A repetitive transcranial magnetic stimulation (rTMS) protocol demonstrates potential success in helping to reduce spasticity in patients with spinal cord injury (SCI), researchers suggest.
The protocol is called excitatory intermittent theta burst stimulation (iTBS). In a study published recently in Restorative Neurology and Neuroscience, researchers suggest it could be a promising therapeutic tool.
“The aim of this study was to assess whether a different rTMS protocol may have significant beneficial clinical effects in the treatment of lower limb spasticity in SCI patients, namely iTBS, a safe, non-invasive and well-tolerated protocol of rTMS. Patients receiving real iTBS, compared to those receiving sham treatment, showed significant improvement,” explains lead investigator Raffaele Nardone, MD, PhD, Paracelsus Medical University, Salzburg, Austria, and the Franz Tappeiner Hospital, Merano, Italy.
Their study included 10 patients with chronic SCI. Five participants received real treatment, and five received sham treatment. After 2 months, the patients receiving sham treatment began receiving real iTBS, and the study continued. All patients took antispastic medications and received physical therapy, both before and after the study, explains a media release from IOS Press.
Patients receiving real iTBS showed significant positive effects in several measurements of nerve function, suggesting increased cortical excitability and decreased spinal excitability. Other improvements measured by the Modified Ashworth Scale and the Spinal Cord Injury Assessment Tool persisted up to 1 week after the end of the iTBS treatment.
Motor-evoked potentials (MEP) were measured in the soleus, or calf muscle, during magnetic stimulation over the most responsive area of the scalp. M-wave and H reflexes, which are measures of muscle contractions due to stimulation of the tibial nerve, were assessed for each subject, and a Hmax/Mmax ratio was determined. These measurements were used to assess any changes in spasticity over the 2-week stimulation period and the 4 weeks afterward, the release continues.
“Although this study has a small sample size and validation with data from a larger group of patients is needed to confirm the results, our findings clearly suggest that iTBS can be considered as a promising tool for the treatment of spasticity in patients with traumatic SCI and perhaps for other pathological conditions. In comparison with standard rTMS protocols, iTBS represents a more feasible approach because of lower stimulation intensity and shorter duration of application in each single session,” Nardone comments in the release.
[Source(s): IOS Press, Science Daily]
