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Restorative Neurology of Spinal Cord Injury$
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Milan R. Dimitrijevic, Byron A. Kakulas, W. Barry McKay, and Gerta Vrbova

Print publication date: 2011

Print ISBN-13: 9780199746507

Published to Oxford Scholarship Online: January 2012

DOI: 10.1093/acprof:oso/9780199746507.001.0001

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Transcutaneous Lumbar Posterior Root Stimulation for Motor Control Studies and Modification of Motor Activity after Spinal Cord Injury

Transcutaneous Lumbar Posterior Root Stimulation for Motor Control Studies and Modification of Motor Activity after Spinal Cord Injury

Chapter:
(p.226) 10 Transcutaneous Lumbar Posterior Root Stimulation for Motor Control Studies and Modification of Motor Activity after Spinal Cord Injury
Source:
Restorative Neurology of Spinal Cord Injury
Author(s):

Karen Minassian

Ursula Hofstoetter

Frank Rattay

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199746507.003.0010

A method for transcutaneous spinal cord stimulation that can be used for noninvasive investigations of lumbar neural circuits' function in human subjects was recently developed. The same technique can be applied as a neuroaugmentative method for the control of spinal spasticity and the enhancement of the neural control of locomotion after spinal cord injury. This chapter describes this novel method for the stimulation of the lumbosacral spinal cord in humans. By elaborating the underlying biophysical principles, it identifies sensory fibers within the posterior roots as the directly stimulated neural structures. The electrophysiology of muscle responses to the electrical stimuli, referred to as “posterior root-muscle reflexes”, is addressed, and their similarity to the soleus Hoffmann reflex is discussed. The potential of transcutaneous spinal cord stimulation to modulate the central state of excitability of lumbar cord circuits, when the stimulation mode is changed from the application of single pulses to trains of stimuli, is illustrated on the basis of two cases.

Keywords:   spinal spasticity, locomotion, neutral control, lumbosacral spinal cord stimulation, posterior root-muscle reflexes, soleus Hoffmann reflex, transcutaneous spinal cord stimulation

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