Jun 28, 2019

Narrative Salchow and Sayenko

Dual interview episode:
Christina Salchow-Hommen from Charité Universitätsmedizin in Berlin, Germany. Her presentation at RehabWeek2019 was titled “Characterization Of Optimal Electrode Configurations For Transcutaneous Spinal Cord Stimulation.” The talk presented her findings from a small trial which included 5 participants living with spinal cord injuries. In the trial, they were trying to find the optimal placements and size of surface stimulation electrodes to elicit a response rectus femoris and the tibialis anterior muscles. The study found variability in electrode placement but some commonalities at the T11 level spinal circuit level. Let’s catch up with her in our interview.

Dimitry Sayenko from the Center for Neurogeneration at Houston Methodist Research Institute gave a talk about Neuromodulation of Spinal Networks to Recover Motor Function: Underlying Mechanisms and Clinical Translations.” His talk discussed the differences in the epidural spinal stimulation clinical trials being conducted at the University of Louisville, UCLA and at EPFL in Geneva Switzerland. There were differences among the labs but he found the key is enabling versus inducing movement with stimulation and argued that the intense exercise regimes from some of these studies is not necessary. Let’s listen in on his interview.

Takeaways:
Electrode placement, along with stimulation parameters plays an important part in the responses to transcutaneous spinal cord stimulation.

[0:00] Ladan introduces the episode with an interview by Jen French of Neurotech Reports with Christina Salchow-Hommen at RehabWeek 2019.
[1:10] Salchow-Hommen introduces herself and her affilitation with technology for people with impairments for restoration of mobility.
[1:38} Discussion of the importance of electrode placement, adjustment of stimulation parameters between the 5 volunteers and patient reported preferences for transcutaneous spinal cord stimulation for people with paralysis.
[3:35] Salchow-Hommen discusses the need to better monitor the brain during stimulation and better measurement tools to quantify reported feedback.
[4:44] Ladan introduces the episode with an interview by Jen French of Neurotech Reports with Dimitry Sayenko at RehabWeek 2019.
[5:17] Sayenko introduces himself and addresses his perspective of how the brain reacts to spinal cord stimulation for the restoration of motor response after paralysis due to SCI. Nearly 80% of spinal cord injuries result in some form of residual function.
[6:41] Involvement of the brain with restoration of movement along with neuroplasticity for connections in the brain.
[8:28] Coupling traditional therapy with spinal cord stimulation. He finds that the intense rehab is not necessary but the first few sessions are critical. Still the technology has an accumulative effect.
[9:45} Discussion of the introduction of electrical stimulation following a spinal cord injury. When to introduce it in therapy.
[10:50] Restoration of gait and the timing of stimulation. His lab found timing was not critical.
[11:50] The introduction of machine learning into this therapy would be helpful. Sayenko expresses his excitement at RehabWeek.