Neuropediatrics 2025; 56(S 01): S1-S24
DOI: 10.1055/s-0045-1812144
Movement Disorders

How to Measure the Neuromodulatory Effect of Sensory Afferent Electrostimulation Using Transcranial Magnetic Stimulation

Authors

  • A. Gschaidmeier

    1   University of Bern, Bern, Switzerland
    2   Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

  • K. Lory

    1   University of Bern, Bern, Switzerland
    2   Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

  • K. Möri

    3   Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland

  • T. Nef

    3   Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
    4   Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland

  • J. Wermelinger

    5   Department of Neurosurgery, Inselspital, Bern University Hospital, Bern, Switzerland

  • K. Seidel

    5   Department of Neurosurgery, Inselspital, Bern University Hospital, Bern, Switzerland

  • R. Everts

    2   Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

  • S. Grunt

    2   Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Background/Purpose: Children with hemiparesis present with sensory and motor deficits. Our study investigates a noninvasive stimulation method to improve hand function in children with hemiparesis. Sensory Afferent Electrostimulation (SAES) triggers action potentials in afferent nerve fibres, leading to increased sensory afferent input in the sensorimotor regions of the brain. In children with hemiparesis/unilateral cerebral palsy, Transcranial magnetic stimulation (TMS) revealed different types of cortico-spinal reorganization, reduced corticospinal excitability, disrupted intracortical inhibition and facilitation, and aberrant corticospinal tract-dependent sensorimotor functional connectivity. In healthy adults, TMS showed that whole-hand SAES induces increased strength of corticospinal projections and intracortical changes. Our goal is to measure the neuromodulatory effect of SAES using TMS.

Methods: We will examine the motor cortical excitability before and after SAES using TMS in a pediatric cohort. The TMS protocol is child-suited. Single Pulse TMS will be delivered to the M1 motor hotspot using a Nexstim system and MRI-guided neuronavigation (nTMS) and will be used to determine the type of reorganization (ipsilateral vs. contralateral vs. mixed), resting motor thresholds (RMT), motor-evoked potential (MEP) latencies, and stimulus recruitment curves (SRC: 100–150% RMT). Paired-pulse TMS will be administered via the Nexstim system connected to a Magstim via a trigger box and will determine intracortical inhibition (SICI) and intracortical facilitation (ICF).

Results: We performed a proof of concept set-up. The method is illustrated using preliminary patient data as an example.

Conclusion: The study will provide insights into the neuroplastic mechanisms of potential treatment responses by examining the motor cortical plasticity and could help to predict suitable patients for SAES. Results of this study could contribute to a basis for implementing SAES in pediatric patients with hemiparesis.



Publication History

Article published online:
26 September 2025

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