Algorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applications

dc.contributor.authorSalchow-Hömmen, Christina
dc.contributor.authorSchauer, Thomas
dc.contributor.authorMüller, Philipp
dc.contributor.authorKühn, Andrea A.
dc.contributor.authorHofstoetter, Ursula S.
dc.contributor.authorWenger, Nikolaus
dc.date.accessioned2021-12-13T15:48:47Z
dc.date.available2021-12-13T15:48:47Z
dc.date.issued2021-11-22
dc.date.updated2021-12-02T16:50:51Z
dc.description.abstractTranscutaneous spinal cord stimulation (tSCS) is a promising intervention that can benefit spasticity control and augment voluntary movement in spinal cord injury (SCI) and multiple sclerosis. Current applications require expert knowledge and rely on the thorough visual analysis of electromyographic (EMG) responses from lower-limb muscles to optimize attainable treatment effects. Here, we devised an automated tSCS setup by combining an electrode array placed over low-thoracic to mid-lumbar vertebrae, synchronized EMG recordings, and a self-operating stimulation protocol to systematically test various stimulation sites and amplitudes. A built-in calibration procedure classifies the evoked responses as reflexes or direct motor responses and identifies stimulation thresholds as recommendations for tSCS therapy. We tested our setup in 15 individuals (five neurologically intact, five SCI, and five Parkinson’s disease) and validated the results against blinded ratings from two clinical experts. Congruent results were obtained in 13 cases for electrode positions and in eight for tSCS amplitudes, with deviations of a maximum of one position and 5 to 10 mA in amplitude in the remaining cases. Despite these minor deviations, the calibration found clinically suitable tSCS settings in 13 individuals. In the remaining two cases, the automatic setup and both experts agreed that no reflex responses could be detected. The presented technological developments may facilitate the dissemination of tSCS into non-academic environments and broaden its use for diagnostic and therapeutic purposes.en
dc.description.sponsorshipDFG, 424778381, Behandlung motorischer Netzwerkstörungen mittels Neuromodulationen
dc.description.sponsorshipDFG, 414044773, Open Access Publizieren 2021 - 2022 / Technische Universität Berlinen
dc.identifier.eissn2077-0383
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/14065
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-12838
dc.language.isoenen
dc.rightsLicensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.otherautomationen
dc.subject.otherelectromyographyen
dc.subject.othernoninvasiveen
dc.subject.otherParkinson’s diseaseen
dc.subject.otherposterior root-muscle reflexesen
dc.subject.otherspasticityen
dc.subject.otherspinal cord injuryen
dc.subject.otherspinal cord stimulationen
dc.subject.othertranscutaneousen
dc.titleAlgorithms for Automated Calibration of Transcutaneous Spinal Cord Stimulation to Facilitate Clinical Applicationsen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.articlenumber5464en
dcterms.bibliographicCitation.doi10.3390/jcm10225464en
dcterms.bibliographicCitation.issue22en
dcterms.bibliographicCitation.journaltitleJournal of Clinical Medicineen
dcterms.bibliographicCitation.originalpublishernameMDPIen
dcterms.bibliographicCitation.originalpublisherplaceBaselen
dcterms.bibliographicCitation.volume10en
tub.accessrights.dnbfreeen
tub.affiliationFak. 4 Elektrotechnik und Informatik>Inst. Energie- und Automatisierungstechnik>FG Regelungssystemede
tub.affiliation.facultyFak. 4 Elektrotechnik und Informatikde
tub.affiliation.groupFG Regelungssystemede
tub.affiliation.instituteInst. Energie- und Automatisierungstechnikde
tub.publisher.universityorinstitutionTechnische Universität Berlinen
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