Emily McNicol

email: e.mcnicol.1@research.gla.ac.uk

 

 

Research title: Transcutaneous Electrical Spinal Cord Stimulation Combined with Brain Compute Interfacing for Motor Rehabilitation of Spinal Cord Injury

Research Summary

Background

Spinal cord injury (SCI) is becoming increasingly recognised as a global health priority, as it is a leading cause of disability, affecting around 500,000 people globally each year. The disruption of communication pathways from the brain to the periphery caused by SCI results in the insufficient transmission of motor and sensory information and consequently, the loss of volitional motor control below the level of injury.

Conventional activity-based therapy utilises residual neurons that extend below the level of injury to optimise functional movements and learn compensatory mechanisms. However, these rehabilitation methods exhibit limited recovery and often reach a plateau after which further improvements are rarely achieved. For this reason, there has been a shift in neurorehabilitation research from compensatory strategies towards functional neuro-recovery. Transcutaneous electrical spinal cord stimulation (TESCS) is a neuromodulatory technique that has recently emerged as a result of this shift. It is believed that this technique can bridge the communication gap between the brain and periphery by increasing the spinal cord excitability, allowing signals to be sent past the level of injury. This novel therapy has shown promising results for the recovery of both upper and lower extremity function, even in individuals who cannot produce volitional movement. 

The Problem

Although there is scientific evidence that TESCS improves motor recovery, the exact mechanism of action is not yet fully understood and is still a matter of debate within the research community. This is an important area of research as it is necessary to understand the mechanism of action of this stimulation technique in order to optimise it's rehabilitative potential. Furthermore, spinal stimulation is more effective when received with physical therapy, as it promotes the reorganisation of neural networks. However, some people with complete SCI cannot perform these physical movements therefore, do not benefit from the same neuroplastic changes.

My Research

The objective of my research is to optimise the motor rehabilitative potential of TESCS for spinal cord injuries. This will be achieved by exploring the underlying mechanisms of TESCS contributing to improved motor function and investigating whether these mechanisms can be augmented by combining TESCS with brain computer interfacing.

Brain computer interface (BCI) is a powerful tool that provides a solution for individuals without volitional motor control to gain the same neurological benefits as that obtained through physical exercise. This is possible as motor imagery activates the same neural substrates as the corresponding real movements and BCI can be used to measure the quality of these signals and provide feedback, allowing people who are unable to perform volitional movements to benefit from the same neuroplastic changes as those who can.

Grants

EPSRC Scholarship 2022 in the College of Science and Engineering.

Additional Information

Education

  • MEng Biomedical Engineering - University of Strathclyde, Scotland, UK (2017 – 2022)