Paired associative nerve stimulation (PANS) was proposed as a potential nerve rehabilitation treatment strategy. However, few relevant documents are available regarding the strategy, and only a few clinical studies have involved healthy people. To determine the feasibility of the neurorehabilitation treatment and to estimate the effect of PANS on nerve plasticity for individuals with incomplete spinal cord injury (iSCI), a design combining repetitive transcranial magnetic stimulation (rTMS) with trans-spinal electrical stimulation was developed for treating individuals with iSCI in this pilot case study. First, a novel PANS system with multiple stimulation modes was designed and verified with resistors and a metal coil as load. Then, the system was applied to three individuals with iSCI, and five types of paired associative stimulation was performed to confirm the feasibility of the system and determine the most effective treatment strategy. The preliminary result showed that 20-Hz rTMS combined with cathodal trans-spinal direct current stimulation (tsDCS) had the greatest effect on corticospinal excitability. Next, stimulations of 20-Hz rTMS (brain) and sham (spine) as well as sham (brain) and cathode tsDCS (spine) were administered to individuals with iSCI, and the results revealed that paired associative stimulation of brain and spine was more effective than only 20-Hz rTMS brain stimulation or cathodal tsDCS stimulation for corticospinal plasticity.

中文翻译：

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新型成对联想神经刺激系统的设计及不完全性脊髓损伤的治疗策略：初步研究


配对联想神经刺激（PANS）被提出作为一种潜在的神经康复治疗策略。然而，关于该策略的相关文件很少，并且只有少数临床研究涉及健康人。为了确定神经康复治疗的可行性并评估 PANS 对不完全脊髓损伤 (iSCI) 个体神经可塑性的影响，开发了一种将重复经颅磁刺激 (rTMS) 与经脊柱电刺激相结合的设计用于治疗个体在此试点案例研究中使用 iSCI。首先，设计并验证了一种具有多种刺激模式的新型PANS系统，并以电阻器和金属线圈作为负载。然后，将该系统应用于三名 iSCI 个体，并进行五种配对联想刺激，以确认该系统的可行性并确定最有效的治疗策略。初步结果表明，20 Hz rTMS 联合阴极经脊柱直流电刺激 (tsDCS) 对皮质脊髓兴奋性的影响最大。接下来，对 iSCI 患者进行 20 Hz rTMS（大脑）和假手术（脊柱）以及假手术（大脑）和阴极 tsDCS（脊柱）刺激，结果显示，大脑和脊柱的配对联想刺激更有效。对于皮质脊髓可塑性而言，比仅 20 Hz rTMS 脑刺激或阴极 tsDCS 刺激更有效。