Enhancing rehabilitation of motor deficits with peripheral nerve stimulation.
A number of different neurorehabilitation strategies include manipulation of the somatosensory system, e.g. in the form of training by passive movement. Recently, peripheral electrical nerve stimulation has been proposed as a simple, painless method of enhancing rehabilitation of motor deficits. Several physiological studies both in animals and in humans indicate that a prolonged period of patterned peripheral electrical stimulation induces short-term plasticity at multiple levels of the motor system. Small-scale studies in humans indicate that these plastic changes are linked with improvement in motor function, particularly in patients with chronic motor deficits after stroke. Somatosensory-mediated disinhibition of motor pathways is a possible underlying mechanism and might explain why peripheral electrical stimulation is more effective when combined with active training. Further large-scale studies are needed to identify the optimal stimulation protocol and the patient groups that stand to benefit the most from this technique.
Kaelin-Lang
Alain
A
Department of Neurology, Inselspital, Berne University Hospital and University of Berne, Switzerland. alain.kaelin@dkf.unibe.ch
D000344:Afferent Pathways / Q000503:physiopathology; D000818:Animals; D004599:Electric Stimulation Therapy; D006801:Humans; D009069:Movement Disorders / Q000534:rehabilitation*; D009473:Neuronal Plasticity / Q000502:physiology; D013003:Somatosensory Cortex / Q000503:physiopathology