Neural Regeneration Research ›› 2022, Vol. 17 ›› Issue (8): 1821-1826.doi: 10.4103/1673-5374.332158

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Effects of cortical intermittent theta burst stimulation combined with precise root stimulation on motor function after spinal cord injury: a case series study

Ye-Ran Mao1, 2, #, Zhong-Xia Jin3, #, Ya Zheng4, Jian Fan5, Li-Juan Zhao4, Wei Xu4, Xiao Hu4, Chun-Ya Gu4, Wei-Wei Lu4, Guang-Yue Zhu4, Yu-Hui Chen4, Li-Ming Cheng4, 6, *, Dong-Sheng Xu2, 7, *   

  1. 1Department of Rehabilitation, Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China; 2Institute of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 3Department of Spinal Cord Injury Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, Shanghai Sunshine Rehabilitation Center, Tongji University School of Medicine, Shanghai, China; 4Spine Surgery Division of Department of Orthopedics, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China; 5Surgery Division of Department of Orthopedics, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China; 6Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Shanghai, China; 7Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
  • Online:2022-08-15 Published:2022-01-22
  • Contact: Dong-Sheng Xu, MD, dxu0927@shutcm.edu.cn; Li-Ming Cheng, PhD, chlm.d@163.com.
  • Supported by:
    This study was supported by National Key R&D Program of China, No. 2020YFC2004202; and the National Natural Science Foundation of China, Nos. 81974358 and 81772453 (all to DSX).

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Abstract: Activation and reconstruction of the spinal cord circuitry is important for improving motor function following spinal cord injury. We conducted a case series study to investigate motor function improvement in 14 patients with chronic spinal cord injury treated with 4 weeks of unilateral (right only) cortical intermittent theta burst stimulation combined with bilateral magnetic stimulation of L3–L4 nerve roots, five times a week. Bilateral resting motor evoked potential amplitude was increased, central motor conduction time on the side receiving cortical stimulation was significantly decreased, and lower extremity motor score, Berg balance score, spinal cord independence measure-III score, and 10 m-walking speed were all increased after treatment. Right resting motor evoked potential amplitude was positively correlated with lower extremity motor score after 4 weeks of treatment. These findings suggest that cortical intermittent theta burst stimulation combined with precise root stimulation can improve nerve conduction of the corticospinal tract and lower limb motor function recovery in patients with chronic spinal cord injury.

Key words: central motor conduction time, intermittent theta burst, lower extremity motor score, motor evoked potential stimulation, neuromodulation, neuronal plasticity, spinal cord injury, transcranial magnetic stimulation