Operant Up-Conditioning of the Tibialis Anterior Motor-Evoked Potential in Multiple Sclerosis: Feasibility Case Studies.
Operant Up-Conditioning of the Tibialis Anterior Motor-Evoked Potential in Multiple Sclerosis: Feasibility Case Studies.
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DOI：
10.1155/2018/4725393
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发表时间：
2018
影响因子：
3.1
通讯作者：
Falivena P
中科院分区：
文献类型：
--
作者：
Thompson AK;Favale BM;Velez J;Falivena P
皮质脊髓通路的损伤通常导致踝关节背屈减弱，从而限制了多发性硬化症（MS）患者的活动能力。因此，加强皮质脊髓连接可以改善运动。在这里，我们调查了胫骨前肌（TA）运动诱发电位（MEP）操作性条件反射的可行性，以及它是否可以增强皮质脊髓兴奋性和缓解运动问题的人与慢性稳定MS。该协议包括6个基线和24个向上调节会议超过10周。在所有会话中，TA MEP在高于活动阈值10%时被引出，而坐姿受试者提供TA背景EMG的30-35%最大自主收缩（MVC）水平。在基线会议期间，简单地测量了MEP。在条件反射阶段的条件反射试验期间，受试者被鼓励增加MEP，并被给予指示MEP大小是否高于标准的即时反馈。在3/4的受试者中，TA MEP增加32- 75%，MVC增加28- 52%，多个腿部肌肉的运动EMG调制改善，并且足下垂变得不那么严重。在其中一个，MEP和MVC的增加保持在整个3年的广泛的后续会议。这些初步结果支持MEP操作性条件反射用于改善MS或其他CNS疾病（如脊髓损伤和中风）患者的运动的治疗可能性。
Damage to the corticospinal pathway often results in weak dorsiflexion of the ankle, thereby limiting the mobility of people with multiple sclerosis (MS). Thus, strengthening corticospinal connectivity may improve locomotion. Here, we investigated the feasibility of tibialis anterior (TA) motor-evoked potential (MEP) operant conditioning and whether it can enhance corticospinal excitability and alleviate locomotor problems in people with chronic stable MS. The protocol consisted of 6 baseline and 24 up-conditioning sessions over 10 weeks. In all sessions, TA MEPs were elicited at 10% above active threshold while the sitting subject provided 30–35% maximum voluntary contraction (MVC) level of TA background EMG. During baseline sessions, MEPs were simply measured. During conditioning trials of the conditioning sessions, the subject was encouraged to increase MEP and was given immediate feedback indicating whether MEP size was above a criterion. In 3/4 subjects, TA MEP increased 32–75%, MVC increased 28–52%, locomotor EMG modulation improved in multiple leg muscles, and foot drop became less severe. In one of them, MEP and MVC increases were maintained throughout 3 years of extensive follow-up sessions. These initial results support a therapeutic possibility of MEP operant conditioning for improving locomotion in people with MS or other CNS disorders, such as spinal cord injury and stroke.
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影响因子：
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