title: Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia.
abstract: The neuromodulation of motor excitability has been shown to improve functional movement in people with central nervous system damage. This study aimed to investigate the mechanism of peripheral neuromuscular electrical stimulation (NMES) in motor excitability and its effects in people with spinocerebellar ataxia (SCA). This single-blind case-control study was conducted on young control (n=9), age-matched control (n=9), and SCA participants (n=9; 7 SCAIII and 2 sporadic). All participants received an accumulated 30 min of NMES (25 Hz, 800 ms on/800 ms off) of the median nerve. The central motor excitability, measured by motor evoked potential (MEP) and silent period, and the peripheral motor excitability, measured by the H-reflex and M-wave, were recorded in flexor carpi radialis (FCR) muscle before, during, and after the NMES was applied. The results showed that NMES significantly enhanced the MEP in all 3 groups. The silent period, H-reflex and maximum M-wave were not changed by NMES. We conclude that NMES enhances low motor excitability in patients with SCA and that the mechanism of the neuromodulation was supra-segmental. These findings are potentially relevant to the utilization of NMES for preparation of motor excitability. The protocol was registered at Clinicaltrials.gov (NCT02103075).
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259, Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259, Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Chuang
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259, Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Hsiao-Chu
authors.initials: HC
authors.lastname: Yang
authors.affiliation: Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan; Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, 100, Tzyou 1st Road, Kaohsiung 807, Taiwan.
authors.forename: Miao-Ju
authors.initials: MJ
authors.lastname: Hsu
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital 5, Fusing St., Kweishan, Taoyuan 333, Taiwan; College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan.
authors.forename: Ying-Zu
authors.initials: YZ
authors.lastname: Huang
authors.affiliation: Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine and Healthy Aging Research Center, Chang Gung University, 259, Wen-Hwa 1st Rd, Kweishan, Taoyuan 333, Taiwan. Electronic address: yjchang@mail.cgu.edu.tw.
authors.forename: Ya-Ju
authors.initials: YJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D019054:Evoked Potentials, Motor; D005260:Female; D006181:H-Reflex; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000502:physiology; D016037:Single-Blind Method; D020754:Spinocerebellar Ataxias / Q000503:physiopathology* / Q000628:therapy; D004561:Transcutaneous Electric Nerve Stimulation
keywords: Cerebellum; Motor evoked potential (MEP); Neuromuscular electrical stimulation (NMES); Silent period; Spinocerebellar ataxia (SCA)