{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:24:38Z","timestamp":1791991478013,"version":"4.4.0"},"reference-count":21,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T00:00:00Z","timestamp":1625184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Repetitive transcranial magnetic stimulation (rTMS) may support motor function recovery in patients with incomplete spinal cord injury (iSCI). Its effectiveness mainly depends on the applied algorithm. This clinical and neurophysiological study aimed to assess the effectiveness of high-frequency rTMS in iSCI patients at the C2\u2013Th12 levels. rTMS sessions (lasting 3\u20135 per month, from 2 to 11 months, 5 months on average) were applied to 26 iSCI subjects. The motor cortex was bilaterally stimulated with a frequency at 20\u201325 Hz and a stimulus strength that was 70\u201380% of the resting motor threshold (15.4\u201345.5% maximal output) during one therapeutic session. Surface electromyography (sEMG) recordings at rest and during maximal contractions and motor evoked potential (MEP) recordings were performed from the abductor pollicis brevis (APB) and the tibialis anterior (TA) muscles. The same neurophysiological studies were also performed in patients treated with kinesiotherapy only (K group, n = 25) and compared with patients treated with both kinesiotherapy and rTMS (K + rTMS). A decrease in sEMG amplitudes recorded at rest from the APB muscles (p = 0.001) and an increase in sEMG amplitudes during the maximal contraction of the APB (p = 0.001) and TA (p = 0.009) muscles were found in the K + rTMS group. A comparison of data from MEP studies recorded from both APB and TA muscles showed significant changes in the mean amplitudes but not in latencies, suggesting a slight improvement in the transmission of spinal efferent pathways from the motor cortex to the lower spinal centers. The application of rTMS at 20\u201325 Hz reduced spasticity in the upper extremity muscles, improved the recruitment of motor units in the upper and lower extremity muscles, and slightly improved the transmission of efferent neural impulses within the spinal pathways in patients with C2\u2013Th12 iSCI. Neurophysiological recordings produced significantly better parameters in the K + rTMS group of patients after therapy. These results may support the hypothesis about the importance of rTMS therapy and possible involvement of the residual efferent pathways including propriospinal neurons in the recovery of the motor control of iSCI patients.<\/jats:p>","DOI":"10.3390\/jcm10132975","type":"journal-article","created":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T10:06:34Z","timestamp":1625220394000},"page":"2975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["The Long-Term Effect of Treatment Using the Transcranial Magnetic Stimulation rTMS in Patients after Incomplete Cervical or Thoracic Spinal Cord Injury"],"prefix":"10.3390","volume":"10","author":[{"given":"Agnieszka","family":"Wincek","sequence":"first","affiliation":[{"name":"Department of Pathophysiology of Locomotor Organs, Poznan University of Medical Sciences, 28 Czerwca 1956 nr 135\/147, 60-545 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-0497","authenticated-orcid":false,"given":"Juliusz","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology of Locomotor Organs, Poznan University of Medical Sciences, 28 Czerwca 1956 nr 135\/147, 60-545 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Leszczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology of Locomotor Organs, Poznan University of Medical Sciences, 28 Czerwca 1956 nr 135\/147, 60-545 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Fortuna","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"},{"name":"Bacteriophage Laboratory, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Okurowski","sequence":"additional","affiliation":[{"name":"Neurorehabilitation Center for Treatment of Spinal Cord Injuries AKSON, ul. Bierutowska 23, 51-317 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Chmielak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Tabakow","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3647","DOI":"10.1113\/jphysiol.2012.233189","article-title":"Corticospinal reorganization after spinal cord injury","volume":"590","author":"Oudega","year":"2012","journal-title":"J. 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