Oluwole O Awosika1, Marco Sandrini2, Rita Volochayev3, Ryan M Thompson3, Nathan Fishman3, Tianxia Wu4, Mary Kay Floeter5, Mark Hallett6, Leonardo G Cohen3. 1. Human Cortical Physiology and Neurorehabilitation Section, NINDS, USA; Department of Neurology and Rehabilitation Medicine, University of Cincinnati, USA. Electronic address: oluwole.awosika@uc.edu. 2. Human Cortical Physiology and Neurorehabilitation Section, NINDS, USA; Department of Psychology, University of Roehampton, London, UK. 3. Human Cortical Physiology and Neurorehabilitation Section, NINDS, USA. 4. Clinical Trials Unit, NINDS, USA. 5. Motor Neuron Disorders Unit, NINDS, USA. 6. Human Motor Control Section, NINDS, USA.
Abstract
BACKGROUND: Ambulation is an essential aspect of daily living and is often impaired after brain and spinal cord injuries. Despite the implementation of standard neurorehabilitative care, locomotor recovery is often incomplete. OBJECTIVE: In this randomized, sham-controlled, double-blind, parallel design study, we aimed to determine if anodal transcutaneous spinal direct current stimulation (anodal tsDCS) could improve training effects on locomotion compared to sham (sham tsDCS) in healthy subjects. METHODS: 43 participants underwent asingle backwards locomotion training (BLT) session on a reverse treadmill with concurrent anodal (n = 22) or sham (n = 21) tsDCS. The primary outcome measure was speed gain measured 24 h post-training. We hypothesized that anodal tsDCS + BLT would improve training effects on backward locomotor speed compared to sham tsDCS + BLT. A subset of participants (n = 31) returned for two additional training days of either anodal (n = 16) or sham (n = 15) tsDCS and underwent (n = 29) H-reflex testing immediately before, immediately after, and 30 min post-training over three consecutive days. RESULTS: A single session of anodal tsDCS + BLT elicited greater speed gain at 24 h relative to sham tsDCS + BLT (p = 0.008, two-sample t-test, adjusted for one interim analysis after the initial 12 subjects). Anodal tsDCS + BLT resulted in higher retention of the acquired skill at day 30 relative to sham tsDCS + BLT (p = 0.002) in the absence of significant group differences in online or offline learning over the three training days (p = 0.467 and p = 0.131). BLT resulted in transient down-regulation of H-reflex amplitude (Hmax/Mmax) in both test groups (p < 0.0001). However, the concurrent application of anodal-tsDCS with BLT elicited a longer lasting effect than sham-tsDCS + BLT (p = 0.050). CONCLUSION:tsDCS improved locomotor skill acquisition and retention in healthy subjects and prolonged the physiological exercise-mediated downregulation of excitability of the alpha motoneuron pool. These results suggest that this strategy is worth exploring in neurorehabilitation of locomotor function. Published by Elsevier Inc.
RCT Entities:
BACKGROUND: Ambulation is an essential aspect of daily living and is often impaired after brain and spinal cord injuries. Despite the implementation of standard neurorehabilitative care, locomotor recovery is often incomplete. OBJECTIVE: In this randomized, sham-controlled, double-blind, parallel design study, we aimed to determine if anodal transcutaneous spinal direct current stimulation (anodal tsDCS) could improve training effects on locomotion compared to sham (sham tsDCS) in healthy subjects. METHODS: 43 participants underwent a single backwards locomotion training (BLT) session on a reverse treadmill with concurrent anodal (n = 22) or sham (n = 21) tsDCS. The primary outcome measure was speed gain measured 24 h post-training. We hypothesized that anodal tsDCS + BLT would improve training effects on backward locomotor speed compared to sham tsDCS + BLT. A subset of participants (n = 31) returned for two additional training days of either anodal (n = 16) or sham (n = 15) tsDCS and underwent (n = 29) H-reflex testing immediately before, immediately after, and 30 min post-training over three consecutive days. RESULTS: A single session of anodal tsDCS + BLT elicited greater speed gain at 24 h relative to sham tsDCS + BLT (p = 0.008, two-sample t-test, adjusted for one interim analysis after the initial 12 subjects). Anodal tsDCS + BLT resulted in higher retention of the acquired skill at day 30 relative to sham tsDCS + BLT (p = 0.002) in the absence of significant group differences in online or offline learning over the three training days (p = 0.467 and p = 0.131). BLT resulted in transient down-regulation of H-reflex amplitude (Hmax/Mmax) in both test groups (p < 0.0001). However, the concurrent application of anodal-tsDCS with BLT elicited a longer lasting effect than sham-tsDCS + BLT (p = 0.050). CONCLUSION: tsDCS improved locomotor skill acquisition and retention in healthy subjects and prolonged the physiological exercise-mediated downregulation of excitability of the alpha motoneuron pool. These results suggest that this strategy is worth exploring in neurorehabilitation of locomotor function. Published by Elsevier Inc.
Entities:
Keywords:
Backwards locomotion; Gait; Hoffman reflex; Locomotor recovery; Motor learning; Transcutaneous spinal direct current stimulation; tsDCS
Authors: Elizabeth A Bye; Martin E Héroux; Claire L Boswell-Ruys; Monica A Perez; Mariel Purcell; Julian Taylor; Bonsan B Lee; Euan J McCaughey; Jane E Butler; Simon C Gandevia Journal: Spinal Cord Date: 2022-01-11 Impact factor: 2.473
Authors: Francisco D Benavides; Hang Jin Jo; Henrik Lundell; V Reggie Edgerton; Yuri Gerasimenko; Monica A Perez Journal: J Neurosci Date: 2020-01-29 Impact factor: 6.167
Authors: Jan H Bettmann; Christine H Meyer-Frießem; Lauren M Schweizer; Lara Schlaffke; Peter K Zahn; Martin Tegenthoff; Oliver Höffken Journal: Sci Rep Date: 2020-12-15 Impact factor: 4.379
Authors: Oluwole O Awosika; Dorothy Chan; Bridget A Rizik; Heidi J Sucharew; Pierce Boyne; Amit Bhattacharya; Kari Dunning; Brett M Kissela Journal: Front Neurol Date: 2022-03-14 Impact factor: 4.003