Neuromodulation in the restoration of function after spinal cord injury

Nicholas D. James, Stephen B. McMahon, Edelle C. Field-Fote, Elizabeth J. Bradbury*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

112 Citations (Scopus)
1401 Downloads (Pure)

Abstract

Neuromodulation, the use of electrical interfaces to alter neuronal activity, has been successful as a treatment approach in several neurological disorders, including deep brain stimulation for Parkinson's disease and epidural spinal stimulation for chronic pain. Neuromodulation can also be beneficial for spinal cord injury, from assisting basic functions such as respiratory pacing and bladder control, through to restoring volitional movements and skilled hand function. Approaches range from electrical stimulation of peripheral muscles, either directly or via brain-controlled bypass devices, to stimulation of the spinal cord and brain. Limitations to widespread clinical application include durability of neuromodulation devices, affordability and accessibility of some approaches, and poor understanding of the underlying mechanisms. Efforts to overcome these challenges through advances in technology, together with pragmatic knowledge gained from clinical trials and basic research, could lead to personalised neuromodulatory interventions to meet the specific needs of individuals with spinal cord injury.

Original languageEnglish
Pages (from-to)905-917
Number of pages13
JournalThe Lancet Neurology
Volume17
Issue number10
Early online date18 Sept 2018
DOIs
Publication statusPublished - 1 Oct 2018

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