The effects of stimulation waveform and carrier frequency on tolerance and motor thresholds elicited by transcutaneous spinal cord stimulation in stroke

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI:10.1016/j.cnp.2025.04.001

Chen Yang , Nicole C. Veit , Kelly A. McKenzie , Shreya Aalla , Ameen Kishta , Kyle Embry , Elliot J. Roth , Richard L. Lieber , Arun Jayaraman

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引用次数: 0

Abstract

Objective

With growing interest in translating transcutaneous spinal cord stimulation (tSCS) into rehabilitation for different neurologic injuries, understanding the effects of various combinations of stimulation parameters becomes essential.

Methods

Twenty-one participants post-stroke completed an assessment to determine their resting motor threshold (RMT) (minimum current required to elicit a muscle response) and tolerance levels (uncomfortable current intensity) to 12 stimulation configurations: two square waveforms, biphasic and monophasic, paired with six carrier frequencies (unmodulated: 0, and modulated: 1, 3, 5, 7, and 10 kHz).

Results

The results demonstrated that increasing carrier frequency increased participants’ tolerance level and RMTs. Carrier frequency nor waveform type significantly altered discomfort when tolerance was normalized to the motor threshold, with 57 ± 23 % tolerated across all configurations. However, higher carrier frequencies, particularly biphasic waveforms at frequencies > 5 kHz, required more charge to reach a muscle activation and activated fewer muscles compared to unmodulated waveforms. No significant differences in discomfort relative to RMT were found between monophasic and biphasic waveforms.

Conclusions

Higher carrier frequency allows stimulation to be more comfortable at a given intensity, but it also requires more current to reach RMTs.

Significance

This study provides an essential feasibility assessment of tSCS configurations in a neurological population.

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刺激波形和载波频率对脑卒中经皮脊髓刺激引起的耐受性和运动阈值的影响

目的随着人们对经皮脊髓刺激（tSCS）在不同神经损伤康复治疗中的应用越来越感兴趣，了解不同刺激参数组合的效果变得至关重要。21名中风后参与者完成了一项评估，以确定他们对12种刺激配置的静息运动阈值（RMT）（引起肌肉反应所需的最小电流）和耐受水平（不舒服的电流强度）：两种方波，双相和单相，搭配6种载波频率（未调制：0，调制：1、3、5、7和10 kHz）。结果结果表明，载体频率的增加增加了被试的耐受性水平和rmt。当容忍度归一化到电机阈值时，载波频率和波形类型显著改变了不适感，所有配置的容忍度为57±23%。然而，较高的载波频率，特别是频率>的双相波形；5 kHz，与未调制波形相比，需要更多的电荷来达到肌肉激活，激活的肌肉更少。相对于RMT，单相和双相波形的不适感没有显著差异。结论较高的载波频率可以使刺激在给定强度下更舒适，但也需要更大的电流才能达到rmt。意义本研究为神经系统人群中tSCS配置提供了必要的可行性评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.