Spinal associative stimulation: a non-invasive stimulation paradigm to modulate spinal excitability.
Publication/Presentation Date
11-1-2011
Abstract
OBJECTIVE: Repetitive, paired peripheral and transcranial stimulation targeting the cerebral cortex can increase cortical excitability, outlasting the stimulation period. It is unknown whether paired stimulation specifically targeting the spinal cord can modulate spinal excitability. We tested whether the H-reflex facilitation from a sub-threshold conditioning TMS pulse could modulate spinal excitability if delivered repetitively.
METHOD: In 13 healthy subjects, we delivered single-pulse TMS (80% RMT) for the right soleus muscle, 20 ms prior to an electrical peripheral nerve stimulus delivered over the posterior tibial nerve on the same side at 0.1 Hz during 15 min.
RESULTS: PNS alone evoked an H-reflex of 0.25 mV ± 0.06 SEM, while pairing of TMS and PNS facilitated the H-reflex to 0.7 ± 0.11 mV. TMS-PNS pairs delivered at 0.1 Hz for 15 min progressively increased in the evoked response to ∼130% (r(2) = 0.97) of the starting amplitude (normalized to 1st min). Post-intervention, H-reflex threshold decreased (pre = 12.9 ± 1.7 mA; post =11.6 ± 1.6 mA; p = 0.04), as did the stimulus intensity at maximum H-reflex amplitude (pre = 23.5 ± 02.8 mA; post = 21.6 ± 2.6 mA; p = 0.03), and recruitment curve width (pre = 11.6 ± 1.5 mA; post = 10.93 ± 1.4 mA; p = 0.03). No such changes were observed with intervention of PNS or TMS alone.
CONCLUSION: Paired stimulation targeting spinal facilitatory interactions, when applied repetitively, can increase spinal excitability during and after the intervention.
SIGNIFICANCE: Spinal associative stimulation may have potential for neuromodulation in spinal cord injury patients.
Volume
122
Issue
11
First Page
2254
Last Page
2259
ISSN
1872-8952
Published In/Presented At
Cortes, M., Thickbroom, G. W., Valls-Sole, J., Pascual-Leone, A., & Edwards, D. J. (2011). Spinal associative stimulation: a non-invasive stimulation paradigm to modulate spinal excitability. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 122(11), 2254–2259. https://doi.org/10.1016/j.clinph.2011.02.038
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
21524606
Department(s)
Administration and Leadership
Document Type
Article