Clinical neuroscience and neurostimulation laboratory, centre de recherche du CHU de Québec, Université Laval, Faculty of Medicine, Departement of Rehabilitation, 2705, boulevard Laurier, RC-9800, G1V 4G2 Quebec, Canada.
Neurophysiol Clin. 2013 Oct;43(4):251-60. doi: 10.1016/j.neucli.2013.05.003. Epub 2013 Jun 10.
Repetitive magnetic stimulation at the periphery (rPMS), i.e. over spinal roots, nerves or muscles, represents a new painless and noninvasive approach that can contribute to motor recovery. This method is based on the assumption that, under rPMS, neural networks involved in motor control would be regulated by the large recruitment of proprioceptive afferents, with little activation of cutaneous receptors.
This literature review dealing with rPMS after-effects on motor control aimed at better understanding the outcome measures and further discussing some possible involved mechanisms.
Our literature search resulted in 13 studies that used different types of outcomes (neurophysiological, biomechanical, clinical) to test the influence of rPMS over spinal roots or muscles in healthy individuals and in persons with stroke or spinal disorders. Dynamic changes were reported post-rPMS, such as spasticity reduction and improvements of movement dynamics. Studies also brought about some interesting insights on the cortical plasticity associated with rPMS effects, such as the activation of fronto-parietal loops that may explain the post-rPMS improvement of motor planning.
Due to the heterogeneous and scant literature on the topic, no conclusion can be drawn to date. However, the results encourage the concurrent testing of clinical, neurophysiological and biomechanical outcomes to investigate more precisely the relevance of rPMS in neurological rehabilitation.
外周重复磁刺激(rPMS),即脊髓神经根、神经或肌肉上的刺激,是一种无痛、非侵入性的新方法,可促进运动功能恢复。这种方法基于以下假设:在 rPMS 下,参与运动控制的神经网络会通过本体感觉传入纤维的大量募集来调节,而皮肤感受器的激活较少。
本文综述了 rPMS 对运动控制的后效,旨在更好地理解其结果评估指标,并进一步探讨一些可能涉及的机制。
我们的文献检索结果显示,有 13 项研究使用了不同类型的结果评估指标(神经生理学、生物力学、临床)来测试 rPMS 对健康个体以及中风或脊髓疾病患者的脊髓神经根或肌肉的影响。rPMS 后会出现动态变化,如痉挛减轻和运动动力学改善。研究还为 rPMS 效应相关的皮质可塑性带来了一些有趣的见解,例如额顶叶回路的激活,这可能解释了 rPMS 后运动规划的改善。
由于该主题的文献存在异质性且稀少,目前无法得出结论。然而,这些结果鼓励同时测试临床、神经生理学和生物力学结果,以更精确地研究 rPMS 在神经康复中的相关性。