Long-term reorganization of human motor cortex driven by short-term sensory stimulation

Hamdy, Shaheen; Rothwell, John C.; Aziz, Qasim; Singh, Krish Devi; Thompson, David G.

doi:10.1038/264

Cited by 424 publications

(294 citation statements)

References 18 publications

Supporting

Mentioning

272

Contrasting

Unclassified

Order By: Relevance

“…7 Intraluminal pharyngeal electrical stimulation (PES) is one such neurostimulation technique that has been shown to promote this type of plasticity in healthy individuals and achieve measurable improvements in swallowing function in dysphagic stroke patients in studies spanning more than a decade. [8][9][10][11][12] In contrast to behavioral swallowing treatments, PES appears to promote functional benefit through a central nonbiomechanical mechanism, such that dysphagia is improved regardless of physiological deficit. Furthermore, the optimal stimulation parameters (5-Hz frequency, 10 minutes duration, and 75% of maximum tolerated intensity) 8 have been shown to reverse the neurophysiological and behavioral effects of experimental brain 1 University of Manchester, Salford, UK 2 Salford Royal Foundation Trust, Salford, UK lesions, 9,13 and a dose-response study provided an optimal regimen in dysphagic stroke patients-once-daily stimulation for 3 days.…”

Section: Introductionmentioning

confidence: 99%

Pharyngeal Electrical Stimulation in Dysphagia Poststroke

Vasant

Michou

O’Leary

et al. 2016

Neurorehabil Neural Repair

Self Cite

View full text Add to dashboard Cite

Background. Pharyngeal electrical stimulation (PES) appears to promote cortical plasticity and swallowing recovery poststroke. Objective. We aimed to assess clinical effectiveness with longer follow-up. Methods. Dysphagic patients (n = 36; median = 71 years; 61% male) recruited from 3 trial centers within 6 weeks of stroke, received active or sham PES in a single-blinded randomized design via an intraluminal pharyngeal catheter (10 minutes, for 3days). The primary outcome measure was the Dysphagia Severity Rating (DSR) scale (<4, no-mild; ≥4, moderate-severe). Secondary outcomes included unsafe swallows on the Penetration-Aspiration Scale (PAS ≥ 3), times to hospital discharge, and nasogastric tube (NGT) removal. Data were analyzed using logistic regression. Odds/hazard ratios (ORs/HRs) >1 for DSR <4, hospital discharge, and NGT removal and OR <1 for PAS ≥3, indicated favorable outcomes for active PES. Results. Two weeks post-active PES, 11/18 (61%) had DSR <4: OR (95% CI) = 2.5 (0.52, 14). Effects of active versus sham for secondary outcomes included the following: PAS ≥3 at 2 weeks, OR (95% CI) = 0.61 (0.27, 1.4); times to hospital discharge, 39 days versus 52 days, HR (95% CI) = 1.2 (0.55, 2.5); NGT removal 8 versus 14 days, HR (95% CI) = 2.0 (0.51, 7.9); and DSR <4 at 3 months, OR (95% CI) = 0.97 (0.13, 7.0). PES was well tolerated, without adverse effects or associations with serious complications (chest infections/death). Conclusions. Although the direction of observed differences were consistent with PES accelerating swallowing recovery over the first 2 weeks postintervention, suboptimal recruitment prevents definitive conclusions. Our study design experience and outcome data are essential to inform a definitive, multicenter randomized trial.

show abstract

Section: Introductionmentioning

confidence: 99%

Pharyngeal Electrical Stimulation in Dysphagia Poststroke

Vasant

Michou

O’Leary

et al. 2016

Neurorehabil Neural Repair

Self Cite

View full text Add to dashboard Cite

show abstract

“…For instance, low-frequency stimulation protocols have been known to increase corticospinal excitability (8,9), whereas less consistent results have been obtained for high-frequency stimulation protocols, with some authors reporting increased (13), decreased (10) or unchanged (8) motor-evoked potential (MEP) responses. Another important parameter which is likely to influence the nature of the modulation is the site of stimulation per se.…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, the vast majority of TMS studies focusing on the effects of repetitive afferent electrical stimulation have mainly concentrated on hand and pharyngeal muscles (8)(9)(10)(11)(12), and very few have sought to determine the effect of afferent repetitive electrical nerve stimulation on the corticospinal excitability of lower-limb muscles (13). The aim of the present study was to address this issue by investigating the effect of a prolonged high-frequency electrical nerve stimulation protocol applied over the anterior thigh area.…”

Section: Introductionmentioning

confidence: 99%

“…They showed that the application of repetitive electrical nerve stimulation over the dorsal cutaneous branch of the ulnar nerve of felines increased the receptive fields of the primary somatosensory cortex (S1) associated with the ulnar nerve territory. These observations were followed by several transcranial magnetic stimulation (TMS) studies which showed that prolonged peripheral electrical stimulation could modulate the corticospinal excitability of human subjects and induce transient changes in cortical representation (8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of repetitive afferent electrical stimulation of the lower limb on corticomotor excitability and implications for rehabilitation

Léonard

Mercier

Tremblay

2013

Journal of Clinical Neuroscience

View full text Add to dashboard Cite

Despite the extensive work published on the effects of electrical stimulation on corticomotor excitability, very few studies have focused on lower limb muscles. The aim of the present study was to determine the effect of high-frequency afferent electrical stimulation of the anterior thigh area on the corticomotor excitability of lower limb muscles. Twenty-two healthy subjects (mean age 23 ± 7 yrs) participated in the study.Electrical stimulation was applied for 60 minutes on the anterior thigh area (frequency 100 Hz, pulse duration 60 µs, intensity below motor threshold). Motor evoked potentials (MEP) of the rectus femoris and biceps femoris muscles were recorded before, and after the electrical stimulation paradigm with a Magstim 200 stimulator. Analyses revealed a significant modulation in MEP amplitude for the RF but not for the BF muscle.Specifically, there was a significant reduction in MEP amplitude for the RF muscle immediately, 15 minutes and 30 minutes after the end of electrical stimulation when compared with baseline. The present results indicate that a 60-minute high-frequency electrical stimulation protocol applied on the anterior thigh area decreases the corticomotor excitability of the RF muscle. Although the exact duration remains unknown, the pattern of modulation observed indicates that the inhibitory effect lasts for more than 30 minutes after the end of stimulation, giving enough time for clinicians to work on the desired motor task during rehabilitation.

show abstract

“…Somatosensory information calibrates motor output (5,(6)(7)(8). Hence, one might expect certain degree of motor plasticity in blind subjects.…”

mentioning

confidence: 99%

Late onset muscle plasticity in the whisker pad of enucleated rats

Toscano-Márquez¹,

Martínez‐Martínez²,

Manjarrez³

et al. 2008

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Blindness leads to a major reorganization of neural pathways associated with touch. Because incoming somatosensory information influences motor output, it is plausible that motor plasticity occurs in the blind. In this work, we evaluated this issue at the peripheral level in enucleated rats. Whisker muscles in enucleated rats 160 days of age or older showed increased cytochrome oxidase activity, capillary density, motor plate size, and amplitude of evoked field potentials as compared with their control counterparts. Such differences were not observed at ages 10 and 60 days, the capillary density was the exception being greater in the enucleated rat at the latter age. Interestingly, there was a trend to increased neurotrophin-3 concentrations in the whisker pads of enucleated rats throughout postnatal development. Our results show that neonatal enucleation leads to late onset plasticity of the whisker's motor system. blindness ͉ metabolic activity ͉ motor plasticity ͉ motor plate potentials ͉ skeletal muscle I n mammals, the loss of vision leads to a large scale sensory reorganization of the brain. Somatosensory and auditory areas enlarge whereas the former visual regions become activated by somatosensory and auditory information (1). These functional modifications are associated with the reorganization of their anatomical substrate (2, 3). The reorganized brain allows the blind to develop the somatosensory and auditory abilities that distinguish them from sighted subjects (4, 5).Somatosensory information calibrates motor output (5, 6-8). Hence, one might expect certain degree of motor plasticity in blind subjects. Accordingly, studies have shown incremental increases in the activity of glutamate dehydrogenase and in the size of neurons located in the motor cortex after visual deprivation (9). Magnetic resonance studies in blind humans have also documented a decreased functional connectivity to motor areas (9, 10), increments in the volume of cortical gray matter associated with sensory-motor cortices (11), and in the volume of the cortico-spinal tract (9). Whether motor plasticity in the blind extends to more peripheral levels is unknown.A good model system to test whether peripheral motor plasticity occurs in the blind is the sensory-motor system controlling whisking in rodents. Sensory information arising from the whiskers calibrates their movements (12) while motor activity modulates sensory information influx (13, 14). Our work was aimed at evaluating the morpho-functional plasticity ongoing in the intrinsic motor apparatus of the facial whiskers of neonatally enucleated rats. The time course and the possible relationship between the plastic response and neurotrophin-3 concentrations were analyzed. Our results document late onset morpho-functional plasticity in the intrinsic musculature of whisker follicles in rats enucleated at birth. The evidence we provide suggests that this plastic response is associated with increments in the concentrations of neurotrophin-3 in the whisker pad. Hence, blind individuals ...

show abstract

Long-term reorganization of human motor cortex driven by short-term sensory stimulation

Cited by 424 publications

References 18 publications

Pharyngeal Electrical Stimulation in Dysphagia Poststroke

Pharyngeal Electrical Stimulation in Dysphagia Poststroke

Effect of repetitive afferent electrical stimulation of the lower limb on corticomotor excitability and implications for rehabilitation

Late onset muscle plasticity in the whisker pad of enucleated rats

Contact Info

Product

Resources

About