Electrical stimulation and stem cell subdural implantation decrease microglia reactivity after spinal cord injury

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Contusive spinal cord injury (SCI) leads to severe and permanent motor, sensory, and autonomic deficits, resulting from both the initial mechanical damage and subsequent secondary pathological cascades. Besides, electrical stimulation (ES) and stem cell therapies have emerged as promising strategies to promote axonal regeneration and neuronal plasticity. Methods We designed a new implantable device, an Electro Pulsed Biohybrid (EPB) device, to provide local ES and carry stem cells (hMSC and iNSC) for subdural implantation, wired and wireless controlled. We assessed locomotion and sensory outputs, cell migration, neuroinflammation, gliosis, fibrosis, and neuronal survival. Results The consecutive application of microsecond pulsed electric fields (μsPEFs) into two different configurations during ten days and further continuous current during five days significantly enhanced the migration and engraftment of the implanted hMSC and a significant reduction in the number of microglia injury-dependent reactive cells. The ES did not exacerbate gliosis, fibrosis, neuropathic pain, or neuronal loss after primary trauma, instead, the electrically stimulated animals in comparison with the non-stimulated controls were able to perform better reducing the time during running. Consistent results were obtained with a wireless and wired configuration for the ES supply. Conclusions The

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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