There are over 15 million people living with spinal cord injury (SCI) worldwide. Experimental treatments using electrical stimulation through the skin may help some patients regain movement, but researchers still have a lot to learn.
"One of the biggest challenges is figuring out the right "recipe" for each person—like how strong the current should be, what kind of signal to use, how often to deliver it, and more," says Shirin Madarshahian, PhD, a data scientist at Thomas Jefferson University's Raphael Center for Neurorestoration , and the lead author of a new study that aims to personalize spinal cord stimulation. The research, published in Bioengineering, finds that adjusting the location, amount, and type of electrical stimulation makes a big difference in outcomes for SCI patients.
The researchers investigated transcutaneous spinal cord stimulation (tSCS), whereby an external device delivers electrical current through the skin and into the spinal cord. The effectiveness of the therapy can be assessed by measuring the electrical response in the affected muscle.
"The goal is to help 'wake up' the spinal cord by stimulating the nerves and encouraging the brain and body to reconnect," Dr. Madarshahian explains.
Past studies using tSCS have taken a one-size-fits-all approach, using the same electrode location and type of stimulation for every person. But in a small group of five participants, this study found that personalized configurations of the tSCS devices helped elicit more electrical responses in the muscles responsible for movement. And in some individuals, certain configurations even modulated blood pressure and reduced pain.
"What we're seeing is that you do need that personalization phase," explains Alessandro Napoli, PhD, lead engineer and co-author on the paper. "Each person is different, especially after an injury."
Mijail D. Serruya, MD, PhD , Director of the Center for Neurorestoration and the senior author on the paper, hopes that this research can not only inform treatment for SCI, but for other movement disorders as well. "It's a rising tide," says Dr. Serruya, who is also a member of Sidney Kimmel Medical College.
By Marilyn Perkins
