Cargando…
Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS)
Advances in our understanding of neural plasticity have prompted the emergence of neuromodulatory interventions, which modulate corticomotor excitability (CME) and hold potential for accelerating stroke recovery. Endogenous paired associative stimulation (ePAS) involves the repeated pairing of a sin...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918620/ https://www.ncbi.nlm.nih.gov/pubmed/33673171 http://dx.doi.org/10.3390/brainsci11020224 |
_version_ | 1783657965175177216 |
---|---|
author | Alder, Gemma Signal, Nada Vandal, Alain C. Olsen, Sharon Jochumsen, Mads Niazi, Imran Khan Taylor, Denise |
author_facet | Alder, Gemma Signal, Nada Vandal, Alain C. Olsen, Sharon Jochumsen, Mads Niazi, Imran Khan Taylor, Denise |
author_sort | Alder, Gemma |
collection | PubMed |
description | Advances in our understanding of neural plasticity have prompted the emergence of neuromodulatory interventions, which modulate corticomotor excitability (CME) and hold potential for accelerating stroke recovery. Endogenous paired associative stimulation (ePAS) involves the repeated pairing of a single pulse of peripheral electrical stimulation (PES) with endogenous movement-related cortical potentials (MRCPs), which are derived from electroencephalography. However, little is known about the optimal parameters for its delivery. A factorial design with repeated measures delivered four different versions of ePAS, in which PES intensities and movement type were manipulated. Linear mixed models were employed to assess interaction effects between PES intensity (suprathreshold (Hi) and motor threshold (Lo)) and movement type (Voluntary and Imagined) on CME. ePAS interventions significantly increased CME compared to control interventions, except in the case of Lo-Voluntary ePAS. There was an overall main effect for the Hi-Voluntary ePAS intervention immediately post-intervention (p = 0.002), with a sub-additive interaction effect at 30 min’ post-intervention (p = 0.042). Hi-Imagined and Lo-Imagined ePAS significantly increased CME for 30 min post-intervention (p = 0.038 and p = 0.043 respectively). The effects of the two PES intensities were not significantly different. CME was significantly greater after performing imagined movements, compared to voluntary movements, with motor threshold PES (Lo) 15 min post-intervention (p = 0.012). This study supports previous research investigating Lo-Imagined ePAS and extends those findings by illustrating that ePAS interventions that deliver suprathreshold intensities during voluntary or imagined movements (Hi-Voluntary and Hi-Imagined) also increase CME. Importantly, our findings indicate that stimulation intensity and movement type interact in ePAS interventions. Factorial designs are an efficient way to explore the effects of manipulating the parameters of neuromodulatory interventions. Further research is required to ensure that these parameters are appropriately refined to maximise intervention efficacy for people with stroke and to support translation into clinical practice. |
format | Online Article Text |
id | pubmed-7918620 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79186202021-03-02 Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) Alder, Gemma Signal, Nada Vandal, Alain C. Olsen, Sharon Jochumsen, Mads Niazi, Imran Khan Taylor, Denise Brain Sci Article Advances in our understanding of neural plasticity have prompted the emergence of neuromodulatory interventions, which modulate corticomotor excitability (CME) and hold potential for accelerating stroke recovery. Endogenous paired associative stimulation (ePAS) involves the repeated pairing of a single pulse of peripheral electrical stimulation (PES) with endogenous movement-related cortical potentials (MRCPs), which are derived from electroencephalography. However, little is known about the optimal parameters for its delivery. A factorial design with repeated measures delivered four different versions of ePAS, in which PES intensities and movement type were manipulated. Linear mixed models were employed to assess interaction effects between PES intensity (suprathreshold (Hi) and motor threshold (Lo)) and movement type (Voluntary and Imagined) on CME. ePAS interventions significantly increased CME compared to control interventions, except in the case of Lo-Voluntary ePAS. There was an overall main effect for the Hi-Voluntary ePAS intervention immediately post-intervention (p = 0.002), with a sub-additive interaction effect at 30 min’ post-intervention (p = 0.042). Hi-Imagined and Lo-Imagined ePAS significantly increased CME for 30 min post-intervention (p = 0.038 and p = 0.043 respectively). The effects of the two PES intensities were not significantly different. CME was significantly greater after performing imagined movements, compared to voluntary movements, with motor threshold PES (Lo) 15 min post-intervention (p = 0.012). This study supports previous research investigating Lo-Imagined ePAS and extends those findings by illustrating that ePAS interventions that deliver suprathreshold intensities during voluntary or imagined movements (Hi-Voluntary and Hi-Imagined) also increase CME. Importantly, our findings indicate that stimulation intensity and movement type interact in ePAS interventions. Factorial designs are an efficient way to explore the effects of manipulating the parameters of neuromodulatory interventions. Further research is required to ensure that these parameters are appropriately refined to maximise intervention efficacy for people with stroke and to support translation into clinical practice. MDPI 2021-02-12 /pmc/articles/PMC7918620/ /pubmed/33673171 http://dx.doi.org/10.3390/brainsci11020224 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Alder, Gemma Signal, Nada Vandal, Alain C. Olsen, Sharon Jochumsen, Mads Niazi, Imran Khan Taylor, Denise Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) |
title | Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) |
title_full | Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) |
title_fullStr | Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) |
title_full_unstemmed | Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) |
title_short | Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS) |
title_sort | investigating the intervention parameters of endogenous paired associative stimulation (epas) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918620/ https://www.ncbi.nlm.nih.gov/pubmed/33673171 http://dx.doi.org/10.3390/brainsci11020224 |
work_keys_str_mv | AT aldergemma investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas AT signalnada investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas AT vandalalainc investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas AT olsensharon investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas AT jochumsenmads investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas AT niaziimrankhan investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas AT taylordenise investigatingtheinterventionparametersofendogenouspairedassociativestimulationepas |