TY - JOUR
T1 - Design of a Novel Paired Associative Nerve Stimulation System and Treatment Strategy for Incomplete Spinal Cord Injury
T2 - A Preliminary Study
AU - Zhang, Zhao
AU - Lin, Bor Shing
AU - Peng, Chih Wei
AU - Chan, Wing P.
AU - Lin, Bor Shyh
AU - Lai, Chien Hung
N1 - Funding Information:
Manuscript received December 4, 2020; revised May 12, 2021; accepted July 5, 2021. Date of publication July 9, 2021; date of current version July 20, 2021. This work was supported in part by the Ministry of Science and Technology, Taiwan, under Grant MOST 108-2314-B-305-001, Grant MOST 108-2314-B-038-021, Grant MOST 109-2314-B-305-001, Grant MOST 109-2314-B-038-132, Grant MOST 109-2221-E-305-001-MY2, Grant MOST 110-2221-E-A49-096-MY3, and Grant MOST 110-2221-E-038-011; in part by the University System of Taipei Joint Research Program under Grant USTP-NTPU-TMU-109-03; in part by the Faculty Group Research Funding Sponsorship by National Taipei University under Grant 2020-NTPU-ORDA-02; in part by the “Academic Top-Notch and Features Field Project” Funding Sponsorship of National Taipei University, Taiwan, under Grant 109-NTPU_ORDA-F-005; in part by the Higher Education Sprout Project of the National Yang Ming Chiao Tung University and Ministry of Education (MOE); in part by the Higher Education Sprout Project by the Ministry of Education under Grant DP2-110-21121-01-N-02-02; and in part by Taipei Medical University Hospital, Taiwan, under Grant 109IIT08. (Corresponding author: Chien-Hung Lai.) This work involved human subjects in its research. Approval of all ethical and experimental procedures and protocols was granted by the Ethics Committee of Taipei Medical University under IRB No. N201905031.
Publisher Copyright:
© 2001-2011 IEEE.
PY - 2021
Y1 - 2021
N2 - Paired associative nerve stimulation (PANS) was proposed as a potential nerve rehabilitation treatment strategy. However, few relevant documents are available regarding the strategy, and only a few clinical studies have involved healthy people. To determine the feasibility of the neurorehabilitation treatment and to estimate the effect of PANS on nerve plasticity for individuals with incomplete spinal cord injury (iSCI), a design combining repetitive transcranial magnetic stimulation (rTMS) with trans-spinal electrical stimulation was developed for treating individuals with iSCI in this pilot case study. First, a novel PANS system with multiple stimulation modes was designed and verified with resistors and a metal coil as load. Then, the system was applied to three individuals with iSCI, and five types of paired associative stimulation was performed to confirm the feasibility of the system and determine the most effective treatment strategy. The preliminary result showed that 20-Hz rTMS combined with cathodal trans-spinal direct current stimulation (tsDCS) had the greatest effect on corticospinal excitability. Next, stimulations of 20-Hz rTMS (brain) and sham (spine) as well as sham (brain) and cathode tsDCS (spine) were administered to individuals with iSCI, and the results revealed that paired associative stimulation of brain and spine was more effective than only 20-Hz rTMS brain stimulation or cathodal tsDCS stimulation for corticospinal plasticity.
AB - Paired associative nerve stimulation (PANS) was proposed as a potential nerve rehabilitation treatment strategy. However, few relevant documents are available regarding the strategy, and only a few clinical studies have involved healthy people. To determine the feasibility of the neurorehabilitation treatment and to estimate the effect of PANS on nerve plasticity for individuals with incomplete spinal cord injury (iSCI), a design combining repetitive transcranial magnetic stimulation (rTMS) with trans-spinal electrical stimulation was developed for treating individuals with iSCI in this pilot case study. First, a novel PANS system with multiple stimulation modes was designed and verified with resistors and a metal coil as load. Then, the system was applied to three individuals with iSCI, and five types of paired associative stimulation was performed to confirm the feasibility of the system and determine the most effective treatment strategy. The preliminary result showed that 20-Hz rTMS combined with cathodal trans-spinal direct current stimulation (tsDCS) had the greatest effect on corticospinal excitability. Next, stimulations of 20-Hz rTMS (brain) and sham (spine) as well as sham (brain) and cathode tsDCS (spine) were administered to individuals with iSCI, and the results revealed that paired associative stimulation of brain and spine was more effective than only 20-Hz rTMS brain stimulation or cathodal tsDCS stimulation for corticospinal plasticity.
KW - Incomplete spinal cord injury
KW - neurorehabilitation
KW - paired associative nerve stimulation
KW - repetitive transcranial magnetic stimulation
KW - trans-spinal electrical stimulation
UR - http://www.scopus.com/inward/record.url?scp=85111147799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111147799&partnerID=8YFLogxK
U2 - 10.1109/TNSRE.2021.3095842
DO - 10.1109/TNSRE.2021.3095842
M3 - Article
C2 - 34242169
AN - SCOPUS:85111147799
SN - 1534-4320
VL - 29
SP - 1341
EP - 1349
JO - IEEE Transactions on Neural Systems and Rehabilitation Engineering
JF - IEEE Transactions on Neural Systems and Rehabilitation Engineering
M1 - 9478864
ER -