Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study
Loss of arm and hand function is one of the most devastating consequences of cervical spinal cord injury (SCI). Although some residual functional neurons often pass the site of injury, recovery after SCI is extremely limited. Recent efforts have aimed to augment traditional rehabilitation by combini...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Rehabilitation Sciences |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fresc.2022.896766/full |
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| author | Ciarán McGeady Aleksandra Vučković Niraj Singh Tharu Yong-Ping Zheng Monzurul Alam |
| author_facet | Ciarán McGeady Aleksandra Vučković Niraj Singh Tharu Yong-Ping Zheng Monzurul Alam |
| author_sort | Ciarán McGeady |
| collection | DOAJ |
| description | Loss of arm and hand function is one of the most devastating consequences of cervical spinal cord injury (SCI). Although some residual functional neurons often pass the site of injury, recovery after SCI is extremely limited. Recent efforts have aimed to augment traditional rehabilitation by combining exercise-based training with techniques such as transcutaneous spinal cord stimulation (tSCS), and movement priming. Such methods have been linked with elevated corticospinal excitability, and enhanced neuroplastic effects following activity-based therapy. In the present study, we investigated the potential for facilitating tSCS-based exercise-training with brain-computer interface (BCI) motor priming. An individual with chronic AIS A cervical SCI with both sensory and motor complete tetraplegia participated in a two-phase cross-over intervention whereby they engaged in 15 sessions of intensive tSCS-mediated hand training for 1 h, 3 times/week, followed by a two week washout period, and a further 15 sessions of tSCS training with bimanual BCI motor priming preceding each session. We found using the Graded Redefined Assessment for Strength, Sensibility, and Prehension that the participant's arm and hand function improved considerably across each phase of the study: from 96/232 points at baseline, to 117/232 after tSCS training alone, and to 131/232 points after BCI priming with tSCS training, reflecting improved strength, sensation, and gross and fine motor skills. Improved motor scores and heightened perception to sharp sensations improved the neurological level of injury from C4 to C5 following training and improvements were generally maintained four weeks after the final training session. Although functional improvements were similar regardless of the presence of BCI priming, there was a moderate improvement of bilateral strength only when priming preceded tSCS training, perhaps suggesting a benefit of motor priming for tSCS training. |
| first_indexed | 2024-04-11T01:49:05Z |
| format | Article |
| id | doaj.art-b19ae12de00342c386eda73aef665078 |
| institution | Directory Open Access Journal |
| issn | 2673-6861 |
| language | English |
| last_indexed | 2024-04-11T01:49:05Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Rehabilitation Sciences |
| spelling | doaj.art-b19ae12de00342c386eda73aef6650782023-01-03T07:02:56ZengFrontiers Media S.A.Frontiers in Rehabilitation Sciences2673-68612022-06-01310.3389/fresc.2022.896766896766Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case StudyCiarán McGeady0Aleksandra Vučković1Niraj Singh Tharu2Yong-Ping Zheng3Monzurul Alam4Centre for Rehabilitation Engineering, University of Glasgow, Glasgow, United KingdomCentre for Rehabilitation Engineering, University of Glasgow, Glasgow, United KingdomDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, ChinaDepartment of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, ChinaLoss of arm and hand function is one of the most devastating consequences of cervical spinal cord injury (SCI). Although some residual functional neurons often pass the site of injury, recovery after SCI is extremely limited. Recent efforts have aimed to augment traditional rehabilitation by combining exercise-based training with techniques such as transcutaneous spinal cord stimulation (tSCS), and movement priming. Such methods have been linked with elevated corticospinal excitability, and enhanced neuroplastic effects following activity-based therapy. In the present study, we investigated the potential for facilitating tSCS-based exercise-training with brain-computer interface (BCI) motor priming. An individual with chronic AIS A cervical SCI with both sensory and motor complete tetraplegia participated in a two-phase cross-over intervention whereby they engaged in 15 sessions of intensive tSCS-mediated hand training for 1 h, 3 times/week, followed by a two week washout period, and a further 15 sessions of tSCS training with bimanual BCI motor priming preceding each session. We found using the Graded Redefined Assessment for Strength, Sensibility, and Prehension that the participant's arm and hand function improved considerably across each phase of the study: from 96/232 points at baseline, to 117/232 after tSCS training alone, and to 131/232 points after BCI priming with tSCS training, reflecting improved strength, sensation, and gross and fine motor skills. Improved motor scores and heightened perception to sharp sensations improved the neurological level of injury from C4 to C5 following training and improvements were generally maintained four weeks after the final training session. Although functional improvements were similar regardless of the presence of BCI priming, there was a moderate improvement of bilateral strength only when priming preceded tSCS training, perhaps suggesting a benefit of motor priming for tSCS training.https://www.frontiersin.org/articles/10.3389/fresc.2022.896766/fulltranscutaneous spinal cord stimulationneuromodulationrehabilitationbrain-computer interfacemotor primingspinal cord injury |
| spellingShingle | Ciarán McGeady Aleksandra Vučković Niraj Singh Tharu Yong-Ping Zheng Monzurul Alam Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study Frontiers in Rehabilitation Sciences transcutaneous spinal cord stimulation neuromodulation rehabilitation brain-computer interface motor priming spinal cord injury |
| title | Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study |
| title_full | Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study |
| title_fullStr | Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study |
| title_full_unstemmed | Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study |
| title_short | Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study |
| title_sort | brain computer interface priming for cervical transcutaneous spinal cord stimulation therapy an exploratory case study |
| topic | transcutaneous spinal cord stimulation neuromodulation rehabilitation brain-computer interface motor priming spinal cord injury |
| url | https://www.frontiersin.org/articles/10.3389/fresc.2022.896766/full |
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