Effects of Long-Term Paired Associative Stimulation on Strength of Leg Muscles and Walking in Chronic Tetraplegia : A Proof-of-Concept Pilot Study

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Rodionov , A , Savolainen , S , Kirveskari , E , Mäkelä , J P & Shulga , A 2020 , ' Effects of Long-Term Paired Associative Stimulation on Strength of Leg Muscles and Walking in Chronic Tetraplegia : A Proof-of-Concept Pilot Study ' , Frontiers in neurology , vol. 11 , 397 . https://doi.org/10.3389/fneur.2020.00397

Title: Effects of Long-Term Paired Associative Stimulation on Strength of Leg Muscles and Walking in Chronic Tetraplegia : A Proof-of-Concept Pilot Study
Author: Rodionov, Andrei; Savolainen, Sarianna; Kirveskari, Erika; Mäkelä, Jyrki P.; Shulga, Anastasia
Contributor: University of Helsinki, BioMag Laboratory
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Medical Imaging Center
Date: 2020-05-20
Language: eng
Number of pages: 10
Belongs to series: Frontiers in neurology
ISSN: 1664-2295
URI: http://hdl.handle.net/10138/316979
Abstract: Recovery of lower-limb function after spinal cord injury (SCI) is dependent on the extent of remaining neural transmission in the corticospinal pathway. The aim of this proof-of-concept pilot study was to explore the effects of long-term paired associative stimulation (PAS) on leg muscle strength and walking in people with SCI. Five individuals with traumatic incomplete chronic tetraplegia (>34 months post-injury, motor incomplete, 3 females, mean age 60 years) with no contraindications to transcranial magnetic stimulation (TMS) received PAS to one or both legs for 2 months (28 sessions in total, 5 times a week for the first 2 weeks and 3 times a week thereafter). The participants were evaluated with the Manual Muscle Test (MMT), AIS motor and sensory examination, Modified Asworth Scale (MAS), and the Spinal Cord Independence Measure (SCIM) prior to the intervention, after 1 and 2 months of PAS, and after a 1-month follow-up. The study was registered at (NCT03459885). During the intervention, MMT scores and AIS motor scores increased significantly (p = 0.014 and p = 0.033, respectively). Improvements were stable in follow-up. AIS sensory scores, MAS, and SCIM were not modified significantly. MMT score prior to intervention was a good predictor of changes in walking speed (Radj2 = 0.962). The results of this proof-of-concept pilot study justify a larger trial on the effect of long-term PAS on leg muscle strength and walking in people with chronic incomplete SCI.
Subject: paired associative stimulation
walking
TMS
spinal cord injury
neuroplasticity
SPINAL-CORD-INJURY
NONINVASIVE BRAIN-STIMULATION
MOTOR CORTEX
PLASTICITY
EXCITABILITY
INDUCTION
RECOVERY
NERVE
3112 Neurosciences
3124 Neurology and psychiatry
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