To further explore the mechanisms underlying cortical reorganization in patients with phantom sensations after deafferentation, a repetitive transcranial magnetic stimulation study was carried out in two patients with referred phantom sensations (RPS) after incomplete spinal cord injury at the thoracic level. We delivered continuous (inhibitory), intermittent (excitatory), and placebo theta burst stimulation to the contralateral primary motor cortex (M1), primary somatosensory cortex (S1), and secondary somatosensory cortex (S2). Perception of RPS was significantly and transiently disrupted by inhibitory theta burst stimulation applied over S1 and, to a lesser extent, S2. This study supports the hypothesis that RPS depend on remapping in the somatosensory cortex and provides further electrophysiological evidence in vivo that cortical reorganizational processes are critically modulated by GABAergic mechanisms. Enhancement of GABAergic activity may block cortical reorganization, leading to RPS in spinal cord injury patients.
Useful keywords (using NLM MeSH Indexing)
Spinal Cord Injuries/complications
Spinal Cord Injuries/physiopathology*
Spinal Cord Injuries/therapy
Transcranial Magnetic Stimulation/methods*
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