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Effects of Somatosensory Stimulation on Use-Dependent Plasticity in Chronic Stroke

Background and Purpose— There is a need to develop strategies to enhance the beneficial effects of motor training, including use-dependent plasticity (UDP), in neurorehabilitation. Peripheral nerve stimulation (PNS) modulates motor cortical excitability in healthy humans and could influence training effects in stroke patients. Methods— We compared the ability of PNS applied to the (1) arm, (2) leg, and (3) idle time to influence training effects in the paretic hand in 7 chronic stroke patients. The end point measure was the magnitude of UDP. Results— UDP was more prominent with arm stimulation (increased by 22.8%) than with idle time (by 2.9%) or leg stimulation (by 6.4%). Conclusions— PNS applied to the paretic limb paired with motor training enhances training effects on cortical plasticity in stroke patients.