TY - JOUR T1 - Preferential activation of proprioceptive and cutaneous sensory fibers compared to motor fibers during cervical transcutaneous spinal cord stimulation: A computational study JF - bioRxiv DO - 10.1101/2022.02.02.478757 SP - 2022.02.02.478757 AU - Roberto M. de Freitas AU - Marco Capogrosso AU - Taishin Nomura AU - Matija Milosevic Y1 - 2022/01/01 UR - http://biorxiv.org/content/early/2022/02/06/2022.02.02.478757.abstract N2 - Objective Cervical transcutaneous spinal cord stimulation (tSCS) is a promising technology that can support motor function recovery of upper-limbs after spinal cord injury. Its efficacy may depend on the ability to recruit sensory afferents and convey excitatory inputs onto motoneurons. Therefore, understanding its physiological mechanisms is critical to accelerate its development towards clinical applications. In this study, we used an anatomically realistic computational model of the cervical spine to compare α-motor, Aα-sensory, and Aβ-sensory fiber activation thresholds and activation sites.Approach We developed a tridimensional geometry of the cervical body and tSCS electrodes with a cathode centred at the C7 spinous process and an anode placed over the anterior neck. The geometrical model was used to estimate the electric potential distributions along motor and sensory fiber trajectories at the C7 spinal level using a finite element method. We implemented dedicated motor and sensory fiber models to simulate the α-motor and Aα-sensory fibers using 12, 16, and 20 μm diameter fibers, and Aβ-sensory fibers using 6, 9, and 12 μm diameter fibers. We estimated nerve fiber activation thresholds and sites for a 2 ms monophasic stimulating pulse and compared them across the fiber groups.Main results Our results showed lower activation thresholds of Aα- and Aβ-sensory fibers compared with α-motor fibers, suggesting preferential sensory fiber activation. We also found no differences between activation thresholds of Aα-sensory and large Aβ-sensory fibers, implying they were co-activated. The activation sites were located at the dorsal and ventral root levels.Significance Using a realistic computational model, we demonstrated preferential activation of dorsal root Aα- and Aβ-sensory fibers compared with ventral root α-motor fibers during cervical tSCS. These findings suggest high proprioceptive and cutaneous contributions to neural activations during cervical tSCS, which inform the underlying mechanisms of upper-limb functional motor recovery.Competing Interest StatementM.C. holds several patents on spinal cord stimulation technologies for motor recovery, additionally he is a shareholder of Reach Neuro Inc., a company developing spinal cord stimulation for post-stroke motor recovery. The remaining authors have no conflicts of interest, financial or otherwise. ER -