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Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke

An increasing number of studies suggests that a novel neuromodulation technique targeting the spinal circuitry enhances gait rehabilitation, but research on its application to stroke survivors is limited. Therefore, we investigated the characteristics of spinal motor-evoked responses (sMERs) from lo...

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Autores principales: Moon, Yaejin, Zuleger, Taylor, Lamberti, Martina, Bansal, Ashir, Mummidisetty, Chaithanya K., McKenzie, Kelly A., Yingling, Lindsey, Madhavan, Sangeetha, Roth, Elliot J., Lieber, Richard L., Jayaraman, Arun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996860/
https://www.ncbi.nlm.nih.gov/pubmed/33652677
http://dx.doi.org/10.3390/brainsci11030289
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author Moon, Yaejin
Zuleger, Taylor
Lamberti, Martina
Bansal, Ashir
Mummidisetty, Chaithanya K.
McKenzie, Kelly A.
Yingling, Lindsey
Madhavan, Sangeetha
Roth, Elliot J.
Lieber, Richard L.
Jayaraman, Arun
author_facet Moon, Yaejin
Zuleger, Taylor
Lamberti, Martina
Bansal, Ashir
Mummidisetty, Chaithanya K.
McKenzie, Kelly A.
Yingling, Lindsey
Madhavan, Sangeetha
Roth, Elliot J.
Lieber, Richard L.
Jayaraman, Arun
author_sort Moon, Yaejin
collection PubMed
description An increasing number of studies suggests that a novel neuromodulation technique targeting the spinal circuitry enhances gait rehabilitation, but research on its application to stroke survivors is limited. Therefore, we investigated the characteristics of spinal motor-evoked responses (sMERs) from lower-limb muscles obtained by transcutaneous spinal cord stimulation (tSCS) after stroke compared to age-matched and younger controls without stroke. Thirty participants (ten stroke survivors, ten age-matched controls, and ten younger controls) completed the study. By using tSCS applied between the L1 and L2 vertebral levels, we compared sMER characteristics (resting motor threshold (RMT), slope of the recruitment curve, and latency) of the tibialis anterior (TA) and medial gastrocnemius (MG) muscles among groups. A single pulse of stimulation was delivered in 5 mA increments, increasing from 5 mA to 250 mA or until the subjects reached their maximum tolerance. The stroke group had an increased RMT (27–51%) compared to both age-matched (TA: p = 0.032; MG: p = 0.005) and younger controls (TA: p < 0.001; MG: p < 0.001). For the TA muscle, the paretic side demonstrated a 13% increased latency compared to the non-paretic side in the stroke group (p = 0.010). Age-matched controls also exhibited an increased RMT compared to younger controls (TA: p = 0.002; MG: p = 0.007), suggesting that altered sMER characteristics present in stroke survivors may result from both stroke and normal aging. This observation may provide implications for altered spinal motor output after stroke and demonstrates the feasibility of using sMER characteristics as an assessment after stroke.
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spelling pubmed-79968602021-03-27 Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke Moon, Yaejin Zuleger, Taylor Lamberti, Martina Bansal, Ashir Mummidisetty, Chaithanya K. McKenzie, Kelly A. Yingling, Lindsey Madhavan, Sangeetha Roth, Elliot J. Lieber, Richard L. Jayaraman, Arun Brain Sci Article An increasing number of studies suggests that a novel neuromodulation technique targeting the spinal circuitry enhances gait rehabilitation, but research on its application to stroke survivors is limited. Therefore, we investigated the characteristics of spinal motor-evoked responses (sMERs) from lower-limb muscles obtained by transcutaneous spinal cord stimulation (tSCS) after stroke compared to age-matched and younger controls without stroke. Thirty participants (ten stroke survivors, ten age-matched controls, and ten younger controls) completed the study. By using tSCS applied between the L1 and L2 vertebral levels, we compared sMER characteristics (resting motor threshold (RMT), slope of the recruitment curve, and latency) of the tibialis anterior (TA) and medial gastrocnemius (MG) muscles among groups. A single pulse of stimulation was delivered in 5 mA increments, increasing from 5 mA to 250 mA or until the subjects reached their maximum tolerance. The stroke group had an increased RMT (27–51%) compared to both age-matched (TA: p = 0.032; MG: p = 0.005) and younger controls (TA: p < 0.001; MG: p < 0.001). For the TA muscle, the paretic side demonstrated a 13% increased latency compared to the non-paretic side in the stroke group (p = 0.010). Age-matched controls also exhibited an increased RMT compared to younger controls (TA: p = 0.002; MG: p = 0.007), suggesting that altered sMER characteristics present in stroke survivors may result from both stroke and normal aging. This observation may provide implications for altered spinal motor output after stroke and demonstrates the feasibility of using sMER characteristics as an assessment after stroke. MDPI 2021-02-26 /pmc/articles/PMC7996860/ /pubmed/33652677 http://dx.doi.org/10.3390/brainsci11030289 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Moon, Yaejin
Zuleger, Taylor
Lamberti, Martina
Bansal, Ashir
Mummidisetty, Chaithanya K.
McKenzie, Kelly A.
Yingling, Lindsey
Madhavan, Sangeetha
Roth, Elliot J.
Lieber, Richard L.
Jayaraman, Arun
Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke
title Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke
title_full Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke
title_fullStr Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke
title_full_unstemmed Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke
title_short Characterization of Motor-Evoked Responses Obtained with Transcutaneous Electrical Spinal Stimulation from the Lower-Limb Muscles after Stroke
title_sort characterization of motor-evoked responses obtained with transcutaneous electrical spinal stimulation from the lower-limb muscles after stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996860/
https://www.ncbi.nlm.nih.gov/pubmed/33652677
http://dx.doi.org/10.3390/brainsci11030289
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