Transcranial direct current stimulation (tDCS) paired with massed practice training to promote adaptive plasticity and motor recovery in chronic incomplete tetraplegia: A pilot study

Kelsey A. Potter-Baker, Daniel P. Janini, Yin Liang Lin, Vishwanath Sankarasubramanian, David A. Cunningham, Nicole M. Varnerin, Patrick Chabra, Kevin L. Kilgore, Mary Ann Richmond, Frederick S. Frost, Ela B. Plow*

*此作品的通信作者

研究成果: Article同行評審

20 引文 斯高帕斯(Scopus)

摘要

Objective: Our goal was to determine if pairing transcranial direct current stimulation (tDCS) with rehabilitation for two weeks could augment adaptive plasticity offered by these residual pathways to elicit longer-lasting improvements in motor function in incomplete spinal cord injury (iSCI). Design: Longitudinal, randomized, controlled, double-blinded cohort study. Setting: Cleveland Clinic Foundation, Cleveland, Ohio, USA. Participants: Eight male subjects with chronic incomplete motor tetraplegia. Interventions: Massed practice (MP) training with or without tDCS for 2 hrs, 5 times a week. Outcome Measures: We assessed neurophysiologic and functional outcomes before, after and three months following intervention. Neurophysiologic measures were collected with transcranial magnetic stimulation (TMS). TMS measures included excitability, representational volume, area and distribution of a weaker and stronger muscle motor map. Functional assessments included a manual muscle test (MMT), upper extremity motor score (UEMS), action research arm test (ARAT) and nine hole peg test (NHPT). Results: We observed that subjects receiving training paired with tDCS had more increased strength of weak proximal (15% vs 10%), wrist (22% vs 10%) and hand (39% vs. 16%) muscles immediately and three months after intervention compared to the sham group. Our observed changes in muscle strength were related to decreases in strong muscle map volume (r=0.851), reduced weak muscle excitability (r=0.808), a more focused weak muscle motor map (r=0.675) and movement of weak muscle motor map (r=0.935). Conclusion: Overall, our results encourage the establishment of larger clinical trials to confirm the potential benefit of pairing tDCS with training to improve the effectiveness of rehabilitation interventions for individuals with SCI. Trial Registration: NCT01539109.

原文English
頁(從 - 到)503-517
頁數15
期刊Journal of Spinal Cord Medicine
41
發行號5
DOIs
出版狀態Published - 3 9月 2018

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