On demand and localized treatment for excessive muscle tone after spinal cord injury (SCI) is currently not available. Here we examine the reduction in leg hypertonus in a person with mid-thoracic, motor-complete SCI using a commercial transcutaneous electrical stimulator (TES) applied at 50 or 150-Hz to the lower back and the possible mechanisms producing this bilateral reduction in leg tone. Hypertonus of knee extensors without and during TES, with both cathode and anode placed over the spinal column (MID) or 10-cm to the left of midline (LAT) to only active underlying skin and muscle afferents, was simultaneously measured in both legs with the pendulum test. Spinal reflexes mediated by proprioceptive (H-reflex) and cutaneomuscular (CMR) afferents were examined in the right leg opposite to the applied LAT TES. Hypertonus disappeared in both legs but only during thoracolumbar TES, and even during LAT TES. The marked reduction in tone was reflected in the greater distance both lower legs first dropped to after being released from a fully extended position, increasing by 172.8% and 94.2% during MID and LAT TES, respectively, compared to without TES. Both MID and LAT (left) TES increased H-reflexes but decreased the first burst, and lengthened the onset of subsequent bursts, in the cutaneomuscular reflex of the right leg. Thoracolumbar TES is a promising method to decrease leg hypertonus in chronic, motor-complete SCI without activating spinal cord structures and may work by facilitating proprioceptive inputs that activate excitatory interneurons with bilateral projections that in turn recruit recurrent inhibitory neurons.

中文翻译：

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皮肤刺激而非背根刺激可减少胸运动完全性脊髓损伤的张力过高：单一病例报告。

目前尚无法针对脊髓损伤 (SCI) 后肌张力过度进行按需和局部治疗。在这里，我们检查了使用商业经皮电刺激器 (TES) 在 50 或 150 Hz 下应用到下背部时，中胸、运动完全性 SCI 患者腿部张力过度的减少，以及产生这种双侧腿部张力减少的可能机制。语气。在没有 TES 的情况下和在 TES 期间，将阴极和阳极放置在脊柱 (MID) 上方或中线左侧 10 厘米 (LAT) 处，仅激活下面的皮肤和肌肉传入神经，同时测量双腿的膝关节伸肌张力过高，并使用摆锤试验。在与所应用的 LAT TES 相对的右腿中检查了由本体感觉（H 反射）和皮肤肌肉（CMR）传入神经介导的脊髓反射。双腿张力过高消失，但仅在胸腰段 TES 期间消失，甚至在 LAT TES 期间也消失。音调的显着降低反映在双小腿从完全伸展位置释放后首次下降的距离更大，与没有 TES 相比，在 MID 和 LAT TES 期间分别增加了 172.8% 和 94.2%。 MID 和 LAT（左）TES 均增加了右腿皮肤肌肉反射中的 H 反射，但减少了第一次爆发，​​并延长了后续爆发的开始时间。胸腰段 TES 是一种很有前途的方法，可以在不激活脊髓结构的情况下减少慢性、运动性完全性 SCI 中腿部张力过高，并且可能通过促进本体感觉输入来发挥作用，该输入激活具有双边投射的兴奋性中间神经元，进而招募复发性抑制性神经元。