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Toward a better understanding and terminology of transcutaneous spinal cord stimulation techniques

Spinal Cord volume 62, pages 195–196 (2024)Cite this article

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After reading with great interest the meta-analysis by Hassan et al. (2023) published in Spinal Cord titled “Effect of transcutaneous direct current stimulation on spasticity in upper motor neuron conditions: a systematic review and meta-analysis” [1]. First, we would like to thank the authors for this interesting study, which explored the effects of transcutaneous spinal direct current stimulation (tsDCS) on spasticity. This study is commendable for its well-structured approach and contribution to the understanding of the potential applications of tsDCS in modulating spinal cord activity.

Our careful examination of the published work has revealed significant inconsistencies in the terminology employed, particularly in the conflation of distinct non-invasive spinal cord stimulation techniques included and mixed in the meta-analysis; each intervention produces markedly different neurophysiological effects and should not be confounded. One is tsDCS, which involves the application of galvanic or direct current at the spinal level through rubber pads, either on the skin with a conductive gel or within saline-soaked sponges, with an intensity usually ranging between 1.5 and 2.5 mA. The main proposed mechanism of action of tsDCS includes the induction of changes in the resting membrane potential of neurons, in a polarity-dependent way, and without inducing neuron depolarization. A recent systematic review published by our group has shown inconsistent effects of anodal tsDCS to decrease hypertonia, neuropathic pain intensity, and balance deficits in people with hereditary spastic paraplegia, multiple sclerosis, and primary orthostatic tremor, respectively [2].

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References

  1. Hassan AB, Salihu AT, Masta MA, Gunn H, Marsden J, Abdullahi A, et al. Effect of transcutaneous spinal direct current stimulation on spasticity in upper motor neuron conditions: a systematic review and meta-analysis. Spinal Cord. 2023;61:587–99.

    Article  PubMed  Google Scholar 

  2. Fernández-Pérez JJ, Serrano-Muñoz D, Beltran-Alacreu H, Avendaño-Coy J, Gómez-Soriano J. Trans-Spinal Direct Current Stimulation in Neurological Disorders: A systematic review. J Neurol Phys Ther. 2023. https://doi.org/10.1097/NPT.0000000000000463.

    Article  PubMed  Google Scholar 

  3. Megía García A, Serrano-Muñoz D, Taylor J, Avendaño-Coy J, Gómez-Soriano J. Transcutaneous Spinal Cord Stimulation and Motor Rehabilitation in Spinal Cord Injury: A Systematic Review. Neurorehabil Neural Repair. 2020;34:3–12.

    Article  PubMed  Google Scholar 

  4. Alashram AR, Padua E, Raju M, Romagnoli C, Annino G. Transcutaneous spinal cord stimulation effects on spasticity in patients with spinal cord injury: A systematic review. J Spinal Cord Med. 2023;46:582–9.

    Article  PubMed  Google Scholar 

  5. Bikson M, Esmaeilpour Z, Adair D, Kronberg G, Tyler WJ, Antal A, et al. Transcranial Electrical Stimulation Nomenclature. Brain Stimul. 2019;12:1349.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain

    Juan José Fernández-Pérez & Julio Gómez-Soriano

  2. Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey

    Gülser Cinbaz

Authors
  1. Juan José Fernández-Pérez
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  2. Gülser Cinbaz
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  3. Julio Gómez-Soriano
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JJFP was responsible for writing the correspondence. GC was responsible for writing the correspondence. JGS was responsible for writing and provided feedback on the correspondence.

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Correspondence to Gülser Cinbaz.

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Fernández-Pérez, J.J., Cinbaz, G. & Gómez-Soriano, J. Toward a better understanding and terminology of transcutaneous spinal cord stimulation techniques. Spinal Cord 62, 195–196 (2024). https://doi.org/10.1038/s41393-024-00975-w

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