PTRCTNeuroRehabilitation2018

The effect of transcutaneous spinal direct current stimulation on corticospinal excitability in chronic incomplete spinal cord injury.

Elizabeth Salmon Powell, Cheryl Carrico, Emily Salyers and 2 others

PMID 30040753

WHAT IT FOUND

Cathodal, anodal, and sham spinal electrical stimulation did not significantly change brain-to-leg muscle signals in people with chronic incomplete spinal cord injury.

This small study found no change to act on.

Key findings

01The primary outcome, change in motor evoked potential amplitude in the right and left soleus muscles, showed no significant pre-post change after anodal, cathodal, or sham tsDCS.

02There were no significant differences between the anodal, cathodal, and sham tsDCS conditions.

03One subject withdrew after 2 sessions, and some subjects had no measurable motor evoked potentials, which were included as 0 μV.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Small feasibility sample; one subject withdrew after 2 sessions. Some subjects had no measurable motor evoked potentials, and zero values were used, which can affect interpretation. Participants varied in time since injury, lesion level, and American Spinal Injury Association grade, which may change how stimulation affects excitability. Only lower-extremity soleus motor evoked potentials were measured, and testing was done seated, not standing. Upper-extremity responses were not measured, so the study cannot speak to arm function. No functional outcomes were measured, so the study does not show effects on walking or daily activity.

Declared interests

The paper's conflict-of-interest statement says the work was supported by NIH National Center for Research Resources and National Center for Advancing Translational Sciences, and by the HealthSouth Cardinal Hill Stroke and Spinal Cord Endowment.

The easy way to misread this

Do not read the reported right-leg increase and left-leg decrease as a proven effect. The primary outcome was null, the changes did not reach significance, and this was a small feasibility study.

Read it on PubMed →