Effects of somatosensory stimulation on use-dependent plasticity in chronic stroke.
OBJECTIVE
There is a need to develop strategies to enhance the beneficial effects of motor training, including use-dependent plasticity (UDP), in neurorehabilitation. Peripheral nerve stimulation (PNS) modulates motor cortical excitability in healthy humans and could influence training effects in stroke patients.


METHODS
We compared the ability of PNS applied to the (1) arm, (2) leg, and (3) idle time to influence training effects in the paretic hand in 7 chronic stroke patients. The end point measure was the magnitude of UDP.


RESULTS
UDP was more prominent with arm stimulation (increased by 22.8%) than with idle time (by 2.9%) or leg stimulation (by 6.4%).


CONCLUSIONS
PNS applied to the paretic limb paired with motor training enhances training effects on cortical plasticity in stroke patients.
Sawaki
Lumy
L
Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. lsawaki@wfubmc.edu
Wu
Carolyn W-H
CW
Kaelin-Lang
Alain
A
Cohen
Leonardo G
LG
D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D004599:Electric Stimulation Therapy; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009044:Motor Cortex; D009474:Neurons / Q000473:pathology; D010291:Paresis / Q000473:pathology*; D010525:Peripheral Nerves / Q000473:pathology*; D020127:Recovery of Function; D020521:Stroke / Q000628:therapy*