Dissertation
Multisite electrode arrays to optimize epidural stimulation for spasticity following spinal cord injury
Doctor of Philosophy (Ph.D.), Drexel University
Aug 2024
DOI:
https://doi.org/10.17918/00010578
Abstract
Spasticity manifests in approximately 75% of spinal cord injury (SCI) patients. Pathological characteristics can involve a combination of involuntary muscle movements, co-contraction of antagonistic muscles, and hyperreflexia; all of which contribute to making daily activities challenging. Pharmacological intervention can aid in reducing these spastic symptoms; however, these treatments can have severe side effects such as seizures and dizziness, and depress overall spinal reflex excitability and muscle activity, further impeding motor recovery. Here, we examine epidural spinal cord stimulation (ES) as an alternative strategy to decrease spasticity following SCI. ES studies have historically centered on locomotor recovery, and the efficacy of ES has relied heavily on optimization in humans or the use of pharmacology in rodents. Little is known regarding if ES can serve as a form of treatment for spasticity following SCI and if it requires similar optimization. Thus, the basis of this thesis is to use individually optimized ES to target spasticity after SCI and elucidate the physiological improvements and neuroplasticity that can be achieved. In summary, we (1) displayed the specificity of ES in a clinically relevant animal model, (2) showed that individually optimized ES can decrease hyperreflexia with and without activity-based training, and (3) demonstrated that ES can be individually optimized for spasticity to generate improvements in presynaptic and postsynaptic inhibition without augmenting motor output. Together, this thesis displays that ES can serve as a treatment option for spasticity following SCI and created a foundation for future exploration on individually optimized ES within a clinically relevant animal model.
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Details
- Title
- Multisite electrode arrays to optimize epidural stimulation for spasticity following spinal cord injury
- Creators
- Jeremy Weinberger
- Contributors
- Marie-Pascale Côté (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- x, 103 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Medicine; Neurology; Drexel University
- Other Identifier
- 991021899614904721