Using transcranial magnetic stimulation to investigate the acute effects of translingual neurostimulation in individuals with Multiple Sclerosis

Blaney, Abby E. (2024) Using transcranial magnetic stimulation to investigate the acute effects of translingual neurostimulation in individuals with Multiple Sclerosis. Masters thesis, Memorial University of Newfoundland.

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Abstract

Introduction: Non-invasive neuromodulation techniques have emerged as a promising treatment to facilitate rehabilitation for individuals with Multiple Sclerosis (MS). One neuromodulation method, translingual neurostimulation (TLNS), involves electrical stimulation of the tongue and when paired with physiotherapy, is proposed to improve gait and balance in individuals with MS. Studies reporting the efficacy of TLNS for improving gait and balance in several neurological disorders are not congruent and the actual mechanisms underlying TLNS is not fully understood. Non-invasive brain stimulation devices such as transcranial magnetic stimulation (TMS) can help elucidate how TLNS may work to influence plasticity and recovery. Methods: Participants were recruited from a clinical trial in which individuals with multiple sclerosis (MS) were randomized to receive either a real or modified TLNS device. TMS variables, including resting motor threshold (RMT), active motor threshold (AMT) and recruitment curves (excitatory and inhibitory) were measured pre and post a 20-minute TLNS stimulation. Results: A repeated measures ANOVA using mixed models was conducted to investigate changes in corticospinal excitability between the TLNS stimulation and sham groups pre and post stimulation. Comparing pre and post RMT, AMT and REC values, there were no significant differences in maximum stimulator output (%MSO), motor evoked potential (MEP) amplitude latency or cortical silent period (CSP) between the stimulation and sham groups (p > 0.1). Conclusion: Our analysis of the TMS variables, RMT, AMT and recruitment curves, indicate that 20 minutes of TLNS did not increase corticospinal excitability or decrease inhibition in individuals with MS. Future research will interrogate overall brain activation through changes in cerebral blood flow.

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