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9. Non-invasive brain and spinal cord stimulation for motor and functional recovery after a spinal cord injury

Author

Kumru, H, Flores, A, Rodriguez-Canon, M, Soriano, I, Garcia, L, and Vidal-Samso, J

Subjects
Transcutaneous spinal-cord stimulation, Transcranial direct current stimulation, Spinal cord injury, Gait, Motor function, Transcranial magnetic stimulation, Non-invasive stimulation
Abstract

Introduction. Spinal cord injury is a traumatic or non-traumatic event that causes an alteration of sensory, motor or autonomic functioning and ultimately affects the physical, psychological and social well-being of the person who suffers it. A comprehensive approach to spinal cord injury requires many health resources and can place a considerable financial burden on patients, their families and the community. Aim. To review the literature published to date on the use of non-invasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and transcutaneous non-invasive spinal cord stimulation (tcSCS), as therapeutic strategies to improve the functionality of patients with spinal cord injury. The studies were grouped as addressing either non-invasive brain stimulation or non-invasive spinal cord stimulation. Development. Altogether 32 studies were identified: 21 involving brain stimulation (14 in rTMS and 7 in tDCS) and 11 with spinal cord stimulation (tcSCS). All the studies were conducted in adult patients who had undergone a spinal Despite significant variability in treatment protocols, patient characteristics and clinical assessment, the changes observed were reported in almost all the studies without producing any side effects and with motor or functional improvement. Conclusion. Non-invasive brain stimulation, as well as spinal cord stimulation, are promising techniques for the rehabilitation of patients with spinal cord injury due to their novelty, effectiveness and minimal side effects.

Published
2020

13. Is HLA matching relevant for treating Spinal Cord Injury with intrathecal administration of expanded Wharton's Jelly Mesenchymal Stromal Cells?

Author

Coll, R., primary, Vidal, J., additional, Kumru, H., additional, Benito, J., additional, Valles, M., additional, Codinach, M., additional, Blanco, M., additional, Vives, J., additional, Querol, S., additional, Salvador, F.Rudilla, additional, Nogués, N., additional, Rodriguez, L., additional, and Garcia, J., additional

Published
2020
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15. Cortical Relay Time Shortens in Parkinson's Disease with Apraxia

Author

Gunduz, A, Kiziltan, ME, Kumru, H, Oguz, S, Kiziltan, G, Ertan, S, and Apaydin, H

Subjects
Apraxia, Parkinson's disease, Cortical relay time
Abstract

Cortical relay time (CRT) is a neurophysiologic method that measures transmission between sensory and motor cortices. In this study, we calculated CRT to evaluate intrahemispheric transmission in idiopathic Parkinson's disease (PD). We recorded the following parameters: 1) long latency reflexes (LLRs), 2) motor-evoked potentials (MEPs), and 3) somatosensory-evoked potentials (SEPs) according to previously published reports, and cortical relay time was calculated using the following formula: Latency of LLR II - (onset latency of MEP response + latency of N20 response of SEP). CRT was shorter in patients with apraxia compared with patients without apraxia. The findings may raise the possibility of intrahemispheric aberrant conduction or abnormal synaptic reorganization in the presence of apraxia in PD.

Published
2017

16. Intrathecal administration of expanded wharton's jelly mesenchymal stromal cells (WJ-MSC) in chronic traumatic spinal cord injury (SCI) (NCT03003364)

Author

Coll, R., primary, Vidal, J., additional, Kumru, H., additional, Benito, J., additional, Valles, M., additional, Ribó, N., additional, Codinach, M., additional, Blanco, M., additional, Gómez, S.G., additional, Vives, J., additional, Querol, S., additional, Rodriguez, L., additional, and Garcia, J., additional

Published
2018
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42. H reflex modulation by transcranial magnetic stimulation in spinal cord injury subjects after gait training with electromechanical systems.

Author

Benito Penalva, J, Opisso, E, Medina, J, Corrons, M, Kumru, H, Vidal, J, and Valls-Solé, J

Subjects
TRANSCRANIAL magnetic stimulation, REFLEXES, PATIENTS with spinal cord injuries, GAIT in humans, MEDICAL rehabilitation, HUMAN locomotion
Abstract

Study design:Prospective longitudinal study.Objectives:The aim of this study was to examine the effects of transcranial magnetic stimulation (TMS) on the soleus H reflex in patients with spinal cord injury (SCI) before and after locomotion training.Setting:Neurorehabilitation hospital in Barcelona, Spain.Methods:H reflex was elicited in 29 incomplete patients with SCI at 20, 50 and 80 ms after single vertex TMS, and compared with 13 healthy subjects. Patients were subdivided in two groups according to time since injury (<3 months, 3–12 months), and all received training with electromechanical systems. The H reflex modulation pattern to TMS was reassessed and the results were analyzed as a function of change in the patient clinical score.Results:Healthy subjects showed a significant H reflex facilitation at 20 ms (186.1%) and at 80 ms (190.6%) compared with the control H reflex. In patients, the H reflex facilitation at 20 ms was significantly reduced before training (142.5%, P=0.039) compared with healthy subjects. After training, patients with <3 months exhibited an increase in H reflex facilitation at 20 ms (170.7%, P=0.04), a greater gait velocity (P=0.014) and a positive correlation with the walking index for spinal cord injury (WISCI II) scale (P=0.050), compared with those with >3 months.Conclusions:TMS-induced H reflex modulation may help in the assessment of changes in the descending control of leg reflexes. Our results suggest that the changes on reflex modulation in patients with SCI occur within the first 3 months after injury. [ABSTRACT FROM AUTHOR]

Published
2010
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