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Abstract

The changing methods of electrical stimulation of the spinal cord employed in patients with MS are described. The most recent innovation is that of epidural placement of electrodes for temporary and permanent stimulation.

The most favorable effects are modification of urinary dysfunction, voluntary motor dysfunction of limbs, pain, equilibratory and non-equilibratory coordinate dysfunction. Not all these changes occur in all patients and when a change occurs it varies from patient to patient. Persistence of effect may persist after stimulation is discontinued over variable periods, and this period is increased with increased duration of prior stimulation.

These experiences indicate it is possible to restore voluntary control, even integrated movement, in patients with MS. It is suggested that there may be an intrinsic pacemaker arrangement within the spinal cord which is modified by electrical stimulation.

There is increasing recognition of the importance of dendritic arborizations and bundles within the spinal cord and it is this type of anatomical arrangement which suggests the potential of sensory-motor computation at the spinal cord level.

The effect of electrical stimulation on the electrical activity of the spinal cord is discussed, and it is noted that the effect is non specific. However, the possibility exists that it may change polarization in areas of dendritic arborization wherein programs may reside for certain types of motor activity. Present information suggests cathodal stimulation may be better than bipolar stimulation.

Keywords

Spinal cord electrical stimulation cathodal stimulation Multiple Sclerosis results functional recovery voluntary motor function dendritic bundles pacemaker

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References

Cook

A.W.

and Weinstein

S. P.

, Chronic dorsal column stimulation in multiple sclerosis. N. Y. State J. Med. 73, 2868—2872, 1973.

Cook

A. W.

, Electrical stimulation of the spinal cord. Letter to the Eds. Lancet ii, 1973.

Cook

A. W.

, Electrical stimulation in multiple sclerosis. Hos. Prac. 2, 51—58, 1976.

Cook

A. W.

, Tahmouresie

, Oygar

, Kleriga

, Pacheco

, Baggenstos

and Nidzgorski

, Epidural electrical stimulation of spinal cord for intractable pain and other abnormal conditions. Acupuncture & Electro-Therapeut. Res., Int. J. 2, 259—270, 1977.

Omura

, The effects of electrical and non-electrical acupuncture in cardiovascular and nervous systems and pre- and post-acupuncture evaluation of the patient. Acupuncture & Electro-Therapeut. Res. Int. J. 3, 000—000, 1978.

Abbate

A. D.

, Cook

A.W.

and Atallah

, Effect of electrical stimulation of the thoracic spinal cord on the function of the bladder in multiple sclerosis. 7. Urol. 117, 285—288, 1977.

Omura

, Critical evaluation of the methods of measurement of tingling threshold, pain threshold, and pain tolerance by electrical stimulation. Acupuncture & Electro-Therapeut. Res., Int. J. 2, 161—236, 1977.

Omura

, The relationship between transmembrane action potential and the voltage-time dependent, negative resistant characteristics of the voltage-current curves of excitable pacemaker and non-pacemaker cell membrane. Trans. N.Y. Acad. Sci. 33, 467—518, 1971.

Pearson

K. G.

, Foutner

C.R.

and Wong

R. K.

, Nervous control of walking in the cockroach, In Control of Posture and Locomotion, (edited by Stein

R. B.

, Pearson

K. G.

, Smith

R. S.

, and Redford

J.B.

), Plenum Press, New York. 1973.

10.

Grillner

, Locomotiop in vertebrates: control mechanisms and reflex interaction. Physical Rev. 55, 247—304, 1975.

11.

Scheibel

M.E.

and Scheibel

A. B.

, structure substates for integrative patterns in the brainstem reticular core, in Recticular formation of the brain, (edited by Jasper

H. H.

, pp. 31—35. Little Brown, Boston, 1958.

12.

Kostyuk

P. G.

, Interneuronal mechanisms of interaction between discending and afferent signals in the spinal cord, in Golgi Centennial Proceedings, (edited by M. Santini, pp. 247—259. Raven Press, N.Y., 1975.

13.

Schiebel

M.E.

and Scheibel

A. B.

, Dendrites as neuronal cacephers: the dendritic bundle, in Golgi Centennial Symposium Proceedings, (edited by M. Santini), pp. 347—354. Raven Press, N.Y., 1975.

14.

Young

J. Z.

, A Model of the Brain. Clarendon Press, Oxford, 1960.

15.

Ross

Ashby, Design for a Brain. Chapman & Hall, London, 1960.

16.

Taylor

W. K.

, The structure and function of the urinary system. Nature 180, 1388—1390, 1957.

17.

Burns

B. D.

, The Uncertain Nervous System, (edited by Arnold), London, 1968.

Spinal Cord Stimulation in Multiple Sclerosis

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References