Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept
Objective: To evaluate the effect of transcutaneous (tSCS) and epidural electrical spinal cord stimulation (EES) in facilitating volitional movements, balance, and nonmotor functions, in this observational study, tSCS and EES were consecutively tested in 2 participants with motor complete spinal cor...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454823000644 |
| _version_ | 1827359096264720384 |
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| author | Elvira Mukhametova, MD Alena Militskova, MS Artur Biktimirov, MD Nikita Kharin, MS Elena Semenova, MS Oskar Sachenkov, PhD Tatiana Baltina, PhD Igor Lavrov, MD, PhD |
| author_facet | Elvira Mukhametova, MD Alena Militskova, MS Artur Biktimirov, MD Nikita Kharin, MS Elena Semenova, MS Oskar Sachenkov, PhD Tatiana Baltina, PhD Igor Lavrov, MD, PhD |
| author_sort | Elvira Mukhametova, MD |
| collection | DOAJ |
| description | Objective: To evaluate the effect of transcutaneous (tSCS) and epidural electrical spinal cord stimulation (EES) in facilitating volitional movements, balance, and nonmotor functions, in this observational study, tSCS and EES were consecutively tested in 2 participants with motor complete spinal cord injury (SCI). Participants and Methods: Two participants (a 48-year-old woman and a 28-year-old man), both classified as motor complete spinal injury, were enrolled in the study. Both participants went through a unified protocol, such as an initial electrophysiological assessment of neural connectivity, consecutive tSCS and EES combined with 8 wks of motor training with electromyography (EMG) and kinematic evaluation. The study was conducted from May 1, 2019, to December 31, 2021. Results: In both participants, tSCS reported a minimal improvement in voluntary movements still essential to start tSCS-enabled rehabilitation. Compared with tSCS, following EES showed immediate improvement in voluntary movements, whereas tSCS was more effective in improving balance and posture. Continuous improvement in nonmotor functions was found during tSCS-enabled and then during EES-enabled motor training. Conclusion: Results report a significant difference in the effect of tSCS and EES on the recovery of neurologic functions and support consecutive tSCS and EES applications as a potential therapy for SCI. The proposed approach may help in selecting patients with SCI responsive to neuromodulation. It would also help initiate neuromodulation and rehabilitation therapy early, particularly for motor complete SCI with minimal effect from conventional rehabilitation. |
| first_indexed | 2024-03-08T06:21:45Z |
| format | Article |
| id | doaj.art-cf81221704cb43a3b531d55aa861ea4a |
| institution | Directory Open Access Journal |
| issn | 2542-4548 |
| language | English |
| last_indexed | 2024-03-08T06:21:45Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj.art-cf81221704cb43a3b531d55aa861ea4a2024-02-04T04:46:01ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482024-02-0181116Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of ConceptElvira Mukhametova, MD0Alena Militskova, MS1Artur Biktimirov, MD2Nikita Kharin, MS3Elena Semenova, MS4Oskar Sachenkov, PhD5Tatiana Baltina, PhD6Igor Lavrov, MD, PhD7Department of Neurology, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN; Laboratory of Neuromodulation, Kazan Federal University, Institute of Fundamental Medicine and Biology, Kazan, Russia; Laboratory of Movement Physiology, Federal State Institution of Science Institute of Physiology, IP Pavlov, Russian Academy of Sciences, Saint Petersburg, RussiaDepartment of Neurology, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN; Laboratory of Neuromodulation, Kazan Federal University, Institute of Fundamental Medicine and Biology, Kazan, Russia; Laboratory of Movement Physiology, Federal State Institution of Science Institute of Physiology, IP Pavlov, Russian Academy of Sciences, Saint Petersburg, RussiaCenter of Neurotechnologies, Virtual, and Augmented Reality Technologies, Department of Neurosurgery, Far Eastern Federal University, RussiaLaboratory of Shell Mechanics, N.I. Lobachevsky Institute of Mathematics and Mechanics, Kazan Federal University, Kazan, RussiaLaboratory of Shell Mechanics, N.I. Lobachevsky Institute of Mathematics and Mechanics, Kazan Federal University, Kazan, RussiaLaboratory of Shell Mechanics, N.I. Lobachevsky Institute of Mathematics and Mechanics, Kazan Federal University, Kazan, RussiaLaboratory of Neuromodulation, Kazan Federal University, Institute of Fundamental Medicine and Biology, Kazan, RussiaDepartment of Neurology, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN; Correspondence: Address to Igor Lavrov, MD, PhD, Department of Neurology, Department of Physiology and Biomedical Engineering, Mayo Clinic, 500 First Street SW, Rochester, MN 55905.Objective: To evaluate the effect of transcutaneous (tSCS) and epidural electrical spinal cord stimulation (EES) in facilitating volitional movements, balance, and nonmotor functions, in this observational study, tSCS and EES were consecutively tested in 2 participants with motor complete spinal cord injury (SCI). Participants and Methods: Two participants (a 48-year-old woman and a 28-year-old man), both classified as motor complete spinal injury, were enrolled in the study. Both participants went through a unified protocol, such as an initial electrophysiological assessment of neural connectivity, consecutive tSCS and EES combined with 8 wks of motor training with electromyography (EMG) and kinematic evaluation. The study was conducted from May 1, 2019, to December 31, 2021. Results: In both participants, tSCS reported a minimal improvement in voluntary movements still essential to start tSCS-enabled rehabilitation. Compared with tSCS, following EES showed immediate improvement in voluntary movements, whereas tSCS was more effective in improving balance and posture. Continuous improvement in nonmotor functions was found during tSCS-enabled and then during EES-enabled motor training. Conclusion: Results report a significant difference in the effect of tSCS and EES on the recovery of neurologic functions and support consecutive tSCS and EES applications as a potential therapy for SCI. The proposed approach may help in selecting patients with SCI responsive to neuromodulation. It would also help initiate neuromodulation and rehabilitation therapy early, particularly for motor complete SCI with minimal effect from conventional rehabilitation.http://www.sciencedirect.com/science/article/pii/S2542454823000644 |
| spellingShingle | Elvira Mukhametova, MD Alena Militskova, MS Artur Biktimirov, MD Nikita Kharin, MS Elena Semenova, MS Oskar Sachenkov, PhD Tatiana Baltina, PhD Igor Lavrov, MD, PhD Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept |
| title_full | Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept |
| title_fullStr | Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept |
| title_full_unstemmed | Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept |
| title_short | Consecutive Transcutaneous and Epidural Spinal Cord Neuromodulation to Modify Clinical Complete Paralysis—the Proof of Concept |
| title_sort | consecutive transcutaneous and epidural spinal cord neuromodulation to modify clinical complete paralysis the proof of concept |
| url | http://www.sciencedirect.com/science/article/pii/S2542454823000644 |
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