Can somatosensory electrical stimulation relieve spasticity in post-stroke patients? A TMS pilot study
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André Salles Cunha Peres
, Victor Hugo Souza
Abstract
Evidence suggests that somatosensory electrical stimulation (SES) may decrease the degree of spasticity from neural drives, although there is no agreement between corticospinal modulation and the level of spasticity. Thus, stroke patients and healthy subjects were submitted to SES (3 Hz) for 30′ on the impaired and dominant forearms, respectively. Motor evoked potentials induced by single-pulse transcranial magnetic stimulation were collected from two forearm muscles before and after SES. The passive resistance of the wrist joint was measured with an isokinetic system. We found no evidence of an acute carry-over effect of SES on the degree of spasticity.
Author Statement
Research funding: This work was partially funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) [PROCAD 1389/2008], Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) [306817/2014-4 and 480108/2012-9], and CEPID NeuroMat Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) [2013/07699-0]. CDV is also supported by Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) [E-26/110.526/2012] and Financiadora de Estudos e Projetos (FINEP) [PROINFRA HOSPITALAR 18.569-8].
Conflict of interest: Authors state no conflict of interest.
Informed consent: Each volunteer gave written informed consent prior to the experiment
Ethical approval: The research related to human use complied with all the relevant national regulations and institutional policies, in accordance with the Declaration of Helsinki the local ethical committee (process number: 8728/10) approved the protocol.
References
[1] Albert F, Bergenheim M, Ribot-Ciscar E, Roll J-P. The Ia afferent feedback of a given movement evokes the illusion of the same movement when returned to the subject via muscle tendon vibration. Exp Brain Res 2006; 172: 163–174.10.1007/s00221-005-0325-2Search in Google Scholar PubMed
[2] Ansari NN, Naghdi S, Khosravian T, et al. The interrater and intrarater reliability of the Modified Ashworth Scale in the assessment of muscle spasticity: limb and muscle group effect. NeuroReabilitation 2008; 23: 231–237.10.3233/NRE-2008-23304Search in Google Scholar
[3] Burke D, Wissel J, Donnan GA. Pathophysiology of spasticity in stroke. Neurology 2013; 80: S20–S26.10.1212/WNL.0b013e31827624a7Search in Google Scholar PubMed
[4] Catunda JMY. Effect of different frequencies of electrical stimulation in the Hoffman reflex and the passive resistance wrist movement in healthy subjects. MSc Thesis, Program of Biomedical Engineering – COPPE – UFRJ, Brazil, 2009.Search in Google Scholar
[5] Ching-Chen S, Chen Y, Handa Y. The therapeutic effect of surface electrical stimulation on spasticity. Proceedings of the 3th Annual Conference of IFESS and INS; 1998; Luzern, Switzerland.Search in Google Scholar
[6] Conforto AB, Cohen LG, Santos RLD, Scaff M, Marie SKN. Effects of somatosensory stimulation on motor function in chronic cortico-subcortical strokes. J Neurol 2007; 254: 333–339.10.1007/s00415-006-0364-zSearch in Google Scholar PubMed
[7] Daly JJ, Marsolais B, Mendell LM, et al. Therapeutic neural effects of electrical stimulation. IEEE Trans Rehabil Eng 1996; 4: 218–230.10.1109/86.547922Search in Google Scholar PubMed
[8] Dewald JP, Given JD, Rymer WZ. Long-lasting reductions of spasticity induced by skin electrical stimulation. IEEE Trans of Rehabil Eng 1996; 4: 231–242.10.1109/86.547923Search in Google Scholar PubMed
[9] Dobkin BH, Dorsch A. New evidence for therapies in stroke rehabilitation. Curr Atheroscler Rep 2013; 15: 331–345.10.1007/s11883-013-0331-ySearch in Google Scholar PubMed PubMed Central
[10] Douglas AJ, Walsh EG, Wright GW, Creasey GH, Edmond P. The effects of neuromuscular stimulation on muscle tone at the knee in paraplegia. Exp Physiol 1991; 76: 357–367.10.1113/expphysiol.1991.sp003503Search in Google Scholar PubMed
[11] Embrey DG, Holtz SL, Alon G, Brandsman BA, Mccoy SW. Functional electrical stimulation to dorsiflexors and plantar flexors during gait improve walking in adults with chronic hemiplegia. Arch Phys Med Rehabil 2010; 91: 687–696.10.1016/j.apmr.2009.12.024Search in Google Scholar PubMed
[12] Fuentes R, Petersson P, Siesser WB, Caron MG, Nicolelis MAL. Spinal cord stimulation restores locomotion in animal models of Parkinson’s disease. Science 2009; 323: 1578–1582.10.1126/science.1164901Search in Google Scholar PubMed PubMed Central
[13] Garcia MAC, Catunda JMY, Souza MN, et al. Is the frequency in somatosensory electrical stimulation the key parameter in modulating the corticospinal excitability of healthy volunteers and stroke patients with spasticity? Neural Plast 2016; Article ID 3034963: 11.10.1155/2016/3034963Search in Google Scholar
[14] Hallett M. Transcranial magnetic stimulation and the human brain. Nature 2000; 406: 147–150.10.1038/35018000Search in Google Scholar
[15] Hermens HJ, Freriks B, Merletti R, et al. European recommendations for surface electromyography – SENIAM. 8th ed. Enchede: Roessingh Research and Development 1999.Search in Google Scholar
[16] Kandel E, Schwartz J, Jessell T. Principles of neuroscience. 4th ed. New York: McGraw-Hill 2000.Search in Google Scholar
[17] King II TI. The effect of neuromuscular electrical stimulation in reducing tone. Am J Occup Ther 1996; 50: 62–64.10.5014/ajot.50.1.62Search in Google Scholar
[18] Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol 2003; 2: 145–156.10.1016/S1474-4422(03)00321-1Search in Google Scholar
[19] Liepert J, Van Eirmeren GT, Münchau A, et al. Motor excitability in a patient with somatosensory cortex lesion. Clin Neurophysiol 2003; 114: 1003–1008.10.1016/S1388-2457(03)00062-2Search in Google Scholar
[20] Liu H, Jia Y, Wang X. Effects of peripheral nerve stimulation on corticomotor excitability in patients with stroke. Chin J Rehabil Med 2016; 31: 878–883.Search in Google Scholar
[21] Malhorta S, Pandyan AD. Spasticity, an impairment that is poorly defined and poorly measured. Clin Rehabil 2009; 23: 651–658.10.1177/0269215508101747Search in Google Scholar
[22] Park J, Seo D, Choi W, et al. The effects of exercise with TENS on spasticity, balance, and gait in patients with chronic stroke: a randomized controlled trial. Med Sci Monit 2014; 20: 1890–1896.10.12659/MSM.890926Search in Google Scholar
[23] Pitcher JB, Ridding MC, Miles TS. Frequency-dependent, bi-directional plasticity in motor cortex of human adults. Clin Neurophysiol 2003; 114: 1265–1271.10.1016/S1388-2457(03)00092-0Search in Google Scholar
[24] Rossini S, Burke D, Chen R, et al. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: basic principles and procedures for routine clinical and research application. An updated report from I.F.C.N. Committee. Clin Neurophysiol 2015; 126: 1071–1107.10.1016/j.clinph.2015.02.001Search in Google Scholar PubMed PubMed Central
[25] Sonde L, Fernaeus SE, Nilsson CG, et al. Stimulation with low frequency (1.7 Hz) transcutaneous electric nerve stimulation (low-tens) increases motor function of the post-stroke paretic arm. Scand J Rehabil Med 1998; 30: 95–99.10.1080/003655098444192Search in Google Scholar PubMed
[26] Stein C, Fritsch G, Robinson C, et al. Systematic review and meta-analysis of randomized controlled trials. Stroke 2015; 46: 2197–2205.10.1161/STROKEAHA.115.009633Search in Google Scholar PubMed
[27] Tinazzi M, Zarattini S, Valeriani M, et al. Long-lasting modulation of human motor cortex following prolonged transcutaneous electrical nerve stimulation (TENS) of forearm muscles: evidence of reciprocal inhibition and facilitation. Exp Brain Res 2005; 161: 457–464.10.1007/s00221-004-2091-ySearch in Google Scholar PubMed
[28] Veldman MP, Maffiuletti NA, Hallett M, et al. Direct and crossed effects of somatosensory stimulation on neuronal excitability and motor performance in humans. Neurosci Biobehav Rev 2014; 47: 22–35.10.1016/j.neubiorev.2014.07.013Search in Google Scholar PubMed
[29] Vodovnik L, Bowman BR, Hufford P. Effects of electrical stimulation on spinal spasticity. Scand J Rehabil Med 1984; 16: 29–34.10.2340/1650197784162934Search in Google Scholar
[30] Welmer A-K, Widén Holmqvist L, Sommerfeld DK. Location and severity of spasticity in the first 1–2 weeks and at 3 and 18 months after stroke. Eur J Neurol 2010; 17: 720–725.10.1111/j.1468-1331.2009.02915.xSearch in Google Scholar PubMed
©2018 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Research articles
- A new in vitro spine test rig to track multiple vertebral motions under physiological conditions
- In-service characterization of a polymer wick-based quasi-dry electrode for rapid pasteless electroencephalography
- Spike detection using a multiresolution entropy based method
- Obstacles in using a computer screen for steady-state visually evoked potential stimulation
- Classification of pulmonary pathology from breath sounds using the wavelet packet transform and an extreme learning machine
- Filtering of ECG signals distorted by magnetic field gradients during MRI using non-linear filters and higher-order statistics
- Failure analysis of eleven Gates Glidden drills that fractured intraorally during post space preparation. A retrieval analysis study
- Assessing multiple muscle activation during squat movements with different loading conditions – an EMG study
- In-vivo monitoring of infection via implantable microsensors: a pilot study
- Analysis of structural brain MRI and multi-parameter classification for Alzheimer’s disease
- False spectra formation in the differential two-channel scheme of the laser Doppler flowmeter
- A priori knowledge integration for the detection of cerebral aneurysm
- Is the location of the signal intensity weighted centroid a reliable measurement of fluid displacement within the disc?
- Image-based 3D surface approximation of the bladder using structure-from-motion for enhanced cystoscopy based on phantom data
- Fused multivariate empirical mode decomposition (MEMD) and inverse solution method for EEG source localization
- Quantifying the dynamics of electroencephalographic (EEG) signals to distinguish alcoholic and non-alcoholic subjects using an MSE based K-d tree algorithm
- A hybrid active force control of a lower limb exoskeleton for gait rehabilitation
- Short communication
- Can somatosensory electrical stimulation relieve spasticity in post-stroke patients? A TMS pilot study