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

脊髓损伤（SCI）可能是一种毁灭性的疾病，使人们在受伤部位以下的身体完全瘫痪。经皮脊髓电刺激（tSCS）是一种新型的非侵入性刺激方法。这已经显示出对于恢复手臂和手功能的有希望的结果，即使是在被认为患有“完全”SCI的人中，即他们没有希望恢复。虽然有科学证据表明tSCS可以改善运动恢复，但确切的作用机制尚不清楚，并且在研究界仍然存在争议。其主要原因之一是刺激参数是临时应用的，缺乏系统的方法。通常，在患者正在进行某种物理治疗的同时递送tSCS治疗。在“完全”SCI的情况下，这不是不可能的，至少在治疗开始时。因此，我们将使用另一种神经技术，脑机接口（BCI），来支持想象和尝试运动的实践，作为物理治疗的替代。随着治疗的进展，患者停止想象，并能够进行真实的运动。 该项目的具体目标是：（一）确定最佳持续时间和刺激参数，以增加健康人的脊髓反射。(ii)了解健康人脊髓下（通过BCI的大脑）和脊髓回路（通过tSCS）激活之间的因果关系。测试基于组合BCI和tSCS的新疗法的概念。(iii)创建和测试软件应用程序，用于简单的半自动选择最佳刺激参数。(iv)在（i）和（ii）中开发的脊髓损伤患者的测试概念这是与伊丽莎白女王国家脊髓损伤单位的合作项目。

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.