Neuro-Rehabilitation Center, JORU Rehabilitation Hospital, Yixing, China.
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Front Neural Circuits. 2021 Mar 18;15:616084. doi: 10.3389/fncir.2021.616084. eCollection 2021.
We aimed to examine the effects of repetitive peripheral nerve magnetic stimulation (rPNMS) on the excitability of the contralateral motor cortex and motor function of the upper limb in healthy subjects. Forty-six healthy subjects were randomly assigned to either a repetitive peripheral nerve magnetic stimulation group ( = 23) or a sham group ( = 23). The repetitive peripheral nerve magnetic stimulation group received stimulation using magnetic pulses at 20 Hz, which were applied on the median nerve of the non-dominant hand, whereas the sham group underwent the same protocol without the stimulation output. The primary outcome was contralateral transcranial magnetic stimulation (TMS)-induced corticomotor excitability for the abductor pollicis brevis of the stimulated hand in terms of resting motor threshold (rMT), the slope of recruitment curve, and peak amplitude of motor evoked potential (MEP), which were measured at baseline and immediately after each session. The secondary outcomes were motor hand function including dexterity and grip strength of the non-dominant hand assessed at baseline, immediately after stimulation, and 24 h post-stimulation. Compared with the sham stimulation, repetitive peripheral nerve magnetic stimulation increased the peak motor evoked potential amplitude immediately after the intervention. The repetitive peripheral nerve magnetic stimulation also increased the slope of the recruitment curve immediately after intervention and enhanced hand dexterity after 24 h. However, the between-group difference for the changes was not significant. The significant changes in hand dexterity and peak amplitude of motor evoked potential after repetitive peripheral nerve magnetic stimulation were associated with their baseline value. Repetitive peripheral nerve magnetic stimulation may modulate the corticomotor excitability together with a possible lasting improvement in hand dexterity, indicating that it might be helpful for clinical rehabilitation.
我们旨在研究重复外周神经磁刺激(rPNMS)对健康受试者对侧运动皮层兴奋性和上肢运动功能的影响。46 名健康受试者被随机分配到重复外周神经磁刺激组(n = 23)或假刺激组(n = 23)。重复外周神经磁刺激组接受 20Hz 磁脉冲刺激,施加在非优势手的正中神经上,而假刺激组则在没有刺激输出的情况下接受相同的方案。主要结果是刺激手的拇短展肌的经颅磁刺激(TMS)诱导的对侧皮质运动兴奋性,以静息运动阈值(rMT)、募集曲线斜率和运动诱发电位(MEP)的峰值幅度表示,在基线和每次治疗后立即测量。次要结果是在基线、刺激后立即和刺激后 24 小时评估非优势手的运动手功能,包括灵巧度和握力。与假刺激相比,重复外周神经磁刺激在干预后立即增加了运动诱发电位的峰值幅度。重复外周神经磁刺激还增加了募集曲线的斜率,并在 24 小时后增强了手的灵巧度。然而,组间差异不显著。重复外周神经磁刺激后手灵巧度和运动诱发电位峰值幅度的显著变化与其基线值相关。重复外周神经磁刺激可能调节皮质运动兴奋性,并可能对手的灵巧度产生持久的改善,表明其可能有助于临床康复。