{"id":"https://openalex.org/W7220922599","doi":"https://doi.org/10.3389/fresc.2026.1942850","title":"Combined intermittent theta-burst stimulation and functional electrical stimulation as adjuncts to intrathecal baclofen in hereditary spastic paraplegia type 11: a case report","display_name":"Combined intermittent theta-burst stimulation and functional electrical stimulation as adjuncts to intrathecal baclofen in hereditary spastic paraplegia type 11: a case report","publication_year":2026,"publication_date":"2026-10-08","ids":{"openalex":"https://openalex.org/W7220922599","doi":"https://doi.org/10.3389/fresc.2026.1942850","pmid":"https://pubmed.ncbi.nlm.nih.gov/42923028","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13687370"},"language":"en","primary_location":{"id":"doi:10.3389/fresc.2026.1942850","doi":"https://doi.org/10.3389/fresc.2026.1942850","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fresc.2026.1942850","pdf_url":"https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2026.1942850/pdf","source":{"id":"https://openalex.org/S4210195722","display_name":"Frontiers in Rehabilitation Sciences","issn_l":"2673-6861","issn":["2673-6861"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Rehabilitation Sciences","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2026.1942850/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5157939007","display_name":"Haodong Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210135395","display_name":"Shanghai Eighth People Hospital","ror":"https://ror.org/0309pcg09","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210135395"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Haodong Zhang","raw_affiliation_strings":["Department of Rehabilitation Medicine, Shanghai Eighth People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Rehabilitation Medicine, Shanghai Eighth People's Hospital","institution_ids":["https://openalex.org/I4210135395"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157982082","display_name":"Jie Shen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210135395","display_name":"Shanghai Eighth People Hospital","ror":"https://ror.org/0309pcg09","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210135395"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jie Shen","raw_affiliation_strings":["Department of Rehabilitation Medicine, Shanghai Eighth People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Rehabilitation Medicine, Shanghai Eighth People's Hospital","institution_ids":["https://openalex.org/I4210135395"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5157980626","display_name":"Yanping Qu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210135395","display_name":"Shanghai Eighth People Hospital","ror":"https://ror.org/0309pcg09","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210135395"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Yanping Qu","raw_affiliation_strings":["Department of Rehabilitation Medicine, Shanghai Eighth People's Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Rehabilitation Medicine, Shanghai Eighth People's Hospital","institution_ids":["https://openalex.org/I4210135395"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5157980626"],"corresponding_institution_ids":["https://openalex.org/I4210135395"],"apc_list":{"value":1950,"currency":"CHF","value_usd":2353},"apc_paid":{"value":1950,"currency":"CHF","value_usd":2353},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.75361648,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"7","issue":null,"first_page":"1942850","last_page":"1942850"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11274","display_name":"Botulinum Toxin and Related Neurological Disorders","score":0.92330002784729,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11274","display_name":"Botulinum Toxin and Related Neurological Disorders","score":0.92330002784729,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10614","display_name":"Transcranial Magnetic Stimulation Studies","score":0.030400000512599945,"subfield":{"id":"https://openalex.org/subfields/2808","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10925","display_name":"Spinal Cord Injury Research","score":0.012199999764561653,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/intrathecal-baclofen","display_name":"intrathecal baclofen","score":0.875},{"id":"https://openalex.org/keywords/intermittent-theta-burst-stimulation","display_name":"intermittent theta burst stimulation","score":0.9990000128746033},{"id":"https://openalex.org/keywords/functional-electrical-stimulation","display_name":"functional electrical stimulation","score":1.0},{"id":"https://openalex.org/keywords/spasticity","display_name":"spasticity","score":0.8220000267028809},{"id":"https://openalex.org/keywords/corticospinal-tract-degeneration","display_name":"corticospinal tract degeneration","score":0.9010000228881836},{"id":"https://openalex.org/keywords/neuroplasticity","display_name":"neuroplasticity","score":0.8240000009536743},{"id":"https://openalex.org/keywords/motor-recovery","display_name":"motor recovery","score":0.5839999914169312},{"id":"https://openalex.org/keywords/balance","display_name":"balance","score":0.8259999752044678},{"id":"https://openalex.org/keywords/anxiety-and-depression","display_name":"anxiety and depression","score":0.6840000152587891},{"id":"https://openalex.org/keywords/interdisciplinary-rehabilitation","display_name":"interdisciplinary rehabilitation","score":0.531000018119812}],"concepts":[{"id":"https://openalex.org/C2780395223","wikidata":"https://www.wikidata.org/wiki/Q657516","display_name":"Hereditary spastic paraplegia","level":4,"score":0.8027999997138977},{"id":"https://openalex.org/C2779012798","wikidata":"https://www.wikidata.org/wiki/Q117060","display_name":"Spasticity","level":2,"score":0.7421000003814697},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7372999787330627},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.565500020980835},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.5428000092506409},{"id":"https://openalex.org/C2777597760","wikidata":"https://www.wikidata.org/wiki/Q1049655","display_name":"Paraplegia","level":3,"score":0.5253999829292297},{"id":"https://openalex.org/C2777766275","wikidata":"https://www.wikidata.org/wiki/Q1327643","display_name":"Functional electrical stimulation","level":3,"score":0.5108000040054321},{"id":"https://openalex.org/C2776195251","wikidata":"https://www.wikidata.org/wiki/Q7573993","display_name":"Spastic","level":3,"score":0.4677000045776367},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.4417000114917755},{"id":"https://openalex.org/C2780566999","wikidata":"https://www.wikidata.org/wiki/Q25098821","display_name":"Modified Ashworth scale","level":3,"score":0.435699999332428},{"id":"https://openalex.org/C24998067","wikidata":"https://www.wikidata.org/wiki/Q4114622","display_name":"Stimulation","level":2,"score":0.4237000048160553},{"id":"https://openalex.org/C558461103","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Anxiety","level":2,"score":0.4230000078678131},{"id":"https://openalex.org/C2780317758","wikidata":"https://www.wikidata.org/wiki/Q3339235","display_name":"Neurological disorder","level":3,"score":0.38749998807907104},{"id":"https://openalex.org/C2781201050","wikidata":"https://www.wikidata.org/wiki/Q413717","display_name":"Baclofen","level":4,"score":0.3774000108242035},{"id":"https://openalex.org/C151800584","wikidata":"https://www.wikidata.org/wiki/Q2370000","display_name":"Gait","level":2,"score":0.35350000858306885},{"id":"https://openalex.org/C2777515770","wikidata":"https://www.wikidata.org/wiki/Q507369","display_name":"Electromyography","level":2,"score":0.3368000090122223},{"id":"https://openalex.org/C2780832504","wikidata":"https://www.wikidata.org/wiki/Q1183041","display_name":"Stretch reflex","level":3,"score":0.32679998874664307},{"id":"https://openalex.org/C2779636300","wikidata":"https://www.wikidata.org/wiki/Q3029045","display_name":"Spastic diplegia","level":3,"score":0.32339999079704285},{"id":"https://openalex.org/C2779248504","wikidata":"https://www.wikidata.org/wiki/Q574942","display_name":"Hypertonia","level":2,"score":0.30959999561309814},{"id":"https://openalex.org/C2781306077","wikidata":"https://www.wikidata.org/wiki/Q944758","display_name":"Tetraplegia","level":4,"score":0.2953000068664551},{"id":"https://openalex.org/C2778559928","wikidata":"https://www.wikidata.org/wiki/Q906492","display_name":"Dystonia","level":2,"score":0.2897999882698059},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.28949999809265137},{"id":"https://openalex.org/C83974742","wikidata":"https://www.wikidata.org/wiki/Q179405","display_name":"Reflex","level":2,"score":0.27790001034736633},{"id":"https://openalex.org/C173906292","wikidata":"https://www.wikidata.org/wiki/Q1493441","display_name":"Gait analysis","level":3,"score":0.2685999870300293},{"id":"https://openalex.org/C2777478456","wikidata":"https://www.wikidata.org/wiki/Q208413","display_name":"Botulinum toxin","level":2,"score":0.2671999931335449}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/fresc.2026.1942850","doi":"https://doi.org/10.3389/fresc.2026.1942850","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fresc.2026.1942850","pdf_url":"https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2026.1942850/pdf","source":{"id":"https://openalex.org/S4210195722","display_name":"Frontiers in Rehabilitation Sciences","issn_l":"2673-6861","issn":["2673-6861"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Rehabilitation Sciences","raw_type":"journal-article"},{"id":"pmid:42923028","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42923028","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in rehabilitation sciences","raw_type":"Case Reports"},{"id":"pmh:oai:pubmedcentral.nih.gov:13687370","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13687370/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Rehabil Sci","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:a020e298be4b4802ba64947d8a4fc47d","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/a020e298be4b4802ba64947d8a4fc47d","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Rehabilitation Sciences, Vol 7 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fresc.2026.1942850","doi":"https://doi.org/10.3389/fresc.2026.1942850","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fresc.2026.1942850","pdf_url":"https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2026.1942850/pdf","source":{"id":"https://openalex.org/S4210195722","display_name":"Frontiers in Rehabilitation Sciences","issn_l":"2673-6861","issn":["2673-6861"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Rehabilitation Sciences","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220922599.pdf","grobid_xml":"https://content.openalex.org/works/W7220922599.grobid-xml"},"referenced_works_count":41,"referenced_works":["https://openalex.org/W2083920471","https://openalex.org/W2090851195","https://openalex.org/W2107433900","https://openalex.org/W2119807619","https://openalex.org/W2416121930","https://openalex.org/W2883978164","https://openalex.org/W2906301423","https://openalex.org/W2915011416","https://openalex.org/W2955209654","https://openalex.org/W2964609340","https://openalex.org/W2997901555","https://openalex.org/W3120975285","https://openalex.org/W3212739146","https://openalex.org/W4210406224","https://openalex.org/W4213132974","https://openalex.org/W4220719412","https://openalex.org/W4220731950","https://openalex.org/W4226218590","https://openalex.org/W4282913939","https://openalex.org/W4283267949","https://openalex.org/W4309785935","https://openalex.org/W4322577101","https://openalex.org/W4377102984","https://openalex.org/W4380789444","https://openalex.org/W4383879089","https://openalex.org/W4384501575","https://openalex.org/W4386049970","https://openalex.org/W4387244273","https://openalex.org/W4389571737","https://openalex.org/W4391106010","https://openalex.org/W4395694522","https://openalex.org/W4403342897","https://openalex.org/W4403837268","https://openalex.org/W4405728553","https://openalex.org/W4408067864","https://openalex.org/W4413862614","https://openalex.org/W4415596599","https://openalex.org/W4417332937","https://openalex.org/W7119515169","https://openalex.org/W7134254440","https://openalex.org/W7161384195"],"related_works":["https://openalex.org/W7102415929","https://openalex.org/W2325796332","https://openalex.org/W2069505541","https://openalex.org/W2964609340","https://openalex.org/W4377102984","https://openalex.org/W4391106010","https://openalex.org/W2219184092","https://openalex.org/W2090458196","https://openalex.org/W3213562278","https://openalex.org/W7098129643"],"abstract_inverted_index":{"Background:":[0],"Spastic":[1],"paraplegia":[2],"type":[3],"11":[4],"(SPG11)":[5],"is":[6,18],"the":[7,129,136,145,153,159,170,210,242],"most":[8],"common":[9],"autosomal":[10],"recessive":[11],"subtype":[12],"of":[13,128,150,168,183,215,241],"hereditary":[14],"spastic":[15],"paraplegia,":[16],"and":[17,27,56,106,109,121,158,193,199,217,231,252],"characterized":[19],"by":[20,189],"progressive":[21],"corticospinal":[22],"tract":[23],"degeneration,":[24],"lower-limb":[25,99],"spasticity,":[26,35,100],"gait":[28],"impairment.":[29],"Intrathecal":[30],"baclofen":[31],"(ITB)":[32],"effectively":[33],"alleviates":[34],"but":[36],"fails":[37],"to":[38,73,103,176,221],"reverse":[39],"upstream":[40],"neural":[41],"pathway":[42],"damage,":[43],"resulting":[44],"in":[45,49,75,227,234],"a":[46,114],"\"functional":[47],"ceiling\"":[48],"motor":[50,228,253],"recovery.":[51],"Intermittent":[52],"theta-burst":[53],"stimulation":[54,59],"(iTBS)":[55],"functional":[57],"electrical":[58],"(FES)":[60],"have":[61],"shown":[62],"potential":[63],"for":[64,248],"enhancing":[65],"neuroplasticity;":[66],"however,":[67],"their":[68],"combined":[69,116],"use":[70],"as":[71,219],"adjuncts":[72,220],"ITB":[74,94,130,172,222,243],"SPG11":[76,88],"remains":[77],"unreported.":[78],"Case":[79],"presentation:":[80],"A":[81],"23-year-old":[82],"female":[83],"patient":[84,112],"with":[85,97,124,225,236],"genetically":[86],"confirmed":[87],"was":[89,174,223],"admitted":[90],"2":[91],"weeks":[92],"after":[93],"pump":[95],"implantation":[96],"severe":[98],"an":[101],"inability":[102],"walk":[104],"independently,":[105],"mild":[107],"anxiety":[108],"depression.":[110],"The":[111,180,197,213],"underwent":[113],"3-month":[115],"intervention":[117],"comprising":[118],"iTBS,":[119],"FES,":[120],"conventional":[122],"rehabilitation,":[123],"dynamic":[125],"interdisciplinary":[126,239],"titration":[127,240],"dosage.":[131],"Outcomes":[132],"were":[133,202],"assessed":[134],"using":[135],"Modified":[137],"Ashworth":[138],"Scale":[139,156,162],"(MAS),":[140],"Manual":[141],"Muscle":[142],"Testing":[143],"(MMT),":[144],"Berg":[146],"Balance":[147],"Scale,":[148],"center":[149],"pressure":[151],"analysis,":[152],"Hamilton":[154,160],"Anxiety":[155],"(HAMA),":[157],"Depression":[161],"(HAMD).":[163],"Outcomes:":[164],"After":[165],"3":[166],"months":[167],"intervention,":[169],"optimal":[171],"dose":[173,244],"determined":[175],"be":[177,246],"62.82":[178],"\u03bcg/d.":[179],"MAS":[181],"scores":[182,201],"both":[184],"legs":[185],"progressively":[186],"declined,":[187],"accompanied":[188],"increased":[190],"MMT":[191],"grades":[192],"improved":[194],"standing":[195],"balance.":[196],"HAMA":[198],"HAMD":[200],"markedly":[203],"reduced.":[204],"No":[205],"adverse":[206],"events":[207],"occurred":[208],"during":[209],"treatment.":[211],"Conclusions:":[212],"combination":[214],"iTBS":[216],"FES":[218],"associated":[224],"improvements":[226],"function,":[229],"balance,":[230],"psychological":[232],"status":[233],"patients":[235],"SPG11.":[237],"Dynamic":[238],"may":[245],"important":[247],"balancing":[249],"spasticity":[250],"control":[251],"learning.":[254]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-09T00:00:00"}
