ArticleFrontiers in neuroscience2019
Paired Associative Stimulation as a Tool to Assess Plasticity Enhancers in Chronic Stroke.
Article in Frontiers in neuroscience, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Pooled it
- Resting motor threshold in the course of hand motor recovery after stroke: a systematic review.Journal of neuroengineering and rehabilitation · 2021Pooled it
- Contribution of Glutamatergic and GABAergic Mechanisms to the Plasticity-Modulating Effects of Dopamine in the Human Motor Cortex.Human brain mapping · 2025Trial
- Repetitive peripheral magnetic stimulation combined with transcranial magnetic stimulation in rehabilitation of upper extremity hemiparesis following stroke: a pilot study.Journal of rehabilitation medicine · 2024Trial
- Does sonification of action simulation training impact corticospinal excitability and audiomotor plasticity?Experimental brain research · 2021Trial
- Visuomotor paired associative stimulation enhances corticospinal excitability in post-stroke patients with upper-limb hemiparesis.Scientific reports · 2025Article
- Improving Spasticity by Using Botulin Toxin: An Overview Focusing on Combined Approaches.Brain sciences · 2024Review
- The Effectiveness of Paired Associative Stimulation on Motor Recovery after Stroke: A Scoping Review.Neurology international · 2024Article
- The Effectiveness of Transcranial Magnetic Stimulation in Treating Apraxia.CNS & neurological disorders drug targets · 2024Review
- Article
- Effects of transcranial magnetic stimulation on neurobiological changes in Alzheimer's disease (Review).Molecular medicine reports · 2022Review
- Targeting Sensory and Motor Integration for Recovery of Movement After CNS Injury.Frontiers in neuroscience · 2021Review
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe potential for adaptive plasticity in the post-stroke brain is difficult to estimate, as is the demonstration of central nervous system (CNS) target engagement of drugs that show promise in facilitating stroke recovery. We set out to determine if paired associative stimulation (PAS) can be used (a) as an assay of CNS plasticity in patients with chronic stroke, and (b) to demonstrate CNS engagement by memantine, a drug which has potential plasticity-modulating effects for use in motor recovery following stroke.
methodsWe examined the effect of PAS in fourteen participants with chronic hemiparetic stroke at five time-points in a within-subjects repeated measures design study: baseline off-drug, and following a week of orally administered memantine at doses of 5, 10, 15, and 20 mg, comprising a total of seventy sessions. Each week, MEP amplitude pre and post-PAS was assessed in the contralesional hemisphere as a marker of enhanced or diminished plasticity. Strength and dexterity were recorded each week to monitor motor-specific clinical status across the study period.
resultsWe found that MEP amplitude was significantly larger after PAS in baseline sessions off-drug, and responsiveness to PAS in these sessions was associated with increased clinical severity. There was no observed increase in MEP amplitude after PAS with memantine at any dose. Motor threshold (MT), strength, and dexterity remained unchanged during the study.
conclusionPaired associative stimulation successfully induced corticospinal excitability enhancement in chronic stroke subjects at the group level. However, this response did not occur in all participants, and was associated with increased clinical severity. This could be an important way to stratify patients for future PAS-drug studies. PAS was suppressed by memantine at all doses, regardless of responsiveness to PAS off-drug, indicating CNS engagement.
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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.