Brain stimulation protocol reduces spasticity in spinal cord injury patients

June 19, 2017

Spasticity, uncontrolled muscle contractions, is a common disorder experienced by patients with spinal cord injuries (SCI). Previous studies have shown that excitatory repetitive transcranial magnetic stimulation (rTMS) can reduce spasticity. In a new study published in Restorative Neurology and Neuroscience, researchers found that a protocol of rTMS, excitatory intermittent theta burst stimulation (iTBS), was successful in reducing spasticity in patients with SCI and therefore may be a promising therapeutic tool.

"The aim of this study was to assess whether a different rTMS protocol may have significant beneficial clinical effects in the treatment of lower limb spasticity in SCI , namely iTBS, a safe, non-invasive and well-tolerated protocol of rTMS. Patients receiving real iTBS, compared to those receiving sham treatment, showed significant improvement," explained lead investigator Raffaele Nardone, MD, PhD, Paracelsus Medical University, Salzburg, Austria, and the Franz Tappeiner Hospital, Merano, Italy.

Ten patients with chronic SCI, classified as grades C or D according to the American Spinal Cord Injury Association Impairment Scale, participated in the study. Five received real treatment and the remaining five received sham treatment. After two months, the sham group was switched to real iTBS and the study continued. All eligible patients took antispastic medications and received physical therapy, both before and after the study.

Patients receiving real iTBS showed significant positive effects in several measurements of nerve function, suggesting increased cortical excitability and decreased spinal excitability. Other improvements measured by the Modified Ashworth Scale and the Spinal Cord Injury Assessment Tool persisted up to one week after the end of the iTBS treatment.

Motor-evoked potentials (MEP) were measured in the soleus, or calf muscle, during magnetic stimulation over the most responsive area of the scalp. M-wave and H reflexes, which are measures of muscle contractions due to stimulation of the tibial nerve, were assessed for each subject and a Hmax/Mmax ratio was determined. These measurements were used to assess any changes in spasticity over the two-week stimulation period and the four weeks afterwards.

"Although this study has a small sample size and validation with data from a larger group of patients is needed to confirm the results, our findings clearly suggest that iTBS can be considered as a promising tool for the of spasticity in patients with traumatic SCI and perhaps for other pathological conditions. In comparison with standard rTMS protocols, iTBS represents a more feasible approach because of lower stimulation intensity and shorter duration of application in each single session," commented Dr. Nardone.

Explore further: Magnetic stimulation effective in helping Parkinson's patients walk

More information: Raffaele Nardone et al, Effects of intermittent theta burst stimulation on spasticity after spinal cord injury, Restorative Neurology and Neuroscience (2017). DOI: 10.3233/RNN-160701

Related Stories

Two potential therapeutic avenues for spasticity

March 17, 2016

Following spinal cord injury, most patients experience an exaggeration of muscle tone called spasticity, which frequently leads to physical disability. A team at the Institut de Neurosciences de la Timone (CNRS/Aix-Marseille ...

Recommended for you

Chatter in the deep brain spurs empathy in rats

June 23, 2017

It's a classic conundrum: while rushing to get to an important meeting or appointment on time, you spot a stranger in distress. How do you decide whether to stop and help, or continue on your way?

The neural relationship between light and sleep

June 23, 2017

Humans are diurnal animals, meaning that we usually sleep at night and are awake during the day, due at least in part to light or the lack thereof. Light is known to affect sleep indirectly by entraining—modifying the length ...

How pheromones trigger female sexual behavior

June 22, 2017

A study by a group of Japanese scientists showed how a male pheromone in mice enhances sexual behaviors in females—and how it may enhance a different behavior, aggression, in males—by identifying distinct neural circuits ...

Coupling of movement and vision

June 22, 2017

In a study published in Cell, Georg Keller and his group shed light on neural circuits in the cortex that underlie the integration of movement and visual feedback. They identified a mechanism in the visual cortex responsible ...

Forgetting can make you smarter

June 21, 2017

For most people having a good memory means being able to remember more information clearly for long periods of time. For neuroscientists too, the inability to remember was long believed to represent a failure of the brain's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.