Kuck Alexander, Stegeman Dick F, van der Kooij Herman, van Asseldonk Edwin H F
Laboratory of Biomechanical Engineering, Department of Engineering Technology, University of Twente, Enschede, Netherlands.
Neuronal Rhythms in Movement Unit, Okinawa Institute of Science and Technology Graduate University, Onna-son, Japan.
Front Neurosci. 2018 Mar 28;12:151. doi: 10.3389/fnins.2018.00151. eCollection 2018.
Trans-spinal direct current stimulation (tsDCS) is an electro-modulatory tool with possible application in the rehabilitation of spinal cord injury. TsDCS generates a small electric field, aiming to induce lasting, functional neuromodulation in the targeted neuronal networks. Earlier studies have shown significant modulatory effects after application of lumbar tsDCS. However, for clinical application, a better understanding of application specific factors is required. Our goal was to investigate the effect of different electrode configurations using lumbar spinal tsDCS on spinal excitability. We applied tsDCS (2.5 mA, 15 min) in 10 healthy subjects with three different electrode configurations: (1) Anode and cathode placed over vertebra T11, and the posterior left shoulder respectively (LSC-S) (one polarity), and (2) Both electrodes placed in equal distance (ED) (7 cm) above and below vertebra T11, investigated for two polarities (ED-Anodal/Cathodal). The soleus H-Reflex is measured before, during and after tsDCS in either electrode configuration or a sham condition. To account for genetic predispositions in response to direct current stimulation, subject BDNF genotype was assessed. Stimulation in configuration ED-Cathodal induced an amplitude reduction of the H-reflex, 30 min after tsDCS with respect to baseline, whereas none of the other configurations led to significant post intervention effects. BDNF genotype did not correlate with post intervention effects. Furthermore, we failed to replicate effects shown by a previous study, which highlights the need for a better understanding of methodological and subject specific influences on tsDCS outcome. The H-reflex depression after tsDCS (Config. ED-Cathodal) provides new insights and may foster our understanding of the working mechanism of tsDCS.
经脊髓直流电刺激(tsDCS)是一种电调制工具,可能应用于脊髓损伤的康复。tsDCS产生一个小电场,旨在在目标神经网络中诱导持久的功能性神经调节。早期研究表明,应用腰部tsDCS后有显著的调节作用。然而,对于临床应用,需要更好地了解特定应用因素。我们的目标是研究使用腰部脊髓tsDCS的不同电极配置对脊髓兴奋性的影响。我们在10名健康受试者中应用tsDCS(2.5 mA,15分钟),采用三种不同的电极配置:(1)阳极和阴极分别置于第11胸椎和左后肩部(LSC-S)(一种极性),以及(2)两个电极等距(ED)(7厘米)置于第11胸椎上方和下方,研究两种极性(ED-阳极/阴极)。在tsDCS的任何一种电极配置或假刺激条件下,在tsDCS之前、期间和之后测量比目鱼肌H反射。为了考虑对直流电刺激反应的遗传易感性,评估了受试者的BDNF基因型。在配置ED-阴极刺激下,tsDCS后30分钟,H反射幅度相对于基线降低,而其他配置均未导致显著的干预后效应。BDNF基因型与干预后效应无关。此外,我们未能重复先前一项研究显示的效应,这突出表明需要更好地理解方法学和受试者特定因素对tsDCS结果的影响。tsDCS(配置ED-阴极)后H反射的抑制提供了新的见解,可能有助于我们理解tsDCS的工作机制。