Efficacy of QuadroPulse rTMS for improving motor function after spinal cord injury: Three case studies

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772314Y.0000000279 · Published: January 1, 2016

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study examines if a novel type of brain stimulation called repetitive QuadroPulse transcranial magnetic stimulation (rTMSQP) can improve hand and leg function in people with spinal cord injuries (SCI). The researchers applied magnetic stimuli to the motor cortex areas related to hand and leg movement. Three adults with cervical SCI participated in the study. They underwent various protocols involving rTMSQP alone, exercise alone, and a combination of both. The results suggest that rTMSQP may offer a functional benefit for motor recovery after SCI, especially when combined with targeted exercises. The authors suggest expanding this pilot study.

Study Duration

Not specified

Participants

Three adult subjects with cervical SCI

Evidence Level

Level 4: Case Series

Key Findings

1
Single-day rTMSQP application improved walking speed in the person targeted for walking, accompanied by increased cortical excitability and reduced spinal excitability.
2
All 3 subjects showed functional improvement following the 5-day rTMSQP intervention, an effect being even more pronounced after the five-day combined rTMSQP + exercise sessions.
3
Two of the three subjects reported feeling 'less rigid' and 'more loose' after completing any single session that included rTMSQP.

Research Summary

The study investigated the effects of repetitive QuadroPulse transcranial magnetic stimulation (rTMSQP) on motor function in three individuals with spinal cord injury (SCI). The interventions involved single-day and five-day exposures to rTMSQP, exercise, and a combination of both, targeting hand and leg motor areas. The results suggest a potential functional benefit of rTMSQP, especially when combined with exercise, warranting further investigation in a larger population.

Practical Implications

Rehabilitation Potential

rTMSQP could be a valuable add-on modality to conventional physical therapy, particularly when physical exercise alone has reached a plateau in improving motor function.

Combination Therapy

Combining rTMSQP with targeted exercises appears to augment the effects of either intervention alone, suggesting a synergistic approach to motor rehabilitation after SCI.

Future Research

The findings warrant expansion of the pilot study to a larger subject population to further validate the efficacy and safety of rTMSQP in SCI rehabilitation.

Study Limitations

1
Small sample size (three subjects)
2
Lack of statistical comparisons due to the underpowered nature of the study
3
The study design included both single-session and five-day regimens of stimulation, which could have influenced the results.

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