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Decreased neuroplasticity in minor burn injury survivors compared to non-injured adults: A pilot study in burn injury survivors aged 45 years and older
Authors:Casey J Whife  Ann-Maree Vallence  Dale W Edgar  Fiona M Wood
Institution:1. Burn Injury Research Unit, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia;2. Psychology, Murdoch University, Western Australia, Australia;3. Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Western Australia, Australia;4. Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Western Australia, Australia;5. Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia;6. Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
Abstract:ObjectiveNeuroplasticity is the capacity of the brain to change or adapt with experience: brain changes occur with use, disuse, and injury. Repetitive transcranial magnetic stimulation (rTMS) can be used to induce neuroplasticity in the human brain. Here, we examined rTMS-induced neuroplasticity in the primary motor cortex in burns survivors and controls without injury, and whether neuroplasticity is associated with functional recovery in burns survivors.MethodsSixteen burn injury survivors (total body surface area of burn injury <15%) and 13 non-injured control participants were tested. Repetitive TMS (specifically, spaced continuous theta-burst stimulationcTBS]) was applied to induce neuroplasticity 6 and 12 weeks after injury in burn survivors and in two sessions separated by 6 weeks in controls. Motor evoked potentials (MEPs) elicited by single-pulse TMS were measured before and after rTMS to measure neuroplasticity. Burns survivors completed a functional assessment 12 weeks after injury.ResultsNon-injured controls showed decreased MEP amplitude 15?30 min after spaced cTBS in both experimental sessions. Burn survivors showed a smaller change in MEP amplitude after spaced cTBS compared to controls 6 weeks after burn injury but no difference compared to controls 12 weeks after burn injury. In burn survivors, there was a significant positive association between general health outcome (Short-Form Health Survey) and the change in MEP amplitude after spaced cTBS 12 weeks after injury (r=.73, p = .01).ConclusionsThe current findings suggest that burn survivors have a reduced capacity for neuroplasticity early in the recovery period (6 weeks after injury), which normalizes later in the recovery period (12 weeks after injury). Furthermore, the results provide preliminary evidence to suggest that burn survivors with normalized neuroplasticity 12 weeks after injury recover faster after burn injury.
Keywords:Burn injury  Neuroplasticity  Primary motor cortex  Transcranial magnetic stimulation
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