a2bf784ba2927ea0ff8dfb694e6a9678 pmc_33430460.pdf bce9fd4b2d8a5d5bb0a4b49d7aab004b5394b84f pmc_33430460.pdf 0344d2fa6a3ba5d2f164a3272bade862b5ff4f9fd54be4d68205e5096b6a3445 pmc_33430460.pdf Title: Cervical Electrical Neuromodulation Effectively Enhances Hand Motor Output in Healthy Subjects by Engaging a Use-Dependent Intervention Subject: Electrical enabling motor control (eEmc) through transcutaneous spinal cord stimulation is a non-invasive method that can modify the functional state of the sensory-motor system. We hypothesize that eEmc delivery, together with hand training, improves hand function in healthy subjects more than either intervention alone by inducing plastic changes at spinal and cortical levels. Ten voluntary participants were included in the following three interventions: (i) hand grip training, (ii) eEmc, and (iii) eEmc with hand training. Functional evaluation included the box and blocks test (BBT) and hand grip maximum voluntary contraction (MVC), spinal and cortical motor evoked potential (sMEP and cMEP), and resting motor thresholds (RMT), short interval intracortical inhibition (SICI), and F wave in the abductor pollicis brevis muscle. eEmc combined with hand training retained MVC and increased F wave amplitude and persistency, reduced cortical RMT and facilitated cMEP amplitude. In contrast, eEmc alone only increased F wave amplitude, whereas hand training alone reduced MVC and increased cortical RMT and SICI. In conclusion, eEmc combined with hand grip training enhanced hand motor output and induced plastic changes at spinal and cortical level in healthy subjects when compared to either intervention alone. These data suggest that electrical neuromodulation changes spinal and, perhaps, supraspinal networks to a more malleable state, while a concomitant use-dependent mechanism drives these networks to a higher functional state. Keywords: transcutaneous spinal cord stimulation; hand training; combined intervention; neuromodulation; cervical spinal cord Author: Hatice Kumru, África Flores, María Rodríguez-Cañón, Victor R. Edgerton, Loreto García, Jesús Benito-Penalva, Xavier Navarro, Yury Gerasimenko, Guillermo García-Alías and Joan Vidal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Jan 19 04:49:27 2021 CET ModDate: Tue Jan 19 05:09:09 2021 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 4549421 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- HKPBVE+VnURWPalladioL Type 1 Custom yes yes no 10 0 QGBRLK+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 ZQCSNX+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 LLIDMX+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 FRSUUT+CMSY10 Type 1 Builtin yes yes no 28 0 DCXXPC+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi 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yes yes no 447 0 NJCBIK+Wingdings CID TrueType Identity-H yes yes yes 450 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:35:32 CEST RepresentationInformation: pmc_33430460.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:08:33 CEST Size: 4549421 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 705 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Experimental Section Destination: section.2 Children: Item: Title: Participants Destination: subsection.2.1 Item: Title: Experimental Design Destination: subsection.2.2 Item: Title: Functional Assessment Destination: subsection.2.3 Children: Item: Title: Maximum Voluntary Contraction during Hand Grip Strength Destination: subsubsection.2.3.1 Item: Title: Box and Blocks Test Destination: subsubsection.2.3.2 Item: Title: Neurophysiological Assessment Destination: subsection.2.4 Children: Item: Title: Electromyographical Recording Destination: subsubsection.2.4.1 Item: Title: F Wave Destination: subsubsection.2.4.2 Item: Title: Recruitment Curve of sMEPs Destination: subsubsection.2.4.3 Item: Title: Transcranial Magnetic Stimulation Destination: subsubsection.2.4.4 Item: Title: Interventions Destination: subsection.2.5 Item: Title: Data Analysis and Statistics Destination: subsection.2.6 Item: Title: Results Destination: section.3 Children: Item: Title: Hand Motor Output Destination: subsection.3.1 Item: Title: Spinal Cord Excitability Destination: subsection.3.2 Item: Title: Corticospinal Excitability and Intracortical Inhibition Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Cervical Electrical Neuromodulation Effectively Enhances Hand Motor Output in Healthy Subjects by Engaging a Use-Dependent Intervention Author: Hatice Kumru, África Flores, María Rodríguez-Cañón, Victor R. Edgerton, Loreto García, Jesús Benito-Penalva, Xavier Navarro, Yury Gerasimenko, Guillermo García-Alías and Joan Vidal Subject: Electrical enabling motor control (eEmc) through transcutaneous spinal cord stimulation is a non-invasive method that can modify the functional state of the sensory-motor system. We hypothesize that eEmc delivery, together with hand training, improves hand function in healthy subjects more than either intervention alone by inducing plastic changes at spinal and cortical levels. Ten voluntary participants were included in the following three interventions: (i) hand grip training, (ii) eEmc, and (iii) eEmc with hand training. Functional evaluation included the box and blocks test (BBT) and hand grip maximum voluntary contraction (MVC), spinal and cortical motor evoked potential (sMEP and cMEP), and resting motor thresholds (RMT), short interval intracortical inhibition (SICI), and F wave in the abductor pollicis brevis muscle. eEmc combined with hand training retained MVC and increased F wave amplitude and persistency, reduced cortical RMT and facilitated cMEP amplitude. In contrast, eEmc alone only increased F wave amplitude, whereas hand training alone reduced MVC and increased cortical RMT and SICI. In conclusion, eEmc combined with hand grip training enhanced hand motor output and induced plastic changes at spinal and cortical level in healthy subjects when compared to either intervention alone. These data suggest that electrical neuromodulation changes spinal and, perhaps, supraspinal networks to a more malleable state, while a concomitant use-dependent mechanism drives these networks to a higher functional state. 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