Effects of paired stimulation with specific waveforms on cortical and spinal plasticity in subjects with a chronic spinal cord injury

Motor Neuroplastic Effects of a Novel Paired Stimulation Technology in an Incomplete Spinal Cord Injury Animal Model

“…In our current study, pre- vs. post-week 1 and week 4 also showed a significant increase in post_25 min ( p = 0.012 *) and post_30 min ( p = 0.026 *) MEPs ( Table 1 ). In another study conducted on SCI subjects, the iTBS/tsDCS waveform produced a significant increase in MEP ( p < 0.050 *) [ 17 ]. The safety of the iTBS/tDCS waveform ranging from 2.5–4.5 mA/cm 2 was previously tested in an animal model without any adverse effects on brain tissue biomarkers or scalp tissue histology [ 35 ].…”

“…The stimulation intervention consisted of different combinations of rTMS, iTBS, and tsDCS on the brain and spinal cord in four groups: (1) iTBS/tsDCS comprised iTBS three pulse bursts at 50 Hz repeated at 5 Hz. Each pulse contained a 2 s train, which was repeated every 10 s for 20 repetitions for 600 pulses [ 26 ] at 0.05 mA on the brain, while tsDCS was applied at 0.5 mA on the T10 spinal cord for 3 min [ 17 , 36 ]. (2) iTBS/ts-iTBS was applied with the same parameters described earlier for 3 min, with iTBS on the brain and ts-iTBS on the T10 level.…”

“…A promising therapeutic approach is neuromodulation [ 16 ] in the form of repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS), direct current stimulation (DCS), or paired stimulations [ 17 ] of the brain and/or spinal cord, which might enhance neuroplasticity [ 18 ] and improve the results of motor rehabilitation in individuals with spinal cord injuries [ 19 ]. Magnetic stimulation, rTMS, is a safe and effective non-invasive method to alter the excitability of the brain or spinal cord [ 20 , 21 ].…”

“…Based on the available evidence, this newly investigated paired stimulation approach needs a deeper understanding of its effects due to a lack of focused studies in the literature. Some studies have reported the effectiveness of iTBS/tsDCS or rTMS/tsDCS waveforms in clinical and animal settings [ 17 , 32 , 35 , 36 ]. However, no studies have examined different combinations of rTMS, iTBS, and tsDCS applications, particularly for short and long durations, on neuroplasticity after SCI.…”

Novel Strategies for Spinal Cord Regeneration

“…Similarly, Adeel et al [122] investigated paired stimulation in subjects with chronic SCI. By testing different waveforms, the researchers observed that rTMS-iTBS/tsDCS and rTMS-20 Hz/tsDCS improved motor-evoked potential (MEP) latency, MEP amplitude, and lower extremity motor scale during a single neuromodulation experimental trial.…”