The Effect of Non-invasive Spinal Cord Stimulation on Anorectal Function in Individuals With Spinal Cord Injury: A Case Series

Frontiers in Neuroscience, 2022 · DOI: 10.3389/fnins.2022.816106 · Published: February 17, 2022

Spinal Cord Injury Neurology Gastroenterology

Simple Explanation

Spinal cord injury (SCI) can lead to bowel dysfunction, impacting the ability to sense bowel fullness and leading to constipation or incontinence. This study explores using spinal neuromodulation to activate the anorectal regions in patients with SCI. The research showed that spinal stimulation can induce contractions and alter sensation and pressure profiles in the anorectal region. A case report showed that spinal neuromodulation had a beneficial effect on a patient’s bowel program. The study used a non-invasive spinal cord neuromodulator (SCONETM) to deliver electrical stimulation to the spinal cord. This method aims to improve sensorimotor and autonomic function in individuals with spinal cord injuries.

Study Duration

5 weeks (chronic stimulation patient)

Participants

3 acute stimulation patients, 1 chronic stimulation patient, all with SCI

Evidence Level

Case Series

Key Findings

1
Spinal neuromodulation can acutely change motor and sensory function of the anorectum.
2
Spinal stimulation induces contractions as well as changes in sensation and pressure profiles along the length of the anorectal region.
3
Spinal neuromodulation delivered over several weeks may improve bowel function by decreasing the time required to perform a bowel program.

Research Summary

This study demonstrates that non-invasive spinal neuromodulation can acutely alter motor and sensory function in the anorectum of individuals with spinal cord injury (SCI). The study also presents a case report indicating that chronic spinal neuromodulation may improve bowel function by reducing the time needed for bowel programs. The findings suggest that spinal neuromodulation could provide a signal to relevant spinal centers, potentially improving anorectal activity and function in patients with SCI.

Practical Implications

Therapeutic Potential

Non-invasive spinal neuromodulation may offer a new therapeutic avenue for managing neurogenic bowel dysfunction in individuals with SCI.

Improved Bowel Management

Chronic stimulation could lead to reduced bowel program times, improving the quality of life for SCI patients.

Restoration of Sensation

Spinal neuromodulation can potentially restore or improve rectal sensation, contributing to better bowel control.

Study Limitations

1
Small number of patients limits the generalizability of the results.
2
Participants were fairly heterogeneous with varying levels and years post SCI.
3
SCONETM mediated improvement in bowel function after SCI requires further evaluation and conﬁrmation in a rigorous sham-controlled setting.

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