Targeted-plasticity in the corticospinal tract after human spinal cord injury

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Lasse Christiansen, Monica A Perez

Spinal cord injury (SCI) often results in impaired or absent sensorimotor function below the level of the lesion. Recent electrophysiological studies in humans with chronic incomplete SCI demonstrate that voluntary motor output can be to some extent potentiated by noninvasive stimulation that targets the corticospinal tract. We discuss emerging approaches that use transcranial magnetic stimulation (TMS) over the primary motor cortex and electrical stimulation over a peripheral nerve as tools to induce plasticity in residual corticospinal projections. A single TMS pulse over the primary motor cortex has been paired with peripheral nerve electrical stimulation at precise interstimulus intervals to reinforce corticospinal synaptic transmission using principles of spike-timing dependent plasticity. Pairs of TMS pulses have also been used at interstimulus intervals that mimic the periodicity of descending indirect (I) waves volleys in the corticospinal tract. This data, along with information about the extent of the injury, provides a new framework for exploring the contribution of the corticospinal tract to recovery of function following SCI.

Original languageEnglish
JournalNeurotherapeutics
Volume15
Issue number3
Pages (from-to)618-627
Number of pages10
ISSN1933-7213
DOIs
Publication statusPublished - 2018
Externally publishedYes

    Research areas

  • The Faculty of Science - Noninvasive brain stimulation, Physiology of magnetic stimulation, Spinal cord injury, Rehabilitation, Spinal plasticity

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