Dataset Information

Restoring initial steps by intermittent theta burst stimulation in complete spinal cord injury patient: a case report.

ABSTRACT:

Introduction

Spinal cord injury (SCI) causes damage to neurons and results in motor and sensory dysfunction. Intermittent theta burst stimulation (iTBS) has been used to induce neuronal and synaptic plasticity by applying a magnetic field in the brain. The plasticity induced in the cortex has an imperative role in the recovery of motor and sensory functioning. However, the effect of iTBS in complete SCI patients is still elusive.

Case presentation

We report here the case of a 27-year-old female who sustained an L1 complete spinal cord injury (SCI) with an ASIA score of A. The patient lost all the sensory and motor functions below the level of injury. Intermittent theta burst stimulation (iTBS) was administered at 80% of the resting motor threshold over the M1 motor cortex, along with intensive rehabilitation training to promote sensorimotor function.

Discussion

There was a partial recovery in functional, electrophysiological, and neurological parameters. The case report also demonstrates the safety and efficacy of iTBS in complete SCI patients. No adverse event has been observed in the patient during intervention sessions.

SUBMITTER: Patel D

PROVIDER: S-EPMC11298536 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Restoring initial steps by intermittent theta burst stimulation in complete spinal cord injury patient: a case report.

Patel Deeksha D Banerjee Rohit R Farooque Kamran K Gupta Deepak D Garg Bhavuk B Kumar Nand N Thukral Gita H GH Kochhar Kanwal Preet KP Jain Suman S

Spinal cord series and cases 20240804 1

<h4>Introduction</h4>Spinal cord injury (SCI) causes damage to neurons and results in motor and sensory dysfunction. Intermittent theta burst stimulation (iTBS) has been used to induce neuronal and synaptic plasticity by applying a magnetic field in the brain. The plasticity induced in the cortex has an imperative role in the recovery of motor and sensory functioning. However, the effect of iTBS in complete SCI patients is still elusive.<h4>Case presentation</h4>We report here the case of a 27-y ...[more]

PMID: 39098854

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Project description:Transcranial magnetic stimulation (TMS) is a widely used neuromodulation treatment for depression, but its underlying mechanisms are not well understood. Indirect evidence from clinical studies suggests that TMS may act by enhancing plasticity locally within the prefrontal cortical (PFC) target or through network-level effects on downstream areas, but establishing causal mechanisms and optimizing a large stimulation parameter space has been challenging. In an optogenetic model of accelerated intermittent theta burst stimulation targeting the prelimbic PFC (PL-aiTBS), we show that PL-aiTBS drives rapid, antidepressant-like effects on multiple measures of motivated approach and avoidance behavior and reverses stress effects on reward devaluation, with repeated stimulation potentiating local aiTBS-evoked neuronal responses. Spatial transcriptomic profiling revealed a host of cell type-specific effects implicating prefrontal intratelencephalic (IT) projection neurons, including altered expression of genes associated synapse assembly, which in turn was associated with increased postsynaptic dendritic spine density and excitatory currents in prelimbic IT neurons. Using SHIELD tissue clearing, c-Fos immunolabeling, and light sheet imaging to map whole-brain responses to aiTBS, we delineate a network of downstream structures activated by PL-aiTBS, including pronounced effects in insular cortex, which were confirmed by fiber photometry. Chemogenetic and projection-specific optogenetic studies established the necessity and sufficiency of a fronto-insular circuit in mediating aiTBS effects on motivated approach and avoidance behavior. Finally, we validate a key role for TMS-evoked responses in the human insula, showing in intracortical stereo-EEG recordings that prefrontal TMS modulates neuronal activity in insular cortex acutely and that resting state fMRI measures of fronto-insular connectivity predict individual differences in antidepressant responses to aiTBS. Together, these results identify a critical role for aiTBS-induced activation of a fronto-insular circuit in supporting specific antidepressant-like behavioral effects and establish a model for studying aiTBS mechanisms and optimizing stimulation parameters.

Dataset Information

Restoring initial steps by intermittent theta burst stimulation in complete spinal cord injury patient: a case report.

Introduction

Case presentation

Discussion

Publications

Restoring initial steps by intermittent theta burst stimulation in complete spinal cord injury patient: a case report.

Similar Datasets

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