A Systematic Review of Paired Associative Stimulation (PAS) to Modulate Lower Limb Corticomotor Excitability: Implications for Stimulation Parameter Selection and Experimental Design

Simple item page
aut.relation.articlenumber895en_NZ
aut.relation.journalFrontiers in Neuroscienceen_NZ
aut.relation.volume13en_NZ
aut.researcherDrabsch, Julie
dc.contributor.authorAlder, Gen_NZ
dc.contributor.authorSignal, Nen_NZ
dc.contributor.authorOlsen, Sen_NZ
dc.contributor.authorTaylor, Den_NZ
dc.date.accessioned2019-10-30T23:35:17Z
dc.date.available2019-10-30T23:35:17Z
dc.date.copyright2019en_NZ
dc.date.issued2019en_NZ
dc.description.abstractNon-invasive neuromodulatory interventions have the potential to influence neural plasticity and augment motor rehabilitation in people with stroke. Paired associative stimulation (PAS) involves the repeated pairing of single pulses of electrical stimulation to a peripheral nerve and single pulses of transcranial magnetic stimulation over the contralateral primary motor cortex. Efficacy of PAS in the lower limb of healthy and stroke populations has not been systematically appraised. Optimal protocols including stimulation parameter settings have yet to be determined. This systematic review (a) examines the efficacy of PAS on lower limb corticomotor excitability in healthy and stroke populations and (b) evaluates the stimulation parameters employed. Five databases were searched for randomized, non-randomized, and pre-post experimental studies evaluating lower limb PAS in healthy and stroke populations. Two independent reviewers identified eligible studies and assessedmethodological quality using amodified Downs and Blacks Tool and the TMS Checklist. Intervention stimulation parameters and TMS measurement details were also extracted and compared. Twelve articles, comprising 24 experiments, met the inclusion criteria. Four articles evaluated PAS in people with stroke. Following a single session of PAS, 21 experiments reported modulation of corticomotor excitability, lasting up to 60min; however, the research lacked methodological rigor. Intervention stimulation parameters were highly variable across experiments, and whilst these appeared to influence efficacy, variations in the intervention and outcome assessment methods hindered the ability to draw conclusions about optimal parameters. Lower limb PAS research requires further investigation before considering its translation into clinical practice. Eight key recommendations serve as guide for enhancing future research in the field.en_NZ
dc.identifier.citationFrontiers in Neuroscience. 13:895. doi: 10.3389/fnins.2019.00895
dc.identifier.doi10.3389/fnins.2019.00895en_NZ
dc.identifier.issn1662-4548en_NZ
dc.identifier.issn1662-453Xen_NZ
dc.identifier.urihttps://hdl.handle.net/10292/12945
dc.publisherFrontiers Media S.A.
dc.relation.urihttps://www.frontiersin.org/articles/10.3389/fnins.2019.00895/full
dc.rights© 2019 Alder, Signal, Olsen and Taylor. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectPaired associative stimulation; Transcranial magnetic stimulation; Cortical excitability; Neuronal plasticity (MeSH); STDP; Primary motor cortex; Rehabilitation (MeSH); Stroke (MeSH)
dc.titleA Systematic Review of Paired Associative Stimulation (PAS) to Modulate Lower Limb Corticomotor Excitability: Implications for Stimulation Parameter Selection and Experimental Designen_NZ
dc.typeJournal Article
pubs.elements-id363751
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
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Alder_2019_A systematic review.pdf
Size:
1.41 MB
Format:
Adobe Portable Document Format
Description:
Journal article
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
AUT Grant of Licence for Tuwhera Aug 2018.pdf
Size:
276.29 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
School of Clinical Sciences