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Spinal cord injury (SCI) dramatically changes the life of an individual, and it is also a substantial economic burden for society. Many therapies have been developed for this condition, but few have progressed to routine clinical practice. Novel non-invasive, cost-effective, and feasible approaches for SCI rehabilitation are needed. Paired associative stimulation (PAS) is a combination of transcranial magnetic stimulation (TMS) and peripheral electrical stimulation (PNS). A novel variant of paired associative stimulation, high-PAS, consists of non-invasive high-intensity TMS and non-invasive high-frequency PNS. A therapeutic effect of high-PAS in patients with incomplete SCI with a wide range of injury severity, time since injury, and age was observed. Tetraplegic and paraplegic, traumatic, as well as neurological SCI patients benefited from upper- or lower-limb high-PAS. High-PAS settings were optimized in studies in healthy subjects. This chapter is focused on the summary of results, observations, and methodological considerations concerning the use of high-PAS in SCI rehabilitation.

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High-PAS: Paired Associative Stimulation with High-Frequency Peripheral and High-Intensity Central Component in Spinal Cord Injury Rehabilitation

  • 章节

  • 发表日期：

    2025年

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  • Anastasia Shulga,
  • Erika Kirveskari,
  • Jyrki P. Mäkelä,
  • Pantelis Lioumis

摘要

Spinal cord injury (SCI) dramatically changes the life of an individual, and it is also a substantial economic burden for society. Many therapies have been developed for this condition, but few have progressed to routine clinical practice. Novel non-invasive, cost-effective, and feasible approaches for SCI rehabilitation are needed. Paired associative stimulation (PAS) is a combination of transcranial magnetic stimulation (TMS) and peripheral electrical stimulation (PNS). A novel variant of paired associative stimulation, high-PAS, consists of non-invasive high-intensity TMS and non-invasive high-frequency PNS. A therapeutic effect of high-PAS in patients with incomplete SCI with a wide range of injury severity, time since injury, and age was observed. Tetraplegic and paraplegic, traumatic, as well as neurological SCI patients benefited from upper- or lower-limb high-PAS. High-PAS settings were optimized in studies in healthy subjects. This chapter is focused on the summary of results, observations, and methodological considerations concerning the use of high-PAS in SCI rehabilitation.