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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?

SUBMITTER: Tolmacheva A 

PROVIDER: S-EPMC5610384 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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

Tolmacheva Aleksandra A   Savolainen Sarianna S   Kirveskari Erika E   Lioumis Pantelis P   Kuusela Linda L   Brandstack Nina N   Ylinen Aarne A   Mäkelä Jyrki P JP   Shulga Anastasia A  

Journal of neurotrauma 20170721 18


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 h  ...[more]

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