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. 2024 Jun 11;24(1):197.
doi: 10.1186/s12883-024-03699-9.

Neuromuscular electrical stimulation to combat cognitive aging in people with spinal cord injury: protocol for a single case experimental design study

Wouter A J Vints  1   2   3 , Oron Levin  4   5 , Martijn van Griensven  6 , Johan W S Vlaeyen  7   8 , Nerijus Masiulis  4   9 , Jeanine Verbunt  10   11 , Charlotte C M van Laake-Geelen  10   11
Affiliations

Neuromuscular electrical stimulation to combat cognitive aging in people with spinal cord injury: protocol for a single case experimental design study

Wouter A J Vints et al. BMC Neurol. .

Abstract

Introduction: Individuals with spinal cord injury (SCI) can experience accelerated cognitive aging. Myokines (factors released from muscle cells during contractions), such as brain-derived neurotrophic factor (BDNF), are thought to have beneficial effects on cognition. Neuromuscular electrical stimulation (NMES) was shown to elicit a large release of myokines. However, the effects of NMES on cognitive function have not been studied.

Objective: To present the study protocol for a clinical trial evaluating the effects of NMES aimed at improving cognition and BDNF.

Methods: A replicated randomized three-phases single-case experimental design (SCED) with sequential multiple baseline time series and a single-armed prospective trial will be conducted with 15 adults with chronic SCI (> 12 months after injury) above L1 neurological level undergoing 30-min quadriceps NMES, 3 days per week for 12 weeks.

Main study endpoints: Primary endpoint is cognitive performance (assessed by a smartphone test) conducted three times per week during the baseline phase with random duration of 3 to 8 weeks, the intervention phase of 12 weeks, and the follow-up phase of 3 weeks after a no measurement rest period of 12 weeks. Secondary endpoints are changes in BDNF levels and cognitive performance measured before the baseline period, before and after intervention and after a 12 weeks follow-up.

Conclusion: This will be the first study investigating the effects of 12 weeks NMES on both cognition and BDNF levels in individuals with SCI. The SCED results provide information on individual treatment effect courses which may direct future research.

Trial registration: ClinicalTrials.gov (NCT05822297, 12/01/2023).

Keywords: Brain-derived neurotrophic factor; Chronic rehabilitation care; Cognition; Myokine; Neuromuscular electrical stimulation; Neuroplasticity; Single case experimental design; Spinal cord injury.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Experimental design. T1-5 represent measurement time points. During T2-5 the same measurements are repeated, expect the addition of clinical examination in time point T4. The red line is the expected change in cognitive test performance on the smartphone-based cognitive test without intervention, which we expect to show a fast increase in the first ± 3 sessions followed by a slight increase over time due to a learning effect. The X’s mark how cognitive test results are hypothesized to change due to the intervention
Fig. 2
Fig. 2
Placement of the electrodes on the quadriceps muscles
See this image and copyright information in PMC

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