Rehabilitation of motor and sensory function using spinal cord stimulation: Recent advances

Spinal cord stimulation can improve function in neural injuries and disorders. Here, we review recent developments in epidural and transcutaneous spinal cord stimulation (eSCS, tSCS) for motor and sensory rehabilitation. eSCS entails electrodes implanted epidurally over the dorsal spinal cord, while tSCS utilizes adhesive electrodes placed on the surface of the skin. eSCS and tSCS improve volitional motor control in conditions such as spinal cord injury, Parkinson's disease, stroke, multiple sclerosis, and spinal muscular atrophy. They likely improve volitional function by exciting dorsal root afferents which prime motoneurons for supraspinal and propriospinal inputs. Additionally, eSCS and tSCS evoke sensations in missing limbs post-amputation, providing sensory feedback and improving coordination and stability. Hardware advancements aim to optimize targeting and specificity for motor and sensory rehabilitation applications.