After-effects of peripheral neurostimulation on brain plasticity and ankle function in chronic stroke: The role of afferents recruited

• Published in: Neurophysiologie clinique Vol. 47; no. 4; pp. 275 - 291
• Main Authors: Beaulieu, Louis-David, Massé-Alarie, Hugo, Camiré-Bernier, Samuel, Ribot-Ciscar, Édith, Schneider, Cyril
• Format: Journal Article
• Language: English
• Published: France Elsevier SAS 01.09.2017; Elsevier Science Ltd; Elsevier Masson
• Subjects: Adult; Afferent Pathways - physiopathology; Aged; Ankle; Ankle - physiopathology; Brain plasticity; Chronic Disease; Cognitive science; Déficiences sensorimotrices; Electric Stimulation Therapy; Electrical stimuli; Evoked Potentials, Motor; Excitability; Female; Humans; Magnetic Field Therapy; Magnetic fields; Male; Middle Aged; Motor Cortex - physiopathology; Muscle Strength; Muscle tendon vibration; Muscles; Muscular system; Neurology; Neuromuscular diseases; Neuromuscular electrical stimulation; Neuronal Plasticity; Neurorehabilitation; Neuroréadaptation; Neuroscience; Peripheral Nervous System - physiopathology; Plasticity; Plasticité cérébrale; Proprioception; Repetitive peripheral magnetic stimulation; Sensorimotor impairments; Sensorimotor system; Stimulation magnétique périphérique répétitive; Stimulation électrique neuromusculaire; Stroke; Stroke - physiopathology; Stroke Rehabilitation; Tendons; Transcranial Magnetic Stimulation; Vibration musculo-tendineuse; Young Adult; Brain plasticity; Plasticité cérébrale; Neuroréadaptation; Vibration musculo-tendineuse; Déficiences sensorimotrices; Stimulation magnétique périphérique répétitive; Stimulation électrique neuromusculaire; Muscle tendon vibration; Neurorehabilitation; Repetitive peripheral magnetic stimulation; Neuromuscular electrical stimulation; Sensorimotor impairments
• ISSN: 0987-7053; 1769-7131
• DOI: 10.1016/j.neucli.2017.02.003

Summary Aims of the study This study tested the after-effects of neuromuscular electrical stimulation (NMES), repetitive peripheral magnetic stimulation (rPMS) and muscle tendon vibration (VIB) on brain plasticity and sensorimotor impairments in chronic stroke to investigate whether different results could depend on the nature of afferents recruited by each technique. Materials and methods Fifteen people with chronic stroke participated in five sessions (one per week). Baseline measures were collected in session one, then, each participant received 4 randomly ordered interventions (NMES, rPMS, VIB and a ‘control’ intervention of exercises). Interventions were applied to the paretic ankle muscles and parameters of application were matched as closely as possible. Standardized clinical measures of the ankle function on the paretic side and transcranial magnetic stimulation (TMS) outcomes of both primary motor cortices (M1) were collected at pre- and post-application of each intervention. Results The ankle muscle strength was significantly improved by rPMS and VIB ( P ≤ 0.02). rPMS influenced M1 excitability (increase in the contralesional hemisphere, P = 0.03) and inhibition (decrease in both hemispheres, P ≤ 0.04). The group mean of a few clinical outcomes improved across sessions, i.e. independently of the order of interventions. Some TMS outcomes at baseline could predict the responsiveness to rPMS and VIB. Conclusion This original study suggests that rPMS and VIB were efficient to drive M1 plasticity and sensorimotor improvements, likely via massive inflows of ‘pure’ proprioceptive information generated. Usefulness of some TMS outcomes to predict which intervention a patient could be more responsive to should be further tested in future studies.