Evidence map›Paper›PMID 28784042›Full record

Trial reportThe journal of spinal cord medicine2018

Transcranial direct current stimulation (tDCS) paired with massed practice training to promote adaptive plasticity and motor recovery in chronic incomplete tetraplegia: A pilot study.

Kelsey A Potter-Baker, Daniel P Janini, Yin-Liang Lin, Vishwanath Sankarasubramanian, David A Cunningham, Nicole M Varnerin, Patrick Chabra, Kevin L Kilgore, Mary Ann Richmond, Frederick S Frost and 1 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The journal of spinal cord medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01539109 (Improving Spinal Cord Injury Rehabilitation Interventions by Retraining the Brain With Stimulation), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01539109 nacompletednot on this map

Improving Spinal Cord Injury Rehabilitation Interventions by Retraining the Brain With Stimulation: Applying Concepts From Stroke

TypeinterventionalSponsorThe Cleveland ClinicRan2011 to 2019Enrolled20ConditionsSpinal Cord InjuryArmsRehabilitation, Noninvasive brain stimulation: tDCS, Sham tDCS: placebo noninvasive brain stimulation
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  15. Cortical and Subcortical Effects of Transcutaneous Spinal Cord Stimulation in Humans with Tetraplegia.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2020
    Article
  16. Article
  17. Celebrating advances in spinal cord injury care and research.The journal of spinal cord medicine · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kelsey A Potter-Bakera Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.
Daniel P Janinia Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.
Yin-Liang Lina Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.
Vishwanath Sankarasubramaniana Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.
David A Cunninghamc Kessler Foundation , Human Performance & Engineering Laboratory , West Orange , New Jersey , USA.
Nicole M Varnerina Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.ORCID 0000-0003-3018-4042
Patrick Chabraa Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.ORCID 0000-0002-0009-0355
Kevin L Kilgored Functional Electrical Stimulation Center , Louis Stokes Cleveland Department of Veteran's Affairs , Cleveland , Ohio , USA.
Mary Ann Richmondg Spinal Cord Injury and Disorders Service , Louis Stokes Cleveland Department of Veteran's Affairs , Cleveland , Ohio , USA.
Frederick S Frosti Department of Physical Medicine and Rehabilitation , Neurological Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.
Ela B Plowa Department of Biomedical Engineering , Lerner Research Institute, Cleveland Clinic Foundation , Cleveland , Ohio , USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOur goal was to determine if pairing transcranial direct current stimulation (tDCS) with rehabilitation for two weeks could augment adaptive plasticity offered by these residual pathways to elicit longer-lasting improvements in motor function in incomplete spinal cord injury (iSCI).

designLongitudinal, randomized, controlled, double-blinded cohort study.

settingCleveland Clinic Foundation, Cleveland, Ohio, USA.

participantsEight male subjects with chronic incomplete motor tetraplegia.

interventionsMassed practice (MP) training with or without tDCS for 2 hrs, 5 times a week. OUTCOME MEASURES: We assessed neurophysiologic and functional outcomes before, after and three months following intervention. Neurophysiologic measures were collected with transcranial magnetic stimulation (TMS). TMS measures included excitability, representational volume, area and distribution of a weaker and stronger muscle motor map. Functional assessments included a manual muscle test (MMT), upper extremity motor score (UEMS), action research arm test (ARAT) and nine hole peg test (NHPT).

resultsWe observed that subjects receiving training paired with tDCS had more increased strength of weak proximal (15% vs 10%), wrist (22% vs 10%) and hand (39% vs. 16%) muscles immediately and three months after intervention compared to the sham group. Our observed changes in muscle strength were related to decreases in strong muscle map volume (r=0.851), reduced weak muscle excitability (r=0.808), a more focused weak muscle motor map (r=0.675) and movement of weak muscle motor map (r=0.935).

conclusionOverall, our results encourage the establishment of larger clinical trials to confirm the potential benefit of pairing tDCS with training to improve the effectiveness of rehabilitation interventions for individuals with SCI.

trial registrationNCT01539109.

Indexed as

Exercise TherapyHumansMaleMiddle AgedMotor ActivityMuscle ContractionNeurological RehabilitationPilot ProjectsQuadriplegiaRecovery of FunctionSpinal Cord InjuriesTranscranial Direct Current StimulationMotor recoveryPlasticitySpinal cord injuryTranscranial direct current stimulationTranscranial magnetic stimulation

Identifiers

PMID28784042
PMCPMC6117576

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.