Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand

Tutkimustuotos: Lehtiartikkelivertaisarvioitu

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Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand. / Tolmacheva, Aleksandra; Savolainen, Sarianna; Kirveskari, Erika; Lioumis, Pantelis; Kuusela, Linda; Brandstack, Nina; Ylinen, Aarne; Mäkelä, Jyrki P.; Shulga, Anastasia.

julkaisussa: JOURNAL OF NEUROTRAUMA, Vuosikerta 34, Nro 18, 15.09.2017, s. 2668-2674.

Tutkimustuotos: Lehtiartikkelivertaisarvioitu

Harvard

Tolmacheva, A, Savolainen, S, Kirveskari, E, Lioumis, P, Kuusela, L, Brandstack, N, Ylinen, A, Mäkelä, JP & Shulga, A 2017, 'Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand', JOURNAL OF NEUROTRAUMA, Vuosikerta. 34, Nro 18, Sivut 2668-2674. https://doi.org/10.1089/neu.2017.4996, https://doi.org/10.1089/neu.2017.4996

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Author

Tolmacheva, Aleksandra ; Savolainen, Sarianna ; Kirveskari, Erika ; Lioumis, Pantelis ; Kuusela, Linda ; Brandstack, Nina ; Ylinen, Aarne ; Mäkelä, Jyrki P. ; Shulga, Anastasia. / Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand. Julkaisussa: JOURNAL OF NEUROTRAUMA. 2017 ; Vuosikerta 34, Nro 18. Sivut 2668-2674.

Bibtex - Lataa

@article{1a2055cfb8c94a698cb7280715db119a,
title = "Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand",
abstract = "A large proportion of spinal cord injuries (SCI) are incomplete. Even in clinically complete injuries, silent non-functional connections can be present. Therapeutic approaches that can strengthen transmission in weak neural connections to improve motor performance are needed. Our aim was to determine whether long-term delivery of paired associative stimulation (PAS, a combination of transcranial magnetic stimulation [TMS] with peripheral nerve stimulation [PNS]) can enhance motor output in the hands of patients with chronic traumatic tetraplegia, and to compare this technique with long-term PNS. Five patients (4 males; age 38-68, mean 48) with no contraindications to TMS received 4 weeks (16 sessions) of stimulation. PAS was given to one hand and PNS combined with sham TMS to the other hand. Patients were blinded to the treatment. Hands were selected randomly. The patients were evaluated by a physiotherapist blinded to the treatment. The follow-up period was 1 month. Patients were evaluated with Daniels and Worthingham's Muscle Testing (0-5 scale) before the first stimulation session, after the last stimulation session, and 1 month after the last stimulation session. One month after the last stimulation session, the improvement in the PAS-treated hand was 1.02 ± 0.17 points (p < 0.0001, n = 100 muscles from 5 patients). The improvement was significantly higher in PAS-treated than in PNS-treated hands (176 ± 29{\%}, p = 0.046, n = 5 patients). Long-term PAS might be an effective tool for improving motor performance in incomplete chronic SCI patients. Further studies on PAS in larger patient cohorts, with longer stimulation duration and at earlier stages after the injury, are warranted.",
keywords = "paired associative stimulation, peripheral electrical stimulation, plasticity, spinal cord injury, transcranial magnetic stimulation, SPINAL-CORD-INJURY, TIMING-DEPENDENT PLASTICITY, ELECTRICAL-STIMULATION, RECOVERY, INDUCTION, CORTEX, MUSCLE, LTP",
author = "Aleksandra Tolmacheva and Sarianna Savolainen and Erika Kirveskari and Pantelis Lioumis and Linda Kuusela and Nina Brandstack and Aarne Ylinen and M{\"a}kel{\"a}, {Jyrki P.} and Anastasia Shulga",
year = "2017",
month = "9",
day = "15",
doi = "10.1089/neu.2017.4996",
language = "English",
volume = "34",
pages = "2668--2674",
journal = "JOURNAL OF NEUROTRAUMA",
issn = "0897-7151",
publisher = "Mary Ann Liebert Inc.",
number = "18",

}

RIS - Lataa

TY - JOUR

T1 - Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand

AU - Tolmacheva, Aleksandra

AU - Savolainen, Sarianna

AU - Kirveskari, Erika

AU - Lioumis, Pantelis

AU - Kuusela, Linda

AU - Brandstack, Nina

AU - Ylinen, Aarne

AU - Mäkelä, Jyrki P.

AU - Shulga, Anastasia

PY - 2017/9/15

Y1 - 2017/9/15

N2 - A large proportion of spinal cord injuries (SCI) are incomplete. Even in clinically complete injuries, silent non-functional connections can be present. Therapeutic approaches that can strengthen transmission in weak neural connections to improve motor performance are needed. Our aim was to determine whether long-term delivery of paired associative stimulation (PAS, a combination of transcranial magnetic stimulation [TMS] with peripheral nerve stimulation [PNS]) can enhance motor output in the hands of patients with chronic traumatic tetraplegia, and to compare this technique with long-term PNS. Five patients (4 males; age 38-68, mean 48) with no contraindications to TMS received 4 weeks (16 sessions) of stimulation. PAS was given to one hand and PNS combined with sham TMS to the other hand. Patients were blinded to the treatment. Hands were selected randomly. The patients were evaluated by a physiotherapist blinded to the treatment. The follow-up period was 1 month. Patients were evaluated with Daniels and Worthingham's Muscle Testing (0-5 scale) before the first stimulation session, after the last stimulation session, and 1 month after the last stimulation session. One month after the last stimulation session, the improvement in the PAS-treated hand was 1.02 ± 0.17 points (p < 0.0001, n = 100 muscles from 5 patients). The improvement was significantly higher in PAS-treated than in PNS-treated hands (176 ± 29%, p = 0.046, n = 5 patients). Long-term PAS might be an effective tool for improving motor performance in incomplete chronic SCI patients. Further studies on PAS in larger patient cohorts, with longer stimulation duration and at earlier stages after the injury, are warranted.

AB - A large proportion of spinal cord injuries (SCI) are incomplete. Even in clinically complete injuries, silent non-functional connections can be present. Therapeutic approaches that can strengthen transmission in weak neural connections to improve motor performance are needed. Our aim was to determine whether long-term delivery of paired associative stimulation (PAS, a combination of transcranial magnetic stimulation [TMS] with peripheral nerve stimulation [PNS]) can enhance motor output in the hands of patients with chronic traumatic tetraplegia, and to compare this technique with long-term PNS. Five patients (4 males; age 38-68, mean 48) with no contraindications to TMS received 4 weeks (16 sessions) of stimulation. PAS was given to one hand and PNS combined with sham TMS to the other hand. Patients were blinded to the treatment. Hands were selected randomly. The patients were evaluated by a physiotherapist blinded to the treatment. The follow-up period was 1 month. Patients were evaluated with Daniels and Worthingham's Muscle Testing (0-5 scale) before the first stimulation session, after the last stimulation session, and 1 month after the last stimulation session. One month after the last stimulation session, the improvement in the PAS-treated hand was 1.02 ± 0.17 points (p < 0.0001, n = 100 muscles from 5 patients). The improvement was significantly higher in PAS-treated than in PNS-treated hands (176 ± 29%, p = 0.046, n = 5 patients). Long-term PAS might be an effective tool for improving motor performance in incomplete chronic SCI patients. Further studies on PAS in larger patient cohorts, with longer stimulation duration and at earlier stages after the injury, are warranted.

KW - paired associative stimulation

KW - peripheral electrical stimulation

KW - plasticity

KW - spinal cord injury

KW - transcranial magnetic stimulation

KW - SPINAL-CORD-INJURY

KW - TIMING-DEPENDENT PLASTICITY

KW - ELECTRICAL-STIMULATION

KW - RECOVERY

KW - INDUCTION

KW - CORTEX

KW - MUSCLE

KW - LTP

UR - http://www.scopus.com/inward/record.url?scp=85029230767&partnerID=8YFLogxK

U2 - 10.1089/neu.2017.4996

DO - 10.1089/neu.2017.4996

M3 - Article

C2 - 28635523

VL - 34

SP - 2668

EP - 2674

JO - JOURNAL OF NEUROTRAUMA

JF - JOURNAL OF NEUROTRAUMA

SN - 0897-7151

IS - 18

ER -

ID: 39181509