Effects of patterned peripheral nerve stimulation on soleus spinal motor neuron excitability

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Documents

  • Samuel Jimenez
  • Laura Mordillo-Mateos
  • Michele Dileone
  • Michela Campolo
  • Carmen Carrasco-Lopez
  • Fabricia Moitinho-Ferreira
  • Tomas Gallego-Izquierdo
  • Siebner, Hartwig Roman
  • Josep Valls-Solé
  • Juan Aguilar
  • Antonio Oliviero

Spinal plasticity is thought to contribute to sensorimotor recovery of limb function in several neurological disorders and can be experimentally induced in animals and humans using different stimulation protocols. In healthy individuals, electrical continuous Theta Burst Stimulation (TBS) of the median nerve has been shown to change spinal motoneuron excitability in the cervical spinal cord as indexed by a change in mean H-reflex amplitude in the flexor carpi radialis muscle. It is unknown whether continuous TBS of a peripheral nerve can also shift motoneuron excitability in the lower limb. In 26 healthy subjects, we examined the effects of electrical TBS given to the tibial nerve in the popliteal fossa on the excitability of lumbar spinal motoneurons as measured by H-reflex amplitude of the soleus muscle evoked by tibial nerve stimulation. Continuous TBS was given at 110% of H-reflex threshold intensity and compared to non-patterned regular electrical stimulation at 15 Hz. To disclose any pain-induced effects, we also tested the effects of TBS at individual sensory threshold. Moreover, in a subgroup of subjects we evaluated paired-pulse inhibition of H-reflex. Continuous TBS at 110% of H-reflex threshold intensity induced a short-term reduction of H-reflex amplitude. The other stimulation conditions produced no after effects. Paired-pulse H-reflex inhibition was not modulated by continuous TBS or non-patterned repetitive stimulation at 15 Hz. An effect of pain on the results obtained was discarded, since non-patterned 15 Hz stimulation at 110% HT led to pain scores similar to those induced by EcTBS at 110% HT, but was not able to induce any modulation of the H reflex amplitude. Together, the results provide first time evidence that peripheral continuous TBS induces a short-lasting change in the excitability of spinal motoneurons in lower limb circuitries. Future studies need to investigate how the TBS protocol can be optimized to produce a larger and longer effect on spinal cord physiology and whether this might be a useful intervention in patients with excessive excitability of the spinal motorneurons.

Original languageEnglish
Article numbere0192471
JournalPLoS ONE
Volume13
Issue number2
Number of pages13
ISSN1932-6203
DOIs
Publication statusPublished - 2018

    Research areas

  • Adult, Female, H-Reflex, Humans, Male, Median Nerve/physiology, Middle Aged, Motor Neurons/physiology, Muscle, Skeletal/innervation, Spinal Cord/cytology, Tibial Nerve/physiology, Transcutaneous Electric Nerve Stimulation/methods, Young Adult

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