Establishment of neuromodulation therapy with combination of electrical stimulation and Botulinum toxin

本研究的目的是探讨电刺激（ES）和肉毒毒素（BTX）注射作为神经调节疗法治疗三种顽固性损伤的效果，即中枢神经系统损伤后的剩余性麻痹，中风后的异常感觉和疼痛，以及顽固性膀胱过动症。BTX与ES联合治疗可改善上肢功能，持久缓解痉挛。下肢连续应用电刺激和肌电触发电刺激显示了改善步态功能的可能性。BTX未减轻中枢性疼痛，但疼痛阈值趋于正常化。2例顽固性膀胱过动症患者经联合治疗后尿失禁消失。

The purpose of this study is to investigate the effect of electrical stimulation (ES) and Botulinum toxin (BTX) injection as a neuromodulational therapy for treatment of three types of intractable impairments, i.e., remaining paresis after central nervous system damage, abnormal sensation and pain after stroke, and intractable overactive bladder. Combination therapy of BTX with ES provided improvement of upper limb function and long lasting spasticity reduction. Continuous application of ES to lower limb and use of EMG triggered ES showed possibility to improve gait function. Central pain was not reduced by BTX injection but pain threshold tended to normalize. Twopatients with intractable overactive bladder showed long lasting incontinence disappearance after combination therapy.