A novel paired associative stimulation protocol with a high‐frequency peripheral component: A review on results in spinal cord injury rehabilitation

Abstract Background Patients with spinal cord injury (SCI) frequently complain of intractable pain that is resistant to conservative treatments. Here, we report the successful application of 1-kHz high-frequency spinal cord stimulation (SCS) in a patient with refractory neuropathic pain secondary to SCI. Case presentation A 69-year-old male diagnosed with SCI (C4 American Spinal Injury Association Impairment Scale A) presented with severe at-level bilateral upper extremity neuropathic pain. Temporary improvement in his symptoms with a nerve block implied peripheral component involvement. The patient received SCS, and though the tip of the leads could not reach the cervical vertebrae, a 1-kHz frequency stimulus relieved the intractable pain. Conclusions SCI-related symptoms may include peripheral components; SCS may have a considerable effect on intractable pain. Even when the SCS electrode lead cannot be positioned in the target area, 1-kHz high-frequency SCS may still produce positive effects.

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The SCIRehab project: analyzing multidisciplinary inpatient spinal cord injury rehabilitation treatment — second phase

Journal of Spinal Cord Medicine ◽

10.1179/107902611x12971826987977 ◽

2011 ◽

Vol 34 (2) ◽

pp. 131-132 ◽

Cited By ~ 4

Author(s):

Gale Whiteneck ◽

Julie Gassaway ◽

Marcel P. Dijkers ◽

Flora M. Hammond ◽

Daniel P. Lammertse

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Second Phase ◽

Injury Rehabilitation ◽

Rehabilitation Treatment ◽

Cord Injury

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The experience of using the scale of Functional Independence Measure in individuals undergoing spinal cord injury rehabilitation in Brazil

Spinal Cord ◽

10.1038/sc.2013.179 ◽

2014 ◽

Vol 52 (4) ◽

pp. 276-281 ◽

Cited By ~ 8

Author(s):

D C Barbetta ◽

L C Cassemiro ◽

M R Assis

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Independence Measure ◽

Functional Independence ◽

Injury Rehabilitation ◽

Cord Injury

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Function of the nucleus accumbens in motor control during recovery after spinal cord injury

Science ◽

10.1126/science.aab3825 ◽

2015 ◽

Vol 350 (6256) ◽

pp. 98-101 ◽

Cited By ~ 41

Author(s):

Masahiro Sawada ◽

Kenji Kato ◽

Takeharu Kunieda ◽

Nobuhiro Mikuni ◽

Susumu Miyamoto ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Nucleus Accumbens ◽

High Frequency ◽

Neuronal Damage ◽

Recovery Period ◽

Oscillatory Activity ◽

Finger Movements ◽

Early Recovery ◽

Cord Injury

Motivation facilitates recovery after neuronal damage, but its mechanism is elusive. It is generally thought that the nucleus accumbens (NAc) regulates motivation-driven effort but is not involved in the direct control of movement. Using causality analysis, we identified the flow of activity from the NAc to the sensorimotor cortex (SMC) during the recovery of dexterous finger movements after spinal cord injury at the cervical level in macaque monkeys. Furthermore, reversible pharmacological inactivation of the NAc during the early recovery period diminished high-frequency oscillatory activity in the SMC, which was accompanied by a transient deficit of amelioration in finger dexterity obtained by rehabilitation. These results demonstrate that during recovery after spinal damage, the NAc up-regulates the high-frequency activity of the SMC and is directly involved in the control of finger movements.

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