A novel paired associative stimulation protocol with a high‐frequency peripheral component: A review on results in spinal cord injury rehabilitation
In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non‐invasive, cost‐effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associ...
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| Published in | The European journal of neuroscience Vol. 53; no. 9; pp. 3242 - 3257 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
France
Wiley Subscription Services, Inc
01.05.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0953-816X 1460-9568 1460-9568 |
| DOI | 10.1111/ejn.15191 |
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| Abstract | In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non‐invasive, cost‐effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associative stimulation (PAS), high‐PAS, consists of non‐invasive high‐intensity transcranial magnetic stimulation (TMS) and non‐invasive high‐frequency electrical peripheral nerve stimulation (PNS). We observed a therapeutic effect of high‐PAS in 20 patients with incomplete SCI with wide range of injury severity, age, and time since injury. Tetraplegic and paraplegic, traumatic, and neurological SCI patients benefited from upper‐ or lower‐limb high‐PAS. We observed increases in manual motor scores (MMT) of upper and lower limbs, functional hand tests, walking tests, and measures of functional independence. We also optimized PAS settings in several studies in healthy subjects and began elucidating the mechanisms of therapeutic action. The scope of this review is to describe the clinical experience gained with this novel PAS approach. This review is focused on the summary of our results and observations and the methodological considerations for researchers and clinicians interested in adopting and further developing this new method.
High‐PAS is a novel variant of paired associative stimulation (PAS), which consists of non‐invasive high‐intensity transcranial magnetic stimulation (TMS) and non‐invasive high‐frequency electrical peripheral nerve stimulation (PNS). We documented a therapeutic effect of high‐PAS in 20 patients with incomplete SCI and with a wide range of injury severity, age, and time since injury. Tetra‐ and paraplegic, traumatic, and neurological SCI patients benefited from upper or lower limb high‐PAS. |
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| AbstractList | In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non‐invasive, cost‐effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associative stimulation (PAS), high‐PAS, consists of non‐invasive high‐intensity transcranial magnetic stimulation (TMS) and non‐invasive high‐frequency electrical peripheral nerve stimulation (PNS). We observed a therapeutic effect of high‐PAS in 20 patients with incomplete SCI with wide range of injury severity, age, and time since injury. Tetraplegic and paraplegic, traumatic, and neurological SCI patients benefited from upper‐ or lower‐limb high‐PAS. We observed increases in manual motor scores (MMT) of upper and lower limbs, functional hand tests, walking tests, and measures of functional independence. We also optimized PAS settings in several studies in healthy subjects and began elucidating the mechanisms of therapeutic action. The scope of this review is to describe the clinical experience gained with this novel PAS approach. This review is focused on the summary of our results and observations and the methodological considerations for researchers and clinicians interested in adopting and further developing this new method. In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non‐invasive, cost‐effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associative stimulation (PAS), high‐PAS, consists of non‐invasive high‐intensity transcranial magnetic stimulation (TMS) and non‐invasive high‐frequency electrical peripheral nerve stimulation (PNS). We observed a therapeutic effect of high‐PAS in 20 patients with incomplete SCI with wide range of injury severity, age, and time since injury. Tetraplegic and paraplegic, traumatic, and neurological SCI patients benefited from upper‐ or lower‐limb high‐PAS. We observed increases in manual motor scores (MMT) of upper and lower limbs, functional hand tests, walking tests, and measures of functional independence. We also optimized PAS settings in several studies in healthy subjects and began elucidating the mechanisms of therapeutic action. The scope of this review is to describe the clinical experience gained with this novel PAS approach. This review is focused on the summary of our results and observations and the methodological considerations for researchers and clinicians interested in adopting and further developing this new method. High‐PAS is a novel variant of paired associative stimulation (PAS), which consists of non‐invasive high‐intensity transcranial magnetic stimulation (TMS) and non‐invasive high‐frequency electrical peripheral nerve stimulation (PNS). We documented a therapeutic effect of high‐PAS in 20 patients with incomplete SCI and with a wide range of injury severity, age, and time since injury. Tetra‐ and paraplegic, traumatic, and neurological SCI patients benefited from upper or lower limb high‐PAS. In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non-invasive, cost-effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associative stimulation (PAS), high-PAS, consists of non-invasive high-intensity transcranial magnetic stimulation (TMS) and non-invasive high-frequency electrical peripheral nerve stimulation (PNS). We observed a therapeutic effect of high-PAS in 20 patients with incomplete SCI with wide range of injury severity, age, and time since injury. Tetraplegic and paraplegic, traumatic, and neurological SCI patients benefited from upper- or lower-limb high-PAS. We observed increases in manual motor scores (MMT) of upper and lower limbs, functional hand tests, walking tests, and measures of functional independence. We also optimized PAS settings in several studies in healthy subjects and began elucidating the mechanisms of therapeutic action. The scope of this review is to describe the clinical experience gained with this novel PAS approach. This review is focused on the summary of our results and observations and the methodological considerations for researchers and clinicians interested in adopting and further developing this new method.In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non-invasive, cost-effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associative stimulation (PAS), high-PAS, consists of non-invasive high-intensity transcranial magnetic stimulation (TMS) and non-invasive high-frequency electrical peripheral nerve stimulation (PNS). We observed a therapeutic effect of high-PAS in 20 patients with incomplete SCI with wide range of injury severity, age, and time since injury. Tetraplegic and paraplegic, traumatic, and neurological SCI patients benefited from upper- or lower-limb high-PAS. We observed increases in manual motor scores (MMT) of upper and lower limbs, functional hand tests, walking tests, and measures of functional independence. We also optimized PAS settings in several studies in healthy subjects and began elucidating the mechanisms of therapeutic action. The scope of this review is to describe the clinical experience gained with this novel PAS approach. This review is focused on the summary of our results and observations and the methodological considerations for researchers and clinicians interested in adopting and further developing this new method. |
| Author | Shulga, Anastasia Mäkelä, Jyrki P. Savolainen, Sarianna Lioumis, Pantelis Kirveskari, Erika |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33738876$$D View this record in MEDLINE/PubMed |
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| Keywords | spinal cord injury paired associative stimulation transcranial magnetic stimulation peripheral electrical stimulation |
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| SubjectTerms | Magnetic fields paired associative stimulation Paralysis peripheral electrical stimulation Peripheral nerves Rehabilitation Spinal cord injuries spinal cord injury Transcranial magnetic stimulation |
| Title | A novel paired associative stimulation protocol with a high‐frequency peripheral component: A review on results in spinal cord injury rehabilitation |
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