Effects of Skin Stimulation on Sensory-Motor Networks Excitability: Possible Implications for Physical Training in Amyotrophic Lateral Sclerosis

Marco Ceccanti; Chiara Cambieri; Laura Libonati; Giorgio Tartaglia; Federica Moret; Matteo Garibaldi; Maurizio Inghilleri

doi:10.3389/fneur.2022.868792

Effects of Skin Stimulation on Sensory-Motor Networks Excitability: Possible Implications for Physical Training in Amyotrophic Lateral Sclerosis

Front Neurol. 2022 May 25:13:868792. doi: 10.3389/fneur.2022.868792. eCollection 2022.

Authors

Marco Ceccanti¹, Chiara Cambieri¹, Laura Libonati¹, Giorgio Tartaglia¹, Federica Moret¹, Matteo Garibaldi², Maurizio Inghilleri¹

Affiliations

¹ Department of Human Neuroscience, Center for Rare Neuromuscular Diseases, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
² Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Neuromuscular and Rare Disease Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Abstract

Background: Many different trials were assessed for rehabilitation of patients with amyotrophic lateral sclerosis (ALS), with non-unique results. Beside the effects on muscle trophism, some of the encouraging results of physical training could be ascribed to the modulation of cortical excitability, which was found hyperexcited in ALS.

Objective: The effects of tactile skin stimulation in the modulation of the sensory-motor integrative networks in healthy subjects were assayed through the paired associative stimulation (PAS) protocol.

Methods: In total, 15 healthy subjects were enrolled. In the standard PAS session, the average amplitude of the motor evoked potential (MEP) after 10 stimuli of transcranial magnetic stimulation (TMS) was measured at the baseline and after the PAS protocol (0, 10, 20, 30, and 60 min). In the skin stimulation session, the average amplitude of the MEP was measured before and after 10 min of skin stimulation over the hand. Subsequently, each subject underwent the PAS stimulation and the measure of the average amplitude of the MEP (0, 10, 20, 30, and 60 min).

Results: The tactile skin stimulation on healthy subjects increases the PAS-induced sensory-motor network hyperexcitability in healthy subjects.

Conclusion: Skin stimulation should be avoided in the physiotherapeutic approaches for patients with ALS, given the possible hyperexciting effects on the already upmodulated sensory-motor networks. They can be taken into account for diseases characterized by downregulation of cortical and transcortical networks.

Keywords: amyotrophic lateral sclerosis; brain stimulation; cortical excitability; paired associative stimulation; sensory-motor networks.