Transcutaneous spinal cord stimulation: noninvasive tool for activation of locomotor circuitry
This disclosure provides non-invasive methods to induce motor control in a mammal subject to spinal cord or other neurological injuries. In certain embodiments the method involves administering transcutaneous electrical spinal cord stimulation (tSCS) to the mammal at a frequency and intensity that induces the desired locomotor activity.
1. A method of inducing locomotor activity in a mammal, said method comprising administering non-invasive transcutaneous electrical spinal cord stimulation (tSCS) to said mammal at a frequency and intensity sufficient to elicit said locomotor activity, wherein said locomotor activity comprises step-like movements and the frequency of said step like movements does not depend on the frequency of the transdermal electrical stimulation.
2. A method of inducing locomotor activity in a mammal, said method comprising administering non-invasive transcutaneous electrical spinal cord stimulation (tSCS) to said mammal at a frequency and intensity sufficient to elicit said locomotor activity, wherein said locomotor activity comprises step-like movements, wherein the hip, knee, and ankle joints are involved in said step-like movements.
3. The method of claim 1 , or 2 , wherein said transcutaneous electrical spinal cord stimulation is applied paraspinally over T11-T12 vertebrae.
4. The method of claim 1 , or 2 , wherein said transcutaneous stimulation is applied at an intensity ranging from about 10 mA to about 150 mA.
5. The method of claim 1 , or 2 , wherein said transcutaneous stimulation is applied at a frequency ranging from about 3 Hz to about 100 Hz.
6. The method of claim 1 , or 2 , wherein said mammal has a spinal cord injury.
7. The method of claim 6 , wherein said spinal cord injury is clinically classified as motor complete.
8. The method of claim 6 , wherein said spinal cord injury is clinically classified as motor incomplete.
9. The method of claim 1 , or 2 , wherein said mammal has an ischemic brain injury.
10. The method of claim 9 , wherein said ischemic brain injury is brain injury from stroke or acute trauma.
11. The method of claim 1 , or 2 , wherein said mammal has a neurodegenerative brain injury.
12. The method of claim 11 , wherein said neurodegenerative brain injury is brain injury associated with a condition selected from the group consisting of Parkinson's disease, Huntington's disease, Alzheimer's disease, ischemic, stroke, amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), and cerebral palsy.
13. The method of claim 1 or 2 , wherein said mammal is a human and the stimulation is under control of said human.
14. The method of claim 1 or 2 , wherein said method further comprises physical training of said mammal.
15. The method of claim 14 , wherein said physical training comprises robotically guided training.
16. The method of claim 14 , wherein said physical training comprises inducing a load bearing positional change in said mammal.
17. The method according to claim 16 , wherein the load bearing positional change in said subject comprises standing.
18. The method of claim 16 , wherein the load bearing positional change in said subject comprises stepping.
19. The method of claim 1 or 2 , wherein said method further comprises administration of one or more neuropharmaceuticals.
20. The method of claim 19 , wherein said neuropharmaceutical comprises one or more agents selected from the group consisting of a serotonergic drug, a dopaminergic drug, and a noradrenergic drug.
21. The method of claim 1 or 2 , wherein said locomotor activity comprises a walking motor pattern.
22. The method of claim 1 or 2 , wherein said non-invasive transcutaneous electrical spinal cord stimulation comprises a biphasic stimulus filled with a carrier frequency of about 10 kHz.