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Abstract
Paired associative stimulation (PAS) with high-frequency peripheral nerve stimulation (PNS), called “high-PAS”, induces motor-evoked potential (MEP) potentiation in healthy subjects and improves muscle activity and independence in incomplete spinal cord injury patients. Data on optimal PNS intensity in PAS are scarce. In a high-PAS protocol, PNS intensity is defined as “minimal intensity required to produce F-responses”. We sought to further refine this definition and to investigate how PNS intensity affects PAS outcome. Two experiments were performed on 10 healthy subjects where MEP amplitude change was measured 0, 30, and 60 min after PAS. In the first experiment, the intensity required to achieve 7/10 persistence of F-responses was used to define PNS intensity level. In the second experiment, we used the intensity required to achieve 1/10 persistence (“baseline”). In addition, we applied this intensity at + 25%, − 25%, and − 50% levels. In the first experiment, PAS did not produce significant MEP potentiation. In the second experiment, PAS produced statistically significant MEP potentiation, with PNS intensity of “baseline” and “baseline − 25%” levels but not at + 25% or − 50% levels. In conclusion, for PAS utilizing high-frequency PNS, the intensity required to achieve 1/10 F-response persistence or the intensity 25% lower produces significant MEP potentiation in healthy subjects.
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1 Helsinki University Hospital and University of Helsinki, Department of Physical and Rehabilitation Medicine, Helsinki, Finland (GRID:grid.15485.3d) (ISNI:0000 0000 9950 5666); Validia Rehabilitation Center, Helsinki, Finland (GRID:grid.478111.a)
2 University of Helsinki and Helsinki University Hospital, BioMag Laboratory, HUS Diagnostic Center, Helsinki, Finland (GRID:grid.7737.4) (ISNI:0000 0004 0410 2071)
3 University of Helsinki and Helsinki University Hospital, BioMag Laboratory, HUS Diagnostic Center, Helsinki, Finland (GRID:grid.7737.4) (ISNI:0000 0004 0410 2071); Helsinki University Hospital and University of Helsinki, Clinical Neurophysiology, Clinical Neurosciences, HUS Diagnostic Center, Helsinki, Finland (GRID:grid.15485.3d) (ISNI:0000 0000 9950 5666)
4 Helsinki University Hospital and University of Helsinki, Department of Physical and Rehabilitation Medicine, Helsinki, Finland (GRID:grid.15485.3d) (ISNI:0000 0000 9950 5666); University of Helsinki, Faculty of Medicine, Helsinki, Finland (GRID:grid.7737.4) (ISNI:0000 0004 0410 2071)
5 Helsinki University Hospital and University of Helsinki, Department of Physical and Rehabilitation Medicine, Helsinki, Finland (GRID:grid.15485.3d) (ISNI:0000 0000 9950 5666); University of Helsinki and Helsinki University Hospital, BioMag Laboratory, HUS Diagnostic Center, Helsinki, Finland (GRID:grid.7737.4) (ISNI:0000 0004 0410 2071)