Investigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS)

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aut.relation.endpage224
aut.relation.issue2en_NZ
aut.relation.journalBrain Sciencesen_NZ
aut.relation.startpage224
aut.relation.volume11en_NZ
aut.researcherAlder, Gemma
dc.contributor.authorAlder, Gen_NZ
dc.contributor.authorSignal, Nen_NZ
dc.contributor.authorVandal, ACen_NZ
dc.contributor.authorOlsen, Sen_NZ
dc.contributor.authorJochumsen, Men_NZ
dc.contributor.authorNiazi, IKen_NZ
dc.contributor.authorTaylor, Den_NZ
dc.date.accessioned2021-02-15T23:25:09Z
dc.date.available2021-02-15T23:25:09Z
dc.description.abstractAdvances in our understanding of neural plasticity have prompted the emergence of neuromodulatory interventions, which modulate corticomotor excitability (CME) and hold potential for accelerating stroke recovery. Endogenous paired associative stimulation (ePAS) involves the repeated pairing of a single pulse of peripheral electrical stimulation (PES) with endogenous movement-related cortical potentials (MRCPs), which are derived from electroencephalography. However, little is known about the optimal parameters for its delivery. A factorial design with repeated measures delivered four different versions of ePAS, in which PES intensities and movement type were manipulated. Linear mixed models were employed to assess interaction effects between PES intensity (suprathreshold (Hi) and motor threshold (Lo)) and movement type (Voluntary and Imagined) on CME. ePAS interventions significantly increased CME compared to control interventions, except in the case of Lo-Voluntary ePAS. There was an overall main effect for the Hi-Voluntary ePAS intervention immediately post-intervention (p = 0.002), with a sub-additive interaction effect at 30 min’ post-intervention (p = 0.042). Hi-Imagined and Lo-Imagined ePAS significantly increased CME for 30 min post-intervention (p = 0.038 and p = 0.043 respectively). The effects of the two PES intensities were not significantly different. CME was significantly greater after performing imagined movements, compared to voluntary movements, with motor threshold PES (Lo) 15 min post-intervention (p = 0.012). This study supports previous research investigating Lo-Imagined ePAS and extends those findings by illustrating that ePAS interventions that deliver suprathreshold intensities during voluntary or imagined movements (Hi-Voluntary and Hi-Imagined) also increase CME. Importantly, our findings indicate that stimulation intensity and movement type interact in ePAS interventions. Factorial designs are an efficient way to explore the effects of manipulating the parameters of neuromodulatory interventions. Further research is required to ensure that these parameters are appropriately refined to maximise intervention efficacy for people with stroke and to support translation into clinical practice.en_NZ
dc.identifier.citationBrain Sciences, 11(2), 224. doi:10.3390/brainsci11020224
dc.identifier.doi10.3390/brainsci11020224en_NZ
dc.identifier.issn2076-3425en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/13994
dc.languageenen_NZ
dc.publisherMDPI AGen_NZ
dc.relation.urihttps://www.mdpi.com/2076-3425/11/2/224
dc.rights© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectPaired associative stimulation; Movement-related cortical potential; Neuromodulation; Neural plasticity; Rehabilitation (MeSH); Stroke (MeSH); Factorial design; Linear mixed regression
dc.titleInvestigating the Intervention Parameters of Endogenous Paired Associative Stimulation (ePAS)en_NZ
dc.typeJournal Article
pubs.elements-id397900
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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