- Email: [email protected]
Effects of focal muscle vibration on corticospinal excitability
Accepted Manuscript Effects of focal muscle vibration on corticospinal excitability
Raffaele Nardone, Stefan Golaszewski, Monica Christova, Eugen Gallasch, Francesco Brigo, Eugen Trinka PII: DOI: Reference:
S0022-510X(17)30119-3 doi: 10.1016/j.jns.2017.02.023 JNS 15158
To appear in:
Journal of the Neurological Sciences
Received date: Accepted date:
13 January 2017 8 February 2017
Please cite this article as: Raffaele Nardone, Stefan Golaszewski, Monica Christova, Eugen Gallasch, Francesco Brigo, Eugen Trinka , Effects of focal muscle vibration on corticospinal excitability. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Jns(2017), doi: 10.1016/ j.jns.2017.02.023
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Effects of focal muscle vibration on corticospinal excitability
Raffaele Nardonea,b, Stefan Golaszewskia, Monica Christovac, Eugen Gallaschc, Francesco Brigob,d, Eugen Trinkaa,e
Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University,
PT
a
RI
Salzburg, Austria
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
c
Department of Physiology, Medical University of Graz, Austria
d
Department of Neurological and Movement Sciences, University of Verona, Italy
e
Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University,
NU
SC
b
EP T
ED
MA
Salzburg, Austria
Corresponding author: Dr. Raffaele Nardone
AC C
Department of Neurology – “F. Tappeiner” Hospital – Meran/o Via Rossini, 5
39012 Meran/o (BZ) – Italy Tel. 0473/264616
Fax 0473/264449 E-mail address: [email protected]
1
ACCEPTED MANUSCRIPT Key words: muscle vibration; corticospinal excitability; spasticity
Dear Editor, We read with great interest the paper recently published in this Journal entitled „Focal muscle
PT
vibration, an effective rehabilitative approach in severe gait impairment due to multiple
RI
sclerosis“ [1]. The authors found that focal muscle vibration (fMV) improved gait function in
SC
multiple sclerosis (MS) patients affected by severe spasticity of lower limbs, and concluded that these beneficial effects were achieved by reducing spasticity in these patients. These
NU
results are very promising, but we believe that the presented data do not support this conclusion, since spasticity has not been directly assessed in this study. In fact, clinical
MA
measures of spasticity, e.g. the Modified Ashworth Scale or the Spinal Cord Injury Assessment Tool for Spasticity, have not been evaluated. Moreover, also electrophysiological
ED
measures of spinal cord excitability (such as F-wave, H-reflex, Hmax/Mmax, T reflex, or withdrawal reflex) have not been investigated.
EP T
As pointed out by the authors, the degree of gait impairment may be associated with the severity of deficiency in various functional neurological systems, including “muscle power
AC C
loss, level of spasticity, degree of instability due to impaired coordination and degree of sensory impairment”; furthermore, “the impairment in upper motor neuron and coordination mainly contribute to abnormal gait in MS” [1]. The improvement in the spatio-temporal parameters of the Gait Analyis, in particular the reduced Spatial Asymmetry Index and Temporal Asymmetry Index, could therefore be related to an increased descending voluntary drive rather than to a direct effect on spasticity. In a recent study (surprisingly not cited in this article), Farabat and colleagues reported that tibialis anterior prolonged vibration in healthy subject has the potential to modulated corticospinal excitability of lower limbs [2]. They failed to find a concomitant functional
ACCEPTED MANUSCRIPT consequence, but the findings may be different if local vibration is applied to patients with brain and spinal cord disorders that lead to motor impairment and/or spasticity. Interestingly, Paoloni et al. reported an improved gait performance in patients with foot drop secondary to chronic stroke, and hypothesized that the effect of mechanical vibration stimulation is the consequence of effective brain reorganization [3].
PT
The authors itself recognized that the increase of the knee and ankle range of motion could be
RI
also related to the ability of the fMV to modify the sensory inputs through restored
SC
sensorimotor integration [4-7], or to effects at the level of central nervous system [8,9]. It is crucial importance to correctly identify and define the mechanisms of action of fMV, in
NU
order to improve its application in neurorehabilitation. Neurophysiological and neuroimaging
ED
MA
studies may be helpful in establishing the underlying processes at cortical and spinal level.
Conflict of interest:
AC C
EP T
The authors declare that they have no conflict of interest.
Acknowledgments: None.
3
ACCEPTED MANUSCRIPT References [1] F. Camerota, C. Celletti, Di Sipio, De Fino, C. Simbolotti, M. Germanotta, et al., Focal muscle vibration, an effective rehabilitative approach in severe gait impairment due to multiple sclerosis, J. Neurol. Sci. 372 (2017) 33-39. [2] A. Farabet, R. Souron, G.Y. Millet GY, T. Lapole, Changes in tibialis anterior corticospinal
PT
properties after acute prolonged muscle vibration, Eur. J. Appl. Physiol. 116 (2016) 1197-
RI
1205.
SC
[3] M. Paoloni, M. Mangoni, P. Scettri, R. Procaccianti, A. Cometa, V. Santilli, Segmental muscle vibration improves walking in chronic stroke patients with foot drop: a randomized
NU
control trial, Neurorehabil. Neural Repair 24 (2010) 254–262.
[4] F. Camerota, C. Celletti, A. Suppa, C. De Fino, C. Simbolotti, M. Germanotta, Focal
MA
muscle vibration improves gait in Parkinson's disease: a pilot randomized controlled trial, Mov. Disord. Clin. Prac. 372 (2016) 33-39.
ED
[5] Y.P. Ivanenko, R.E. Poppele, F. Laquaniti, Spinal cord maps of spatiotemporal
95 (2006) 602–618.
EP T
alphamotoneuron activation in humans walking at different speeds, J. Neurophysiol.
[6] A.M. De Nunzio, M. Grasso, A. Nardone, M. Godi, M. Schieppati, Alternate rhythmic
AC C
vibratory stimulation of trunk muscles affects walking cadence and velocity in Parkinson's disease, Clin. Neurophysiol. 121 (2010) 240–247. [7] B.D. Schmit, A.McKenna-Cole,W.Z. Rymer, Flexor reflexes in chronic spinal cord injury triggered by imposed ankle rotation, Muscle Nerve 2000 (23) (2000) 793–803. [8] K. Rosenkranz, J.C. Rothwell, Differential effect of muscle vibration on intracortical inhibitory circuits in humans, J. Physiol. 551 (2003) 649–660. [9] S. Siggelkow, A. Kossev, M. Schubert, H.H. Kappels, W. Wolf, R. Dengler, Modulation of motor evoked potentials by muscle vibration: the role of vibration frequency, Muscle Nerve 22 (1999) 1544–1548.
Raffaele Nardone, Stefan Golaszewski, Monica Christova, Eugen Gallasch, Francesco Brigo, Eugen Trinka PII: DOI: Reference:
S0022-510X(17)30119-3 doi: 10.1016/j.jns.2017.02.023 JNS 15158
To appear in:
Journal of the Neurological Sciences
Received date: Accepted date:
13 January 2017 8 February 2017
Please cite this article as: Raffaele Nardone, Stefan Golaszewski, Monica Christova, Eugen Gallasch, Francesco Brigo, Eugen Trinka , Effects of focal muscle vibration on corticospinal excitability. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Jns(2017), doi: 10.1016/ j.jns.2017.02.023
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Effects of focal muscle vibration on corticospinal excitability
Raffaele Nardonea,b, Stefan Golaszewskia, Monica Christovac, Eugen Gallaschc, Francesco Brigob,d, Eugen Trinkaa,e
Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University,
PT
a
RI
Salzburg, Austria
Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
c
Department of Physiology, Medical University of Graz, Austria
d
Department of Neurological and Movement Sciences, University of Verona, Italy
e
Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University,
NU
SC
b
EP T
ED
MA
Salzburg, Austria
Corresponding author: Dr. Raffaele Nardone
AC C
Department of Neurology – “F. Tappeiner” Hospital – Meran/o Via Rossini, 5
39012 Meran/o (BZ) – Italy Tel. 0473/264616
Fax 0473/264449 E-mail address: [email protected]
1
ACCEPTED MANUSCRIPT Key words: muscle vibration; corticospinal excitability; spasticity
Dear Editor, We read with great interest the paper recently published in this Journal entitled „Focal muscle
PT
vibration, an effective rehabilitative approach in severe gait impairment due to multiple
RI
sclerosis“ [1]. The authors found that focal muscle vibration (fMV) improved gait function in
SC
multiple sclerosis (MS) patients affected by severe spasticity of lower limbs, and concluded that these beneficial effects were achieved by reducing spasticity in these patients. These
NU
results are very promising, but we believe that the presented data do not support this conclusion, since spasticity has not been directly assessed in this study. In fact, clinical
MA
measures of spasticity, e.g. the Modified Ashworth Scale or the Spinal Cord Injury Assessment Tool for Spasticity, have not been evaluated. Moreover, also electrophysiological
ED
measures of spinal cord excitability (such as F-wave, H-reflex, Hmax/Mmax, T reflex, or withdrawal reflex) have not been investigated.
EP T
As pointed out by the authors, the degree of gait impairment may be associated with the severity of deficiency in various functional neurological systems, including “muscle power
AC C
loss, level of spasticity, degree of instability due to impaired coordination and degree of sensory impairment”; furthermore, “the impairment in upper motor neuron and coordination mainly contribute to abnormal gait in MS” [1]. The improvement in the spatio-temporal parameters of the Gait Analyis, in particular the reduced Spatial Asymmetry Index and Temporal Asymmetry Index, could therefore be related to an increased descending voluntary drive rather than to a direct effect on spasticity. In a recent study (surprisingly not cited in this article), Farabat and colleagues reported that tibialis anterior prolonged vibration in healthy subject has the potential to modulated corticospinal excitability of lower limbs [2]. They failed to find a concomitant functional
ACCEPTED MANUSCRIPT consequence, but the findings may be different if local vibration is applied to patients with brain and spinal cord disorders that lead to motor impairment and/or spasticity. Interestingly, Paoloni et al. reported an improved gait performance in patients with foot drop secondary to chronic stroke, and hypothesized that the effect of mechanical vibration stimulation is the consequence of effective brain reorganization [3].
PT
The authors itself recognized that the increase of the knee and ankle range of motion could be
RI
also related to the ability of the fMV to modify the sensory inputs through restored
SC
sensorimotor integration [4-7], or to effects at the level of central nervous system [8,9]. It is crucial importance to correctly identify and define the mechanisms of action of fMV, in
NU
order to improve its application in neurorehabilitation. Neurophysiological and neuroimaging
ED
MA
studies may be helpful in establishing the underlying processes at cortical and spinal level.
Conflict of interest:
AC C
EP T
The authors declare that they have no conflict of interest.
Acknowledgments: None.
3
ACCEPTED MANUSCRIPT References [1] F. Camerota, C. Celletti, Di Sipio, De Fino, C. Simbolotti, M. Germanotta, et al., Focal muscle vibration, an effective rehabilitative approach in severe gait impairment due to multiple sclerosis, J. Neurol. Sci. 372 (2017) 33-39. [2] A. Farabet, R. Souron, G.Y. Millet GY, T. Lapole, Changes in tibialis anterior corticospinal
PT
properties after acute prolonged muscle vibration, Eur. J. Appl. Physiol. 116 (2016) 1197-
RI
1205.
SC
[3] M. Paoloni, M. Mangoni, P. Scettri, R. Procaccianti, A. Cometa, V. Santilli, Segmental muscle vibration improves walking in chronic stroke patients with foot drop: a randomized
NU
control trial, Neurorehabil. Neural Repair 24 (2010) 254–262.
[4] F. Camerota, C. Celletti, A. Suppa, C. De Fino, C. Simbolotti, M. Germanotta, Focal
MA
muscle vibration improves gait in Parkinson's disease: a pilot randomized controlled trial, Mov. Disord. Clin. Prac. 372 (2016) 33-39.
ED
[5] Y.P. Ivanenko, R.E. Poppele, F. Laquaniti, Spinal cord maps of spatiotemporal
95 (2006) 602–618.
EP T
alphamotoneuron activation in humans walking at different speeds, J. Neurophysiol.
[6] A.M. De Nunzio, M. Grasso, A. Nardone, M. Godi, M. Schieppati, Alternate rhythmic
AC C
vibratory stimulation of trunk muscles affects walking cadence and velocity in Parkinson's disease, Clin. Neurophysiol. 121 (2010) 240–247. [7] B.D. Schmit, A.McKenna-Cole,W.Z. Rymer, Flexor reflexes in chronic spinal cord injury triggered by imposed ankle rotation, Muscle Nerve 2000 (23) (2000) 793–803. [8] K. Rosenkranz, J.C. Rothwell, Differential effect of muscle vibration on intracortical inhibitory circuits in humans, J. Physiol. 551 (2003) 649–660. [9] S. Siggelkow, A. Kossev, M. Schubert, H.H. Kappels, W. Wolf, R. Dengler, Modulation of motor evoked potentials by muscle vibration: the role of vibration frequency, Muscle Nerve 22 (1999) 1544–1548.