دورية أكاديمية
Skin and not dorsal root stimulation reduces hypertonus in thoracic motor complete spinal cord injury: a single case report.
| العنوان: | Skin and not dorsal root stimulation reduces hypertonus in thoracic motor complete spinal cord injury: a single case report. |
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| المؤلفون: | Lieu B; Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Everaert DG; Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Ho C; Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada., Gorassini MA; Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada. |
| المصدر: | Journal of neurophysiology [J Neurophysiol] 2024 May 01; Vol. 131 (5), pp. 815-821. Date of Electronic Publication: 2024 Mar 20. |
| نوع المنشور: | Journal Article; Case Reports; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Physiological Society Country of Publication: United States NLM ID: 0375404 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-1598 (Electronic) Linking ISSN: 00223077 NLM ISO Abbreviation: J Neurophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Bethesda Md : American Physiological Society Original Publication: Washington [etc.] |
| مواضيع طبية MeSH: | Muscle Hypertonia*/physiopathology , Muscle Hypertonia*/etiology , Muscle Hypertonia*/therapy , Spinal Cord Injuries*/physiopathology , Spinal Cord Injuries*/therapy , Spinal Cord Injuries*/complications , Thoracic Vertebrae*, Humans ; Leg/physiopathology ; Muscle, Skeletal/physiopathology ; Skin/innervation ; Spinal Nerve Roots/physiopathology ; Spinal Nerve Roots/physiology ; Transcutaneous Electric Nerve Stimulation/methods |
| مستخلص: | On demand and localized treatment for excessive muscle tone after spinal cord injury (SCI) is currently not available. Here, we examine the reduction in leg hypertonus in a person with mid-thoracic, motor complete SCI using a commercial transcutaneous electrical stimulator (TES) applied at 50 or 150 Hz to the lower back and the possible mechanisms producing this bilateral reduction in leg tone. Hypertonus of knee extensors without and during TES, with both cathode (T11-L2) and anode (L3-L5) placed over the spinal column (midline, MID) or 10 cm to the left of midline (lateral, LAT) to only active underlying skin and muscle afferents, was simultaneously measured in both legs with the pendulum test. Spinal reflexes mediated by proprioceptive (H-reflex) and cutaneomuscular reflex (CMR) afferents were examined in the right leg opposite to the applied LAT TES. Hypertonus disappeared in both legs but only during thoracolumbar TES, and even during LAT TES. The marked reduction in tone was reflected in the greater distance both lower legs first dropped to after being released from a fully extended position, increasing by 172.8% and 94.2% during MID and LAT TES, respectively, compared with without TES. Both MID and LAT (left) TES increased H-reflexes but decreased the first burst, and lengthened the onset of subsequent bursts, in the cutaneomuscular reflex of the right leg. Thoracolumbar TES is a promising method to decrease leg hypertonus in chronic, motor complete SCI without activating spinal cord structures and may work by facilitating proprioceptive inputs that activate excitatory interneurons with bilateral projections that in turn recruit recurrent inhibitory neurons. NEW & NOTEWORTHY We present proof of concept that surface stimulation of the lower back can reduce severe leg hypertonus in a participant with motor complete, thoracic spinal cord injury (SCI) but only during the applied stimulation. We propose that activation of skin and muscle afferents from thoracolumbar transcutaneous electrical stimulation (TES) may recruit excitatory spinal interneurons with bilateral projections that in turn recruit recurrent inhibitory networks to provide on demand suppression of ongoing involuntary motoneuron activity. |
| معلومات مُعتمدة: | PS 180430 Canadian Government | Canadian Institutes of Health Research (CIHR); 727772 Craig H. Neilsen Foundation (CHNF) |
| فهرسة مساهمة: | Keywords: hypertonus; skin and muscle afferents; spinal cord injury; spinal inhibition; transcutaneous electrical stimulation |
| تواريخ الأحداث: | Date Created: 20240320 Date Completed: 20240423 Latest Revision: 20240507 |
| رمز التحديث: | 20240508 |
| DOI: | 10.1152/jn.00436.2023 |
| PMID: | 38505867 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1522-1598 |
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| DOI: | 10.1152/jn.00436.2023 |