Brain-computer interface priming for cervical transcutaneous spinal cord stimulation therapy: an exploratory case study

McGeady, C., Vučković, A. , Tharu, N. S., Zheng, Y.-P. and Alam, M. (2022) Brain-computer interface priming for cervical transcutaneous spinal cord stimulation therapy: an exploratory case study. Frontiers in Rehabilitation Sciences, 3, 896766. (doi: 10.3389/fresc.2022.896766) (PMID:36188944) (PMCID:PMC9397879)

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Abstract

Loss of arm and hand function is one of the most devastating consequences of cervical spinal cord injury (SCI). Although some residual functional neurons often pass the site of injury, recovery after SCI is extremely limited. Recent efforts have aimed to augment traditional rehabilitation by combining exercise-based training with techniques such as transcutaneous spinal cord stimulation (tSCS), and movement priming. Such methods have been linked with elevated corticospinal excitability, and enhanced neuroplastic effects following activity-based therapy. In the present study, we investigated the potential for facilitating tSCS-based exercise-training with brain-computer interface (BCI) motor priming. An individual with chronic AIS A cervical SCI with both sensory and motor complete tetraplegia participated in a two-phase cross-over intervention whereby they engaged in 15 sessions of intensive tSCS-mediated hand training for 1 h, 3 times/week, followed by a two week washout period, and a further 15 sessions of tSCS training with bimanual BCI motor priming preceding each session. We found using the Graded Redefined Assessment for Strength, Sensibility, and Prehension that the participant's arm and hand function improved considerably across each phase of the study: from 96/232 points at baseline, to 117/232 after tSCS training alone, and to 131/232 points after BCI priming with tSCS training, reflecting improved strength, sensation, and gross and fine motor skills. Improved motor scores and heightened perception to sharp sensations improved the neurological level of injury from C4 to C5 following training and improvements were generally maintained four weeks after the final training session. Although functional improvements were similar regardless of the presence of BCI priming, there was a moderate improvement of bilateral strength only when priming preceded tSCS training, perhaps suggesting a benefit of motor priming for tSCS training.

Item Type:Articles
Additional Information:This work was supported by RCUK PhD scholarship EP/N509668/1, the University of Glasgow Graduate School Mobility Scholarship, The Hong Kong Polytechnic University (UAKB), and the Telefield Charitable Fund (83D1).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McGeady, Ciaran and Vuckovic, Dr Aleksandra
Creator Roles:
McGeady, C.Conceptualization, Methodology, Software, Validation, Formal analysis, Investigation, Data curation, Writing – original draft, Visualization, Funding acquisition
Vuckovic, A.Conceptualization, Validation, Writing – review and editing
Authors: McGeady, C., Vučković, A., Tharu, N. S., Zheng, Y.-P., and Alam, M.
College/School:College of Science and Engineering > School of Engineering > Biomedical Engineering
Journal Name:Frontiers in Rehabilitation Sciences
Publisher:Frontiers Media
ISSN:2673-6861
ISSN (Online):2673-6861
Copyright Holders:Copyright © 2022 McGeady, Vuˇckovi´c, Singh Tharu, Zheng and Alam
First Published:First published in Frontiers in Rehabilitation Sciences 3: 896766
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
172865EPSRC DTP 16/17 and 17/18Mary Beth KneafseyEngineering and Physical Sciences Research Council (EPSRC)EP/N509668/1Research and Innovation Services