Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia

Abstract

The neuromodulation of motor excitability has been shown to improve functional movement in people with central nervous system damage. This study aimed to investigate the mechanism of peripheral neuromuscular electrical stimulation (NMES) in motor excitability and its effects in people with spinocerebellar ataxia (SCA). This single-blind case-control study was conducted on young control (n=9), age-matched control (n=9), and SCA participants (n=9; 7 SCAIII and 2 sporadic). All participants received an accumulated 30 min of NMES (25 Hz, 800 ms on/800 ms off) of the median nerve. The central motor excitability, measured by motor evoked potential (MEP) and silent period, and the peripheral motor excitability, measured by the H-reflex and M-wave, were recorded in flexor carpi radialis (FCR) muscle before, during, and after the NMES was applied. The results showed that NMES significantly enhanced the MEP in all 3 groups. The silent period, H-reflex and maximum M-wave were not changed by NMES. We conclude that NMES enhances low motor excitability in patients with SCA and that the mechanism of the neuromodulation was supra-segmental. These findings are potentially relevant to the utilization of NMES for preparation of motor excitability. The protocol was registered at Clinicaltrials.gov (NCT02103075).

Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial

“…The role of neuromodulation through peripheral nerve stimulation is supported by reports of therapeutic potential in other recent publications [ 12 , 27 ]. Right median nerve stimulation has also been employed in different diseases, including spinocerebellar ataxia [ 28 ], essential tremor [ 29 ], and autonomic nervous system dysfunction [ 30 ]. The cumulative incidence curve of our study showed long-term effects of RMNS treatment, and this trend was also observed in other studies [ 11 , 12 ], with a similar electrical stimulation protocol as applied in this study.…”

Cognition-Enhancement Effect of Median Nerve Electrical Stimulation in Patients with Cognitive Impairment: A Retrospective Cohort Study

“…Changes in cortical excitability after stimulation may also be key factors. MNS can enhance low motor cortex excitability in patients with spinocerebellar ataxia (40).…”

Modulation of the Corticomotor Excitability by Repetitive Peripheral Magnetic Stimulation on the Median Nerve in Healthy Subjects

“…In our previous study, we applied PNS to the radial and ulnar nerves in the paretic upper limb and showed that PNS for 1 h increased the corticomotor excitability, which was assessed by TMS in both hemispheres, and improved the dexterity performance of the affected upper limb in people with chronic stroke (Liu and Au-Yeung, 2017). When the stimulation is performed over the median nerve, PNS upregulated cortical excitability in both healthy subjects and patients with central nervous system lesions (Farias da Guarda and Conforto, 2014;Chen et al, 2015). To compare with PNS, stimulating the peripheral nerves with magnetic pulses, in a process called repetitive peripheral nerve magnetic stimulation (rPNMS), preferentially activates the lower motor nerves with minimal activation of cutaneous fibers so that is considered as a painless method (Szecsi et al, 2014;.…”