title: Effects of theta burst stimulation on referred phantom sensations in patients with spinal cord injury.
abstract: To further explore the mechanisms underlying cortical reorganization in patients with phantom sensations after deafferentation, a repetitive transcranial magnetic stimulation study was carried out in two patients with referred phantom sensations (RPS) after incomplete spinal cord injury at the thoracic level. We delivered continuous (inhibitory), intermittent (excitatory), and placebo theta burst stimulation to the contralateral primary motor cortex (M1), primary somatosensory cortex (S1), and secondary somatosensory cortex (S2). Perception of RPS was significantly and transiently disrupted by inhibitory theta burst stimulation applied over S1 and, to a lesser extent, S2. This study supports the hypothesis that RPS depend on remapping in the somatosensory cortex and provides further electrophysiological evidence in vivo that cortical reorganizational processes are critically modulated by GABAergic mechanisms. Enhancement of GABAergic activity may block cortical reorganization, leading to RPS in spinal cord injury patients.
authors.affiliation: aDepartment of Neurology, Christian Doppler Clinic bSpinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria cDepartment of Neurology, Franz Tappeiner Hospital, Merano dDepartment of Economics and Statistics, University of Torino and Collegio Carlo Alberto, Torino eDepartment of Neurological and Movement Sciences, University of Verona, Verona, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Nardone
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: De Blasi
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Höller
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Taylor
authors.forename: Francesco
authors.initials: F
authors.lastname: Brigo
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D010591:Phantom Limb / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D013003:Somatosensory Cortex / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D013904:Thoracic Vertebrae; D050781:Transcranial Magnetic Stimulation / Q000379:methods*