Developing Stimulation Patterns for Transcutaneous Spinal Cord Stimulation Combined with Brain Computer Interfacing for Motor Rehabilitation

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Spinal Cord Injury (SCI) can be a devastating condition, leaving people completely paralysed in the body below the injury. Transcutaneous Spinal Cord Stimulation (tSCS) is a novel non-invasive method of stimulation., that has shown promising results for the recovery of arm and hand function even in people believed to have "complete" SCI, i.e. they had no hope to recover. Although there is scientific evidence that tSCS improves motor recovery, the exact mechanism of action is unknown, and is still a matter of debate within the research community. One of the main reasons for this is that stimulation parameters are applied ad hock and a systematic approach is lacking. Typically tSCS therapy is delivered while patients are practicing some physical therapy. In case of "complete" SCI that is not impossible, at least at the beginning of the therapy. Therefore we will use another piece of neurotechnology, Brain Computer Interface (BCI), to support practice of imagined and attempted movement as a proxy to physical therapy. As therapy progresses patients stop imagining and become able to perform movements for real. Specific objectives of the project are: (i) Defining optimal duration and stimulation parameters to increase spinal reflexes in healthy people. (ii) Understanding the causal effect between activation of subspinal (brain via BCI) and spinal circuits (via tSCS) in healthy people. Test the concept of novel therapy based on combined BCI and tSCS. (iii) Creating and testing software application for simple semi-automatic selection of optimal stimulation parameters. (iv) Testing concepts developed in (i) and (ii) on people with spinal cord injury This is a collaborative project with Queen Elizabeth National Spinal Injuries Unit.