title: Long-term TENS treatment decreases cortical motor representation in multiple sclerosis.
abstract: This study investigated the effects of a long-term transcutaneous electrical nerve stimulation (TENS) treatment on cortical motor representation in patients with multiple sclerosis (MS). In this double-blind crossover design, patients received either TENS or sham stimulation for 3 weeks (1h per day) on the median nerve region of the most impaired hand, followed by the other stimulation condition after a washout period of 6 months. Cortical motor representation was mapped using transcranial magnetic stimulation (TMS) at the baseline and after the 3-week stimulation protocol. Our results revealed that 3 weeks of daily stimulation with TENS significantly decreased the cortical motor representation of the stimulated muscle in MS patients. Although the mechanisms underlying this decrease remain unclear, our findings indicate that TENS has the ability to induce long-term reorganization in the motor cortex of MS patients.
authors.affiliation: BIOMED, Biomedical Research Institute, Hasselt University, Agoralaan, Building C, B-3590 Diepenbeek, Belgium; REVAL Research Institute, Hasselt University, Agoralaan, Building A, B-3590 Diepenbeek, Belgium; Motor Control Laboratory, Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, K.U. Leuven, Tervuursevest 101, B-3001 Heverlee, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Cuypers
authors.forename: D J F
authors.initials: DJ
authors.lastname: Leenus
authors.forename: F E
authors.initials: FE
authors.lastname: van den Berg
authors.forename: O
authors.initials: O
authors.lastname: Levin
authors.forename: H
authors.initials: H
authors.lastname: Thijs
authors.forename: S P
authors.initials: SP
authors.lastname: Swinnen
authors.forename: R L J
authors.initials: RL
authors.lastname: Meesen
mesh_terms: D000328:Adult; D001931:Brain Mapping; D018592:Cross-Over Studies; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004576:Electromyography; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006112:Gravitation; D006801:Humans; D008134:Long-Term Care; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000628:therapy*; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D009473:Neuronal Plasticity / Q000502:physiology; D050781:Transcranial Magnetic Stimulation; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects*
keywords: APB; CoG; EDSS; EMG; Expanded Disability Status Scale; LQ; M1; MEP; MS; TENS; TMS; abductor pollicis brevis; center of gravity; cortical motor representation; electromyographic; fMRI; functional magnetic resonance imaging; laterality quotient; motor-evoked potential; multiple sclerosis; neural plasticity; primary motor cortex; rMT; rest motor threshold; transcranial magnetic stimulation; transcutaneous electrical nerve stimulation