Method of transcutaneous electrical spinal cord stimulation for facilitation of locomotion
In various embodiments, non-invasive methods to induce motor control in a mammal subject to spinal cord or other neurological injuries are provided. In some embodiments the methods involve administering transcutaneous electrical spinal cord stimulation (tSCS) to the mammal at a frequency and intensity that induces locomotor activity.
1. A method of facilitating locomotor activity in a mammal having a spinal cord injury, an ischemic brain injury, or a neurodegenerative brain injury, said method comprising:
administering to said mammal transcutaneous electrical spinal cord stimulation (tSCS) through an electrode applied to the skin of said mammal over the midline of the spinal cord of said mammal at a frequency and intensity that facilitates the recovery or improved control of said locomotor activity, wherein said stimulation enables or induces a locomotor pattern in said mammal.
2. The method of claim 1 , wherein said mammal is a human.
3. The method of claim 2 , wherein said transcutaneous electrical spinal cord stimulation is applied over the midline of the spinal cord at C4-C5, T11-T12, and/or L1-L2 vertebrae.
4. The method of claim 2 , wherein said transcutaneous electrical spinal cord stimulation is applied over the midline of the spinal cord at C4-C5, T11-T12, and/or L1-L5 vertebrae.
5. The method of claim 2 , wherein said transcutaneous electrical spinal cord stimulation enables or induces a locomotor pattern in said mammal in response to postural proprioceptive signals, locomotor proprioceptive signals, and/or supraspinal signals.
6. The method of claim 5 , wherein said postural proprioceptive signals, locomotor proprioceptive signals, and/or supraspinal signals are provided by physical training of said mammal.
7. The method of claim 6 , wherein said method further comprises physical training of said mammal.
8. The method of claim 7 , wherein said physical training comprises inducing a load bearing positional change in said mammal.
9. The method of claim 7 , wherein the load bearing positional change in said mammal comprises standing.
10. The method of claim 7 , wherein the load bearing positional change in said mammal comprises stepping.
11. The method of claim 7 , wherein said physical training comprises robotically guided training.
12. The method of claim 1 , wherein said transcutaneous stimulation is applied at an intensity ranging from about 30 to 200 mA.
13. The method of claim 1 , wherein said transcutaneous stimulation is applied at a frequency ranging from about 3 Hz to about 100 Hz.
14. The method of claim 1 , wherein said mammal has a spinal cord injury.
15. The method of claim 14 , wherein said mammal has a spinal cord injury that is clinically classified as motor complete.
16. The method of claim 14 , wherein said mammal has a spinal cord injury that is clinically classified as motor incomplete.
17. The method of claim 1 , wherein said mammal has an ischemic brain injury, brain injury from stroke, or acute trauma.
18. The method of claim 1 , wherein said mammal has a neurodegenerative 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.
19. The method of claim 1 , wherein said locomotor activity comprises one or more activities selected from the group consisting of standing, stepping, speech, swallowing or breathing, a walking motor pattern, sitting down, and laying down.
20. The method of claim 1 , wherein the mammal is a human and the stimulation is under control of said human.
21. The method of claim 1 , wherein said method further comprises administration of one or more neuropharmaceuticals.
22. The method of claim 21 , wherein said neuropharmaceutical comprises one or more agents selected from the group consisting of a serotonergic drug, a dopaminergic drug, and a noradrenergic drug.
23. The method of claim 1 , wherein said transcutaneous electrical spinal cord stimulation is superimposed on a carrier frequency that suppresses the sensitivity of pain receptors.
24. The method of claim 23 , wherein said carrier frequency is about 10 kHz.
25. The method of claim 1 wherein said locomotor activity comprises an activity selected from the group consisting of postural control, locomotion, voluntary movement of the arms, voluntary movement of the trunk, and voluntary movement of the legs.
26. The method of claim 1 , wherein said stimulation additionally facilitates autonomic function, where said autonomic function is selected from the group consisting of sexual function, and vasomotor function.