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CASE REPORT article

Front. Med.
Sec. Translational Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1459835

Case Report: Combined Transcutaneous Spinal Cord Stimulation and Physical Therapy on Recovery of Neurological Function after Spinal Cord Infarction

Provisionally accepted
Felix León Felix León 1Carlos Rojas Carlos Rojas 2María J. Aliseda María J. Aliseda 2Gerardo Del Río Gerardo Del Río 2Eduardo Monzalvo Eduardo Monzalvo 2Adriana C. Pliego Adriana C. Pliego 3Jimena Figueroa Jimena Figueroa 2Antonio Ibarra Antonio Ibarra 1,4Igor Lavrov Igor Lavrov 5,6Carlos A. Cuellar Carlos A. Cuellar 7*
  • 1 Centro de Investigación en Ciencias de la Salud, FCS, Universidad Anáhuac México Campus Norte, Huixquilucan,, Estado de Mexico, Mexico
  • 2 Facultad de Ciencias de la Salud, Universidad Anáhuac México Campus Norte, Mexico, Mexico
  • 3 Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, México, Mexico
  • 4 Military School of Health Graduates, Mexico City, Mexico
  • 5 Department of Neurology, Medical Departments and Centers, Mayo Clinic, Scottsdale, United States
  • 6 Kazan State Medical University, Kazan, Tatarstan, Russia
  • 7 School of Sports Science, Anahuac University of North Mexico, Mexico, Mexico

The final, formatted version of the article will be published soon.

    The case of a 37-year-old woman who suffered from spinal cord infarction (SI), resulting in a complete spinal cord injury (AIS A, neurological level T10) and autonomic dysfunction is presented. This study aimed to assess the effect of transcutaneous Spinal Cord Electrical Stimulation (tSCS) on improving motor, sensory, and autonomic function after SI. During the first 8 months, tSCS was applied alone, then, physical therapy (PT) was included in the sessions (tSCS+PT), until completion of 20 months. Compared to baseline, at 20 months, an increase in ISNCSCI motor (50 vs. 57) and sensory scores (light touch, 72 vs. 82; pinprick, 71 vs. 92) were observed. Neurogenic Bladder Symptoms Score (NBSS) changed from 27 at baseline to 17 at 20 months. ISAFSCI scores in sacral autonomic function improved from 0 pts (absent function) to 1 pt. (altered function) indicating better sphincter control. EMG recordings during volitional movements, including overground stepping with 80% of body weight support showed activity in gluteus medialis, tensor fascia latae, sartorius, rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medialis, indicating a partial reversion of paralysis. RMS analysis indicated higher activity during "tSCS on" compared to "tSCS off" during overground stepping in bilateral rectus femoris (p<0.001) and gastrocnemius medialis (p<0.01); and unilateral biceps femoris, and tibialis anterior (p<0.001). As this is the first report on the use of tSCS in the case of SI, future studies in a case series are warranted.

    Keywords: Spinal cord infarction, spinal cord injury, transcutaneous spinal cord stimulation, non-invasive neuromodulation, spinal cord stroke, Paraplegia, Physical Therapy

    Received: 04 Jul 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 León, Rojas, Aliseda, Del Río, Monzalvo, Pliego, Figueroa, Ibarra, Lavrov and Cuellar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Carlos A. Cuellar, School of Sports Science, Anahuac University of North Mexico, Mexico, Mexico

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