title: Modulation of spinal neuronal excitability by spinal direct currents and locomotion after spinal cord injury.
abstract: OBJECTIVE
  Spinal neuronal function is impaired after a severe spinal cord injury (SCI) and can be assessed by the analysis of spinal reflex (SR) behavior. We applied transcutaneous spinal direct current stimulation (tsDCS) and locomotor activity, to determine whether the excitability of spinal neuronal circuitries underlying locomotion can be modulated after motor complete SCI.
  
  
  METHODS
  SRs were evoked by non-noxious electrical stimulation of the tibial nerve. SR behavior was assessed before, immediately after, and 20 min after four different interventions (anodal, cathodal, sham tsDCS, or locomotion) in subjects with motor complete SCI and healthy subjects.
  
  
  RESULTS
  SR amplitudes in SCI subjects were increased after anodal tsDCS by 84% (p < 0.05). Cathodal, sham tsDCS and locomotion had no influence on SR amplitudes. In addition, reflex threshold was lower after anodal tsDCS and locomotion in SCI subjects (p < 0.05).
  
  
  CONCLUSIONS
  Anodal tsDCS is able to modulate spinal neuronal circuitries after SCI.
  
  
  CONCLUSIONS
  This novel, noninvasive approach might be used as a tool to excite spinal neuronal circuitries. If applied repetitively within a training approach, anodal tsDCS might prevent adverse alterations in spinal reflex function in severely affected SCI subjects, i.e., a manifestation of a spinal neuronal dysfunction taking part below the level of a spinal lesion.
authors: Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland. mhubli@paralab.balgrist.ch
authors: M
authors: M
authors: Hubli
authors: V
authors: V
authors: Dietz
authors: M
authors: M
authors: Schrafl-Altermatt
authors: M
authors: M
authors: Bolliger
mesh_terms: D000293:Adolescent; D000328:Adult; D003627:Data Interpretation, Statistical; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000502:physiology / Q000503:physiopathology; D009474:Neurons / Q000502:physiology*; D010264:Paraplegia / Q000503:physiopathology; D012018:Reflex / Q000502:physiology; D013116:Spinal Cord / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013979:Tibial Nerve / Q000502:physiology; D055815:Young Adult