Controversies and clinical applications of non-invasive transspinal magnetic stimulation: a critical review and exploratory trial in hereditary spastic paraplegia

Autor: Rafael Bernhart Carra, Guilherme Diogo Silva, Isabela Bruzzi Bezerra Paraguay, Fabricio Diniz de Lima, Janaina Reis Menezes, Aruane Mello Pineda, Glaucia Aline Nunes, Juliana da Silva Simões, Marcondes Cavalcante França, Rubens Gisbert Cury
Rok vydání: 2022
Předmět:
Zdroj: Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
Journal of Clinical Medicine; Volume 11; Issue 16; Pages: 4748
Popis: Magnetic stimulation is a safe, non-invasive diagnostic tool and promising treatment strategy for neurological and psychiatric disorders. Although most studies address transcranial magnetic stimulation, transspinal magnetic stimulation (TsMS) has received recent attention since trials involving invasive spinal cord stimulation showed encouraging results for pain, spasticity, and Parkinson’s disease. While the effects of TsMS on spinal roots is well understood, its mechanism of action on the spinal cord is still controversial. Despite unclear mechanisms of action, clinical benefits of TsMS have been reported, including improvements in scales of spasticity, hyperreflexia, and bladder and bowel symptoms, and even supraspinal gait disorders such as freezing and camptocormia. In the present study, a critical review on the application of TsMS in neurology was conducted, along with an exploratory trial involving TsMS in three patients with hereditary spastic paraplegia. The goal was to understand the mechanism of action of TsMS through H-reflex measurement at the unstimulated lumbosacral level. Although limited by studies with a small sample size and a low to moderate effect size, TsMS is safe and tolerable and presents consistent clinical and neurophysiological benefits that support its use in clinical practice.
Databáze: OpenAIRE
Externí odkaz: