the motor cortex were precisely timed to arrive at the spinal cord one or two milliseconds before pulses from the peripheral nerve, we observed an increase in spinal cord transmission and voluntary motor output for up to 80 minutes."

After the noninvasive treatment, the majority of the participants in the study could exert more force with their hand muscles. Those effects translated into greater manual dexterity when participants were asked to grasp and manipulate small pegs with their index fingers and thumbs.

More prolonged use of the technique or its combination with other rehabilitation strategies may well improve its therapeutic benefits, the researchers say. The protocol might also be used in the treatment of other kinds of motor disorders involving damage to the corticospinal tract.

"Human electro-physiology can be a powerful tool for developing therapies," Perez concluded. "We need to explore new targets to improve rehabilitation strategies by taking advantage of our knowledge in human physiology and their mechanisms."

Bunday et al.: "Strengthening residual corticospinal-motoneuronal synapses enhances voluntary motor output after human spinal cord injury."

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