{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T17:42:13Z","timestamp":1792863733813,"version":"4.5.0"},"reference-count":59,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T00:00:00Z","timestamp":1660435200000},"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>Magnetic stimulation is a safe, non-invasive diagnostic tool and promising treatment strategy for neurological and psychiatric disorders. Although most studies address transcranial magnetic stimulation, transspinal magnetic stimulation (TsMS) has received recent attention since trials involving invasive spinal cord stimulation showed encouraging results for pain, spasticity, and Parkinson\u2019s disease. While the effects of TsMS on spinal roots is well understood, its mechanism of action on the spinal cord is still controversial. Despite unclear mechanisms of action, clinical benefits of TsMS have been reported, including improvements in scales of spasticity, hyperreflexia, and bladder and bowel symptoms, and even supraspinal gait disorders such as freezing and camptocormia. In the present study, a critical review on the application of TsMS in neurology was conducted, along with an exploratory trial involving TsMS in three patients with hereditary spastic paraplegia. The goal was to understand the mechanism of action of TsMS through H-reflex measurement at the unstimulated lumbosacral level. Although limited by studies with a small sample size and a low to moderate effect size, TsMS is safe and tolerable and presents consistent clinical and neurophysiological benefits that support its use in clinical practice.<\/jats:p>","DOI":"10.3390\/jcm11164748","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T01:47:21Z","timestamp":1660528041000},"page":"4748","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Controversies and Clinical Applications of Non-Invasive Transspinal Magnetic Stimulation: A Critical Review and Exploratory Trial in Hereditary Spastic Paraplegia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-8455","authenticated-orcid":false,"given":"Rafael Bernhart","family":"Carra","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-3763","authenticated-orcid":false,"given":"Guilherme Diogo","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Bruzzi Bezerra","family":"Paraguay","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9946-6032","authenticated-orcid":false,"given":"Fabricio","family":"Diniz de Lima","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Campinas, Campinas 13083-888, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaina Reis","family":"Menezes","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4469-5049","authenticated-orcid":false,"given":"Aruane Mello","family":"Pineda","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Matem\u00e1ticas e de Computa\u00e7\u00e3o, University of S\u00e3o Paulo, S\u00e3o Carlos 13566-590, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glaucia Aline","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana da Silva","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Marcondes Cavalcante","family":"Fran\u00e7a","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Campinas, Campinas 13083-888, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubens Gisbert","family":"Cury","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S0140-6736(85)92413-4","article-title":"Non-invasive magnetic stimulation of human motor cortex","volume":"1","author":"Barker","year":"1985","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/BF02441362","article-title":"Stimulation of nerve trunks with time-varying magnetic fields","volume":"20","author":"Polson","year":"1982","journal-title":"Med. 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