Long-term paired associative stimulation can restore voluntary control over paralyzed muscles in incomplete chronic spinal cord injury patients

Spinal Cord Series and Cases, 2016 · DOI: 10.1038/scsandc.2016.16 · Published: July 14, 2016

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This research explores a non-invasive method called paired associative stimulation (PAS) to improve motor function in patients with chronic spinal cord injuries. PAS involves synchronizing transcranial magnetic brain stimulation with electrical peripheral nerve stimulation to strengthen neural connections. Two patients, one paraplegic and one tetraplegic, received PAS treatment for 20-24 weeks, resulting in regained voluntary movement in previously paralyzed muscles.

Study Duration

20-24 weeks

Participants

Two patients with motor-incomplete chronic spinal cord injuries (one para- and one tetraplegic)

Evidence Level

Proof-of-principle demonstration

Key Findings

1
A paraplegic patient regained plantarflexion and dorsiflexion of the ankles of both legs after PAS treatment.
2
A tetraplegic patient regained grasping ability after PAS treatment.
3
The newly acquired voluntary movements persisted for at least 1 month after the last stimulation session.

Research Summary

This study investigates the effects of long-term paired associative stimulation (PAS) on motor function in two patients with chronic incomplete spinal cord injury (SCI). The patients received PAS for 20–24 weeks, and the results showed that the paraplegic patient regained ankle movement, while the tetraplegic patient regained grasping ability. The restored voluntary movements remained for at least one month after the final stimulation session, suggesting a persistent strengthening of neural connections.

Practical Implications

Therapeutic Potential for SCI

Long-term PAS may offer a non-invasive therapeutic strategy for restoring voluntary movement in patients with chronic incomplete SCI.

Combination Therapies

PAS could be used in combination with other therapeutic strategies to enhance rehabilitation outcomes after SCI.

Further Research Needed

Additional studies are necessary to confirm the effectiveness of long-term PAS and optimize stimulation parameters for SCI rehabilitation.

Study Limitations

1
Small sample size (two patients)
2
Unblinded study design
3
The newly acquired voluntary movements did not lead to increase in SCIM scores

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