Epidural electrical stimulation for spinal cord injury

• Published in: Neural regeneration research Vol. 16; no. 12; pp. 2367 - 2375
• Main Authors: Choi, Elliot, Gattas, Sandra, Brown, Nolan, Hong, John, Limbo, Joshua, Chan, Alvin, Oh, Michael
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.12.2021; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Department of Pharmacology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA; Department of Neurosurgery, University of California, Irvine, CA, USA%Department of Neurosurgery, University of California, Irvine, CA, USA%Department of Ophthalmology, Gavin Herbert Eye Institute, School of Medicine, University of California, Irvine, CA, USA; Department of Ophthalmology, Gavin Herbert Eye Institute, School of Medicine, University of California, Irvine, CA, USA; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Brain stimulation; Care and treatment; central nervous system; chondroitin sulfate proteoglycans; epidural electrical stimulation; glial scar; gliosis; neural activity; neuromodulation; oligodendrocyte; spinal cord injury; Development and progression; Diagnosis; Epidural; Medical prognosis; Review; Spinal cord injuries; Testing; United States; neuromodulation; spinal cord injury; neural activity; glial scar; chondroitin sulfate proteoglycans; oligodendrocyte; epidural electrical stimulation; gliosis; central nervous system
• ISSN: 1673-5374; 1876-7958
• DOI: 10.4103/1673-5374.313017

A long-standing goal of spinal cord injury research is to develop effective repair strategies, which can restore motor and sensory functions to near-normal levels. Recent advances in clinical management of spinal cord injury have significantly improved the prognosis, survival rate and quality of life in patients with spinal cord injury. In addition, a significant progress in basic science research has unraveled the underlying cellular and molecular events of spinal cord injury. Such efforts enabled the development of pharmacologic agents, biomaterials and stem-cell based therapy. Despite these efforts, there is still no standard care to regenerate axons or restore function of silent axons in the injured spinal cord. These challenges led to an increased focus on another therapeutic approach, namely neuromodulation. In multiple animal models of spinal cord injury, epidural electrical stimulation of the spinal cord has demonstrated a recovery of motor function. Emerging evidence regarding the efficacy of epidural electrical stimulation has further expanded the potential of epidural electrical stimulation for treating patients with spinal cord injury. However, most clinical studies were conducted on a very small number of patients with a wide range of spinal cord injury. Thus, subsequent studies are essential to evaluate the therapeutic potential of epidural electrical stimulation for spinal cord injury and to optimize stimulation parameters. Here, we discuss cellular and molecular events that continue to damage the injured spinal cord and impede neurological recovery following spinal cord injury. We also discuss and summarize the animal and human studies that evaluated epidural electrical stimulation in spinal cord injury.