Translating a Preclinically Tested 15 Hz rTMS Protocol to Humans With Chronic Spinal Cord Injury: A Safety and...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Repetitive transcranial magnetic stimulation (rTMS) offers potential for enhancing neural pathways post-spinal cord injury (SCI).
• Preclinical studies show high-frequency (15 Hz) rTMS promotes axon regeneration and motor function recovery.
• Translational research is needed to assess 15 Hz rTMS for chronic SCI patients.

Purpose of the Study:

• To investigate the safety and feasibility of a 15 Hz rTMS protocol as an adjunct therapy for chronic cervical SCI.
• To evaluate neurophysiological and clinical functional outcomes following the combined intervention.

Main Methods:

• A 15-day protocol involving 15 Hz rTMS followed by task-specific hand motor training was administered to 7 individuals with chronic cervical SCI.
• rTMS targeted wrist extensor muscles, with intensity adjusted based on individual motor thresholds and tolerability.
• Safety, feasibility, neurophysiological changes, and clinical functional outcomes were assessed throughout the protocol.

Main Results:

• The 15 Hz rTMS and motor training protocol was generally safe, feasible, and well-tolerated, with no major adverse effects.
• Preliminary evidence of neuroplastic changes, including modulation of corticospinal excitability and intracortical inhibition, was observed.
• Clinical functional improvements were noted and persisted at follow-up assessments.

Conclusions:

• Combining 15 Hz rTMS with task-specific motor training is a feasible and tolerable intervention for chronic cervical SCI.
• The intervention demonstrated potential for inducing neuroplasticity and improving function in individuals with chronic SCI.
• Further research, including larger controlled trials and studies in earlier-stage SCI, is warranted to confirm efficacy.