Department of Anatomy, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.
John Stearne Medical Library, Trinity Centre for Health Sciences, School of Medicine, St. James's Hospital, Dublin, Ireland.
PLoS One. 2021 Nov 18;16(11):e0260166. doi: 10.1371/journal.pone.0260166. eCollection 2021.
Transcutaneous spinal cord stimulation (tSCS) is a non-invasive modality in which electrodes can stimulate spinal circuitries and facilitate a motor response. This review aimed to evaluate the methodology of studies using tSCS to generate motor activity in persons with spinal cord injury (SCI) and to appraise the quality of included trials.
A systematic search for studies published until May 2021 was made of the following databases: EMBASE, Medline (Ovid) and Web of Science. Two reviewers independently screened the studies, extracted the data, and evaluated the quality of included trials. The electrical characteristics of stimulation were summarised to allow for comparison across studies. In addition, the surface electromyography (EMG) recording methods were evaluated.
A total of 3753 articles were initially screened, of which 25 met the criteria for inclusion. Studies were divided into those using tSCS for neurophysiological investigations of reflex responses (n = 9) and therapeutic investigations of motor recovery (n = 16). The overall quality of evidence was deemed to be poor-to-fair (10.5 ± 4.9) based on the Downs and Black Quality Checklist criteria. The electrical characteristics were collated to establish the dosage range across stimulation trials. The methods employed by included studies relating to stimulation parameters and outcome measurement varied extensively, although some trends are beginning to appear in relation to electrode configuration and EMG outcomes.
This review outlines the parameters currently employed for tSCS of the cervicothoracic and thoracolumbar regions to produce motor responses. However, to establish standardised procedures for neurophysiological assessments and therapeutic investigations of tSCS, further high-quality investigations are required, ideally utilizing consistent electrophysiological recording methods, and reporting common characteristics of the electrical stimulation administered.
经皮脊髓电刺激（tSCS）是一种非侵入性的方式，通过电极刺激脊髓回路，促进运动反应。本综述旨在评估使用 tSCS 产生脊髓损伤（SCI）患者运动活动的研究方法，并评价纳入试验的质量。
对截至 2021 年 5 月发表的研究进行了系统检索，检索数据库包括 EMBASE、Medline（Ovid）和 Web of Science。两名评审员独立筛选研究、提取数据，并评价纳入试验的质量。总结了刺激的电特性，以便在研究之间进行比较。此外，还评估了表面肌电图（EMG）记录方法。
最初筛选出 3753 篇文章，其中 25 篇符合纳入标准。研究分为使用 tSCS 进行反射反应的神经生理学研究（n = 9）和运动恢复的治疗研究（n = 16）。根据唐斯和布莱克质量检查表标准，总体证据质量被认为是差到中等（10.5 ± 4.9）。汇集了电特性，以确定刺激试验中的剂量范围。纳入研究中与刺激参数和结果测量相关的方法变化很大，尽管在电极配置和肌电图结果方面开始出现一些趋势。
本综述概述了目前用于产生运动反应的颈胸和胸腰椎区域 tSCS 的参数。然而，为了建立 tSCS 的神经生理学评估和治疗研究的标准化程序，需要进一步进行高质量的研究，理想情况下，应使用一致的电生理记录方法，并报告所施加的电刺激的常见特征。
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