The use of F-response in defining interstimulus intervals appropriate for LTP-like plasticity induction in lower limb spinal paired associative stimulation

Shulga, Anastasia; Lioumis, Pantelis; Kirveskari, Erika; Savolainen, Seppo; Mäkelä, Jyrki P.; Ylinen, Aarne

doi:10.1016/j.jneumeth.2015.01.012

Cited by 34 publications

(54 citation statements)

References 26 publications

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“…We determined ISIs 0 ms (antidromic and orthodromic pulses arriving simultaneously at corticomotoneuronal synapses at the spinal cord level) between TMS pulse and the first pulse of the peripheral train with the formula F latency minus MEP latency, as described previously (Shulga et al, 2015 ). We used minimal F-latency (the shortest latency in a series of 10 measurements) at supramaximal stimulation (the stimulation intensity at which increasing the intensity does not further produce the increase in F wave amplitude) with 0.2 ms pulses.…”

Section: Methodsmentioning

confidence: 99%

“…Paired associative stimulation (PAS) is a technique where transcranial magnetic stimulation (TMS) is synchronized with peripheral nerve electrical stimulation (PNS); signals are timed to coincide at synapses at cortical (Stefan et al, 2000 ) level to enhance corticospinal excitability. In spinal PAS, signals are timed to coincide at the spinal cord level (Taylor and Martin, 2009 ; Cortes et al, 2011 ; Leukel et al, 2012 ; Shulga et al, 2015 ). PAS protocol typically consists of a single TMS pulse combined either with a single PNS pulse or 10-Hz PNS trains (Carson and Kennedy, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

“…These conventional protocols lead to long-term potentiation (LTP)-like effect at a limited range of interstimulus interval (ISIs; Bunday and Perez, 2012 ; Carson and Kennedy, 2013 ; Shulga et al, 2015 ). If PAS would be applied in multiple sessions to enhance corticospinal connections as a tool for long-term rehabilitation, the initially calculated ISI would need to be adjusted constantly, as neuronal conductivity may change over time during recovery of the injury.…”

Section: Introductionmentioning

confidence: 99%

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Paired Associative Stimulation with High-Frequency Peripheral Component Leads to Enhancement of Corticospinal Transmission at Wide Range of Interstimulus Intervals

Shulga

Zubareva

Lioumis

et al. 2016

Front. Hum. Neurosci.

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Background: In spinal paired associative stimulation (PAS), orthodromic and antidromic volleys elicited by transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) coincide at corticomotoneuronal synapses at the spinal cord. The interstimulus interval (ISI) between TMS and PNS determines whether PAS leads to motor-evoked potential (MEP) potentiation or depression. PAS applied as a long-term treatment for neurological patients might alter conduction of neural fibers over time. Moreover, measurements of motoneuron conductance for determination of ISIs may be challenging in these patients.Results: We sought to design a PAS protocol to induce MEP potentiation at wide range of ISIs. We tested PAS consisting of high-intensity (100% stimulator output, SO) TMS and high-frequency (50 Hz) PNS in five subjects at five different ISIs. Our protocol induced potentiation of MEP amplitudes in all subjects at all tested intervals. TMS and PNS alone did not result in MEP potentiation. The variant of PAS protocol described here does not require exact adjustment of ISIs in order to achieve effective potentiation of MEPs.Conclusions: This variant of PAS might be feasible as a long-term treatment in rehabilitation of neurological patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Paired Associative Stimulation with High-Frequency Peripheral Component Leads to Enhancement of Corticospinal Transmission at Wide Range of Interstimulus Intervals

Shulga

Zubareva

Lioumis

et al. 2016

Front. Hum. Neurosci.

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“…We then calculated the ISIs between the TMS and the first pulse of the PNS train using the formula (F-latency minus MEP latency), as described in our previous work. 19 According to these calculations, for the right hand we used the − 1-ms interval (TMS before PNS) for PAS involving the ulnar and radial nerves and the +1-ms (TMS after PNS) for PAS involving the median nerve. For the left hand, we used the ISIs of -4 (ulnar and median) and − 5 (radial) ms.…”

Section: Paired Associative Stimulationmentioning

confidence: 99%

Long-term paired associative stimulation can restore voluntary control over paralyzed muscles in incomplete chronic spinal cord injury patients

Shulga

Lioumis

Zubareva

et al. 2016

Spinal Cord Ser Cases

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Emerging therapeutic strategies for spinal cord injury aim at sparing or restoring at least part of the corticospinal tract at the acute stage. Hence, approaches that strengthen the weak connections that are spared or restored are crucial. Transient plastic changes in the human corticospinal tract can be induced through paired associative stimulation, a noninvasive technique in which transcranial magnetic brain stimulation is synchronized with electrical peripheral nerve stimulation. A single paired associative stimulation session can induce transient plasticity in spinal cord injury patients. It is not known whether paired associative stimulation can strengthen neuronal connections persistently and have therapeutic effects that are clinically relevant. We recruited two patients with motor-incomplete chronic (one para-and one tetraplegic) spinal cord injuries. The patients received paired associative stimulation for 20-24 weeks. The paraplegic patient, previously paralyzed below the knee level, regained plantarflexion and dorsiflexion of the ankles of both legs. The tetraplegic patient regained grasping ability. The newly acquired voluntary movements could be performed by the patients in the absence of stimulation and for at least 1 month after the last stimulation session. In this unblinded proof-of-principle demonstration in two subjects, long-term paired associative stimulation induced persistent and clinically relevant strengthening of neural connections and restored voluntary movement in previously paralyzed muscles. Further study is needed to confirm whether long-term paired associative stimulation can be used in rehabilitation after spinal cord injury by itself and, possibly, in combination with other therapeutic strategies.

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“…Paired associative stimulations consisting of repeated pairs of single electrical stimulation of peripheral nerve followed by a transcranial magnetic stimulation (TMS) pulse delivered to the motor cortex (Fig. 1B) have been shown to increase motor evoked potentials in the human spinal cord depending on the delay between the two paired stimuli [42][43][44][45][46][47][48].…”

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confidence: 99%

Activity-dependent synaptic dynamics in motor circuits of the spinal cord

Cazalets

Bertrand

2019

Current Opinion in Physiology

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In this article, we describe the most relevant recent research studies on the capability of spinal motor synapses to potentiate or depress their connectivity strength depending on their previous activity, termed activity-dependent synaptic plasticity (ADSP). Currently, ADSP in motor spinal circuits is mainly studied in vivo, with a significant body of work conducted in humans. Here, we review recent data obtained on the modulation of the post-activation depression of the electrically-induced stretch reflex (H-reflex), and describe the use of spiketiming dependent plasticity (STDP)-like stimulation protocols to improve motor function after spinal cord insults. Altogether these recent findings point to the salient role played by ADSP in motor functional recovery. However, thus far there are few available data concerning the cellular basis of the synaptic dynamics of motor spinal networks. We therefore believe that we need to bridge this gap to accurately establish stimulation paradigms that restore spinal synaptic dynamics and enable the improvement of motor recovery after injury.

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The use of F-response in defining interstimulus intervals appropriate for LTP-like plasticity induction in lower limb spinal paired associative stimulation

Abstract: Estimation of ISI on the basis of F and MEP latencies is sufficient to effectively enhance corticospinal transmission by lower limb spinal PAS in healthy subjects.

Cited by 34 publications

References 26 publications

Paired Associative Stimulation with High-Frequency Peripheral Component Leads to Enhancement of Corticospinal Transmission at Wide Range of Interstimulus Intervals

Paired Associative Stimulation with High-Frequency Peripheral Component Leads to Enhancement of Corticospinal Transmission at Wide Range of Interstimulus Intervals

Long-term paired associative stimulation can restore voluntary control over paralyzed muscles in incomplete chronic spinal cord injury patients

Activity-dependent synaptic dynamics in motor circuits of the spinal cord

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