Modulation of Corticospinal Excitability by Two Different Somatosensory Stimulation Patterns: A Pilot Study

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Abstract

Following amputation, almost two-thirds of amputees experience unpleasant to painful sensations in the area of the missing limb. Whereas the mechanism of phantom limb pain (PLP) remains unknown, it has been shown that maladaptive cortical plasticity plays a major role in PLP. Transcutaneous electrical nerve stimulation (TENS) generating sensory input is believed to be beneficial for PLP relief. TENS effect may be caused by possible reversing reorganization at the cortical level that can be evaluated by changes in the excitability of the corticospinal (CS) pathway. Excitability changes are dependent on the chosen stimulation patterns and parameters. The aim of this study was to investigate the effect of two TENS patterns on the excitability of the CS tract among healthy subjects. We compared a non-modulated TENS as a conventional pattern with pulse width modulated TENS pattern. Motor evoked potentials (MEPs) from APB muscles of stimulated arm (TENS-APB) and contralateral arm (Control-APB) were recorded. We applied single TMS pulses on two subjects for each TENS pattern. The results showed that both patterns increase the CS excitability, while the effects of the conventional TENS is stronger. However, the amplitude of MEPs from control-APB after TENS delivery remained almost the same.Clinical Relevance- The primary results revealed changes in the activity of CS pathway for both patterns. A future study on a larger population is needed to provide strong evidence on the changes in CS excitability. The evaluation part with more factors such as changes in intracortical inhibition (ICI) may be beneficial to find an optimal modulated TENS pattern to enhance pain alleviation process in PLP.
Original languageEnglish
Title of host publication2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)
Number of pages4
PublisherIEEE
Publication date20 Jul 2020
Pages3573-3576
Article number9175393
ISBN (Print)978-1-7281-1991-5
ISBN (Electronic)978-1-7281-1990-8
DOIs
Publication statusPublished - 20 Jul 2020
Event42nd Annual International Conferences of the IEEE Engineering in Medicine and Biology Society, EMBC 2020 - Montreal, Canada
Duration: 20 Jul 202024 Jul 2020

Conference

Conference42nd Annual International Conferences of the IEEE Engineering in Medicine and Biology Society, EMBC 2020
CountryCanada
CityMontreal
Period20/07/202024/07/2020
SeriesI E E E Engineering in Medicine and Biology Society. Conference Proceedings
ISSN2375-7477

Keywords

  • Phantom Limb Pain
  • cortical plasticity
  • corticospinal excitability
  • transcutaneous electrical nerve stimulation (TENS)

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