{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:22:57Z","timestamp":1790342577206,"version":"4.1.0"},"reference-count":114,"publisher":"IOP Publishing","issue":"4","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/iopscience.iop.org\/page\/copyright"},{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"tdm","delay-in-days":21,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institutes of Health National Center of Neuromodulation"},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006942","name":"Medical University of South Carolina","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006942","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["J. Neural Eng."],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    . Phantom limb pain (PLP) is debilitating and affects over 70% of people with lower-limb amputation. Other neuropathic pain conditions correspond with increased spinal excitability, which can be measured using reflexes and\n                    <jats:italic>F<\/jats:italic>\n                    -waves. Spinal cord neuromodulation can be used to reduce neuropathic pain in a variety of conditions and may affect spinal excitability, but has not been extensively used for treating PLP. Here, we propose using a non-invasive neuromodulation method, transcutaneous spinal cord stimulation (tSCS), to reduce PLP and modulate spinal excitability after transtibial amputation.\n                    <jats:italic>Approach<\/jats:italic>\n                    . We recruited three participants, two males (5- and 9-years post-amputation, traumatic and alcohol-induced neuropathy) and one female (3 months post-amputation, diabetic neuropathy) for this 5 d study. We measured pain using the McGill Pain Questionnaire (MPQ), visual analog scale (VAS), and pain pressure threshold (PPT) test. We measured spinal reflex and motoneuron excitability using posterior root-muscle (PRM) reflexes and\n                    <jats:italic>F<\/jats:italic>\n                    -waves, respectively. We delivered tSCS for 30 min d\n                    <jats:sup>\u22121<\/jats:sup>\n                    for 5 d.\n                    <jats:italic>Main Results<\/jats:italic>\n                    . After 5 d of tSCS, MPQ scores decreased by clinically-meaningful amounts for all participants from 34.0 \u00b1 7.0\u201318.3 \u00b1 6.8; however, there were no clinically-significant decreases in VAS scores. Two participants had increased PPTs across the residual limb (Day 1: 5.4 \u00b1 1.6 lbf; Day 5: 11.4 \u00b1 1.0 lbf).\n                    <jats:italic>F<\/jats:italic>\n                    -waves had normal latencies but small amplitudes. PRM reflexes had high thresholds (59.5 \u00b1 6.1\n                    <jats:italic>\u03bc<\/jats:italic>\n                    C) and low amplitudes, suggesting that in PLP, the spinal cord is hypoexcitable. After 5 d of tSCS, reflex thresholds decreased significantly (38.6 \u00b1 12.2\n                    <jats:italic>\u03bc<\/jats:italic>\n                    C;\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001).\n                    <jats:italic>Significance<\/jats:italic>\n                    . These preliminary results in this non-placebo-controlled study suggest that, overall, limb amputation and PLP may be associated with reduced spinal excitability and tSCS can increase spinal excitability and reduce PLP.\n                  <\/jats:p>","DOI":"10.1088\/1741-2552\/ad6a8d","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T18:53:45Z","timestamp":1722624825000},"page":"046058","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["A preliminary study exploring the effects of transcutaneous spinal cord stimulation on spinal excitability and phantom limb pain in people with a transtibial amputation"],"prefix":"10.1088","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8566-7178","authenticated-orcid":true,"given":"Ashley N","family":"Dalrymple","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9072-3119","authenticated-orcid":true,"given":"Lee E","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9782-3497","authenticated-orcid":false,"given":"Douglas J","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"jnead6a8dbib1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.2217\/pmt-2016-0041","article-title":"A systematic review on the treatment of phantom limb pain with spinal cord stimulation","volume":"7","author":"Aiyer","year":"2017","journal-title":"Pain Manage."},{"key":"jnead6a8dbib2","first-page":"131","article-title":"Discrimination of phantom hand sensations elicited by afferent electrical nerve stimulation in below-elbow amputees","volume":"6","author":"Anani","year":"1979","journal-title":"Med. 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