There is not enough evidence to support the use of spinal cord stimulation over the current medical standard of care to reduce spasticity associated with multiple sclerosis (MS), according to a narrative systematic review published in the journal Brain and Neurorehabilitation.

According to the authors, more research is needed to clarify the potential role of spinal cord stimulation in MS spasticity.

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The team conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, to analyze all primary clinical data on the efficacy of the approach.

A total of 532 case series, clinical trials, and case studies that were published in PubMed, Embase, Cochrane, Scopus, and Web of Science between 1973 and 2019 were analyzed.

The primary outcome measure was the reduction of spasticity.

Of these publications, 188 were removed because they were duplicates. Another 344 were removed after the appraisal of their abstracts and titles. 

The remaining 16 articles were then subjected to full-text appraisal.

The final conclusion was that even though spinal cord stimulation had the potential to reduce MS-associated spasticity, the literature was very variable in terms of the outcomes of the technique. 

“[Spinal cord stimulation] may provide some relief for refractory spasticity induced by MS,” the team noted.

MS is an autoimmune disease affecting the central nervous system. It is characterized by the immune system mistakenly attacking the myelin sheath surrounding the nerve cells.

Symptoms of the disease include fatigue, vision impairments, muscle weakness and stiffness, spasticity, mobility issues, and cognitive dysfunction.

Spinal cord stimulation involves the placement of electrodes in the epidural space and a generator under the skin to allow the use of electrical impulses to mask pain signals before they reach the brain. It can be used as an alternative to medical treatment in some instances.


Goodwin BJ, Mahmud R, TomThundyil S, et al. The efficacy of spinal cord stimulators in the reduction of multiple sclerosis spasticity: a narrative systematic review. Brain Neurorehabil. Published online July 19, 2023. doi:10.12786/bn.2023.16.e19