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Priming Pharyngeal Motor Cortex by Repeated Paired Associative Stimulation: Implications for Dysphagia Neurorehabilitation.
MedLine Citation:
PMID:  23300211     Owner:  NLM     Status:  Publisher    
BACKGROUND: . Several stimulation parameters can influence the neurophysiological and behavioral effects of paired associative stimulation (PAS), a neurostimulation paradigm that repeatedly pairs a peripheral electrical with a central cortical (transcranial magnetic stimulation [TMS]) stimulus. This also appears to be the case when PAS is applied to the pharyngeal motor cortex (MI), with some variability in excitatory responses, questioning its translation into a useful therapy for patients with brain injury. OBJECTIVE: . To investigate whether repeated PAS in both "responders" and "nonresponders" could enhance cortical excitability in pharyngeal MI more robustly. METHODS: . Based on their responses after single PAS, healthy participants were stratified into 2 groups of "responders" and "nonresponders" and underwent 2 periods (60 minutes inter-PAS interval) of active and sham PAS in a randomized order. Neurophysiological measurements with single TMS pulses from pharyngeal motor representation were collected up to 90 minutes after the second PAS period. RESULTS: . Repeated PAS increased cortical excitability up to 95% at 60 minutes following the second PAS in both the "responders" and "nonresponders." Moreover, cortical excitability in the "nonresponders" was significantly different after repeated PAS compared with single and sham application (P = .02; z = -2.2). CONCLUSIONS: . Double dose PAS switched "nonresponders" to "responders." These results are important for PAS application to dysphagic stroke patients who do not initially respond to a single application.
Emilia Michou; Satish Mistry; John Rothwell; Shaheen Hamdy
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-8
Journal Detail:
Title:  Neurorehabilitation and neural repair     Volume:  -     ISSN:  1552-6844     ISO Abbreviation:  Neurorehabil Neural Repair     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892086     Medline TA:  Neurorehabil Neural Repair     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1University of Manchester, Manchester, UK.
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