The use of F-response in defining interstimulus intervals appropriate for LTP-like plasticity induction in lower limb spinal paired associative stimulation

Anastasia Shulga; Pantelis Lioumis; Erika Kirveskari; Sarianna Savolainen; Jyrki P Mäkelä; Aarne Ylinen

doi:10.1016/j.jneumeth.2015.01.012

The use of F-response in defining interstimulus intervals appropriate for LTP-like plasticity induction in lower limb spinal paired associative stimulation

J Neurosci Methods. 2015 Mar 15:242:112-7. doi: 10.1016/j.jneumeth.2015.01.012. Epub 2015 Jan 15.

Authors

Anastasia Shulga¹, Pantelis Lioumis², Erika Kirveskari³, Sarianna Savolainen⁴, Jyrki P Mäkelä⁵, Aarne Ylinen⁶

Affiliations

¹ Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, P.O. Box 372, FI-00029 Helsinki, Finland; BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029 Helsinki, Finland. Electronic address: anastasia.shulga@helsinki.fi.
² BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029 Helsinki, Finland; Neuroscience Center, University of Helsinki, P.O. Box 56, FI-00014, Finland. Electronic address: pantelis.lioumis@hus.fi.
³ Clinical Neurosciences, Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029 Helsinki, Finland. Electronic address: erika.kirveskari@hus.fi.
⁴ Validia Rehabilitation Center, P.O. Box 103, FI-00251 Helsinki, Finland. Electronic address: sarianna.savolainen@thl.fi.
⁵ BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029 Helsinki, Finland. Electronic address: jyrki.makela@hus.fi.
⁶ Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, P.O. Box 372, FI-00029 Helsinki, Finland. Electronic address: aarne.ylinen@hus.fi.

PMID: 25597909
DOI: 10.1016/j.jneumeth.2015.01.012

Abstract

Background: In spinal paired associative stimulation (PAS), orthodromic volleys are induced by transcranial magnetic stimulation (TMS) in upper motor neurons, and antidromic volleys by peripheral nerve stimulation (PNS) in lower motor neurons of human corticospinal tract. The volleys arriving synchronously to the corticomotoneuronal synapses induce spike time-dependent plasticity in the spinal cord. For clinical use of spinal PAS, it is important to develop protocols that reliably induce facilitation of corticospinal transmission. Due to variability in conductivity of neuronal tracts in neurological patients, it is beneficial to estimate interstimulus interval (ISI) between TMS and PNS on individual basis. Spinal root magnetic stimulation has previously been used for this purpose in spinal PAS targeting upper limbs. However, at lumbar level this method does not take into account the conduction time of spinal nerves of the cauda equina in the spinal canal.

New method: For lower limbs spinal PAS, we propose estimating appropriate ISIs on the basis of F-response and motor-evoked potential (MEP) latencies. The use of navigation in TMS and ensuring correct PNS electrode placement with F-response recording enhances the precision of the method.

Results: Our protocol induced 186±17% (mean±STE) MEP amplitude facilitation in healthy subjects, being effective in all subjects and nerves tested.

Comparison with existing method: We report for the first time the individual estimation of ISIs in spinal PAS for lower limbs.

Conclusions: Estimation of ISI on the basis of F and MEP latencies is sufficient to effectively enhance corticospinal transmission by lower limb spinal PAS in healthy subjects.

Keywords: Electrical stimulation therapy; F-response; Neuronal plasticity; Paired associative stimulation; Transcranial magnetic stimulation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Electric Stimulation Therapy / methods*
Evoked Potentials, Motor
Feasibility Studies
Female
Femoral Nerve / physiology
Humans
Lower Extremity / physiology
Male
Middle Aged
Motor Neurons / physiology
Muscle, Skeletal / physiology
Neuronal Plasticity / physiology*
Peroneal Nerve / physiology
Pyramidal Tracts / physiology*
Tibial Nerve / physiology
Transcranial Magnetic Stimulation / methods*