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

Magnetic stimulation effective in helping Parkinson's patients walk

August 31, 2015
About 50% of patients with Parkinson's disease (PD) experience freezing of gait (FOG), an inability to move forward while walking. This can affect not only mobility but also balance. In a new study published in Restorative ...

Repeated stimulation treatment can restore movement to paralyzed muscles

July 15, 2016
Conducted at the BioMag laboratory at the Helsinki University Hospital, a new patient study could open a new opportunity to rehabilitate patients with spinal cord damage.

Magnetic stimulation of the brain may help patients with cocaine addiction

December 3, 2015
Targeted magnetic pulses to the brain were shown to reduce craving and substance use in cocaine-addicted patients. The results of this pilot study, published in the peer-reviewed journal European Neuropsychopharmacology, ...

Short-term benefits seen with repetitive transcranial magnetic stimulation for focal hand dystonia

April 9, 2013
Repetitive transcranial magnetic stimulation (rTMS) is being increasingly explored as a therapeutic tool for movement disorders associated with deficient inhibition throughout the central nervous system. This includes treatment ...

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 ...

Tickling the brain with magnetic stimulation improves memory in schizophrenia

March 12, 2013
Cognitive impairments are disabling for individuals with schizophrenia, and no satisfactory treatments currently exist. These impairments affect a wide range of cognition, including memory, attention, verbal and motor skills, ...

Recommended for you

Researchers discover spinal cord neurons that inhibit distracting input to focus on task at hand

December 8, 2017
We think of our brain as masterminding all of our actions, but a surprising amount of information related to movement gets processed by our spinal cord.

The mysterious case of the boy missing most of his visual cortex who can see anyway

December 8, 2017
(Medical Xpress)—A team of researchers with Monash University recently gave a presentation at a neuroscience conference in Australia outlining their study of the brain of a seven-year-old boy who was missing most of his ...

How a seahorse-shaped brain structure may help us recognize others

December 8, 2017
How do we recognize others? How do we know friend from foe, threat from reward? How does the brain compute the multitude of cues telling us that Susan is not Erica even though they look alike? The complexity of social interactions—human ...

Brain networks that help babies learn to walk ID'd

December 8, 2017
Scientists have identified brain networks involved in a baby's learning to walk—a discovery that eventually may help predict whether infants are at risk for autism.

Why we can't always stop what we've started

December 7, 2017
When we try to stop a body movement at the last second, perhaps to keep ourselves from stepping on what we just realized was ice, we can't always do it—and Johns Hopkins University neuroscientists have figured out why.

Mutations in neurons accumulate as we age: The process may explain normal cognitive decline and neurodegeneration

December 7, 2017
Scientists have wondered whether somatic (non-inherited) mutations play a role in aging and brain degeneration, but until recently there was no good technology to test this idea. A study published online today in Science, ...

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.