Action of 5 Hz repetitive transcranial magnetic stimulation on sensory, motor and autonomic function in human spinal cord injury

被引:64
作者
Kuppuswamy, A.
Balasubramaniam, A. V.
Maksimovic, R.
Mathias, C. J.
Gall, A. [2 ]
Craggs, M. D. [2 ,3 ]
Ellaway, P. H. [1 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Ctr Clin Neurosci, Div Expt Med, London W6 8RP, England
[2] Royal Natl Orthopaed Hosp NHS Trust, London Spinal Cord Injuries Ctr, Stanmore HA7 4LP, Middx, England
[3] UCL, Inst Orthopaed & Musculoskeletal Sci, Div Surg & Intervent Sci, London WC1E 6BT, England
关键词
Spinal cord injury; Repetitive transcranial magnetic stimulation; ASIA impairment scale; Motor evoked potentials; Electrical perceptual threshold; Sympathetic skin response; THETA-BURST STIMULATION; CORTICAL SILENT PERIOD; INTERNATIONAL STANDARDS; PERCEPTUAL THRESHOLD; CORTEX EXCITABILITY; PARKINSONS-DISEASE; CLINICAL-TRIALS; CENTRAL PAIN; ICCP PANEL; PLASTICITY;
D O I
10.1016/j.clinph.2011.04.022
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To assess the effectiveness of physiological outcome measures in detecting functional change in the degree of impairment of spinal cord injury (SCI) following repetitive transcranial magnetic stimulation (rTMS) of the sensorimotor cortex. Methods: Subjects with complete or incomplete cervical (or T1) SCI received real and sham rTMS in a randomised placebo-controlled single-blinded cross-over trial. rTMS at sub-threshold intensity for upper-limb muscles was applied (5 Hz, 900 stimuli) on 5 consecutive days. Assessments made before and for 2 weeks after treatment comprised the ASIA (American Spinal Injuries Association) impairment scale (AIS), the Action Research Arm Test (ARAT), a peg-board test, electrical perceptual test (EPT), motor evoked potentials, cortical silent period, cardiovascular and sympathetic skin responses. Results: There were no significant differences in AIS outcomes between real and sham rTMS. The ARAT was increased at 1 h after real rTMS compared to baseline. Active motor threshold for the most caudally innervated hand muscle was increased at 72 and 120 h compared to baseline. Persistent reductions in EPT to rTMS occurred in two individuals. Conclusions: Changes in cortical motor threshold measures may accompany functional gains to rTMS in SCI subjects. Significance: Electrophysiological measures may provide a useful adjunct to ASIA impairment scales. (C) 2011 Published by Elsevier Ireland Ltd. on behalf of International Federation of Clinical Neurophysiology.
引用
收藏
页码:2452 / 2461
页数:10
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