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Thread: Common neural structures activated by epidural and transcutaneous stimulation

  1. #1

    Common neural structures activated by epidural and transcutaneous stimulation

    PLoS One. 2018 Jan 30;13(1):e0192013.

    Common neural structures activated by epidural and transcutaneous lumbar spinal cord stimulation: Elicitation of posterior root-muscle reflexes.

    Hofstoetter US1, Freundl B2, Binder H2, Minassian K1,3.

    Author information
    Epidural electrical stimulation of the lumbar spinal cord is currently regaining momentum as a neuromodulation intervention in spinal cord injury (SCI) to modify dysregulated sensorimotor functions and augment residual motor capacity. There is ample evidence that it engages spinal circuits through the electrical stimulation of large-to-medium diameter afferent fibers within lumbar and upper sacral posterior roots. Recent pilot studies suggested that the surface electrode-based method of transcutaneous spinal cord stimulation (SCS) may produce similar neuromodulatory effects as caused by epidural SCS. Neurophysiological and computer modeling studies proposed that this noninvasive technique stimulates posterior-root fibers as well, likely activating similar input structures to the spinal cord as epidural stimulation. Here, we add a yet missing piece of evidence substantiating this assumption. We conducted in-depth analyses and direct comparisons of the electromyographic (EMG) characteristics of short-latency responses in multiple leg muscles to both stimulation techniques derived from ten individuals with SCI each. Post-activation depression of responses evoked by paired pulses applied either epidurally or transcutaneously confirmed the reflex nature of the responses. The muscle responses to both techniques had the same latencies, EMG peak-to-peak amplitudes, and waveforms, except for smaller responses with shorter onset latencies in the triceps surae muscle group and shorter offsets of the responses in the biceps femoris muscle during epidural stimulation. Responses obtained in three subjects tested with both methods at different time points had near-identical waveforms per muscle group as well as same onset latencies. The present results strongly corroborate the activation of common neural input structures to the lumbar spinal cord-predominantly primary afferent fibers within multiple posterior roots-by both techniques and add to unraveling the basic mechanisms underlying electrical SCS.
    “As the cast of villains in SCI is vast and collaborative, so too must be the chorus of hero's that rise to meet them” Ramer et al 2005

  2. #2
    Senior Member lynnifer's Avatar
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    Gonna need this one in English. lol
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

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  3. #3
    So both activate the reflexes? Didn't we already know this? Or, are they saying function can be gained? What frequency and waveform do I use on regular e stim then?

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