Journal of hospital Pula, Vol. 2 No. 2, 2005.
Preliminary communication
MAGNETIC BRAIN STIMULATION MODULATES NEURONAL PLASTICITY IN SPINAL CORD INJURY PATIENTS
Maurizio Belci
Maria Catley
Massud Husain
Hans L. Frankel
Nick J. Davey
Abstract
Patients can often recover good motor function in muscles below an incomplete spinal cord injury. Within a few days of injury natural processes lead to down-regulation of inhibitory pathways within the motor cortex than can be demonstrated electrophysiologically. We believe that this natural change might encourage motor recovery by allowing an increased excitability of surviving descending corticospinal neurones. Repetitive transcranial magnetic stimulation (rTMS) can produce similar changes in corticospinal inhibition in normal uninjured individuals, albeit rather short-lasting. In this preliminary study we have delivered a sham rTMS over one week followed by another week of real treatment to four stable incomplete spinal cord injury patients who already showed reduced inhibition compared with controls. Intracortical inhibition was further reduced during the week of treatment but recovered basal levels within the three-week follow-up period. Longer-term improvements were seen in the clinical scores for both motor and sensory function, perceptual threshold to electrical stimulation of the skin and the time taken to complete a standard peg-board test. Although the measurable electrophysiological effects of rTMS are short-lived it would appear that functional recovery persists for at least three weeks after the treatment. Spinal cord injury patients might be more susceptible to the plastic cortical changes evoked by rTMS than non-injured individuals. This preliminary study provides promising data on which to base a larger investigation with the aim of substantiating the use of rTMS as a tool for routine use in rehabilitation.
Keywords
spinal cord injury; magnetic stimulation
Hrčak ID:
7632
URI
Publication date:
15.6.2005.
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