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Helsinki PAS Project

CLINICAL RESEARCH ON SPINAL CORD INJURY REHABILITATION

2026

Nätkynmäki A, Higdon M, Avela J, Shulga A. Improving hand function in chronic incomplete tetraplegia by high-PAS intervention with alternative equipment: a case report. Spinal Cord Ser Cases, 2026 Apr 1;12(1):6., doi: 10.1038/s41394-026-00731-7

Holopainen K, Pohjonen M, Kirveskari E, Vaalto S, Mäkelä JP, Arokoski J, Shulga A. Paired associative stimulation with a high-intensity cortical component and a high-frequency peripheral component in treatment of neuropathic pain after incomplete spinal cord injury - a pilot trial. Spinal Cord Ser Cases, 2026 Mar 4;12(1):3., doi: 10.1038/s41394-026-00729-1

2025

Haakana P, Holopainen K, Tarvainen M, Shulga A. Heart rate variability in patients with incomplete spinal cord injury during a single session of paired associative stimulation. Sci Rep, 2025 Nov 25;15(1):41869., doi: 10.1038/s41598-025-25802-x

Shulga A, Nätkynmäki A, Pelkonen AL, Pohjonen M, Savolainen S, Kirveskari E, Brandstack N, Mäkelä JP, Arokoski J. Paired associative stimulation improves outcomes when applied at the subacute stage after incomplete cervical spinal cord injury. Neurotherapeutics, 2025 Nov 3:e00778.doi: 10.1016/j.neurot.2025.e00778.

Holopainen K, Tolmacheva A, Bersch I, Haakana P, Pohjonen M, Kirveskari E, Arokoski J, Shulga A. Stable improvement in hand muscle strength in incomplete spinal cord injury patients by long-term paired associative stimulation—a case series study. Front. Neurol., 04 February 202Sec. NeurorehabilitationVolume 16 - 2025 |, https://doi.org/10.3389/fneur.2025.1486591

2024

Nätkynmäki A, Lauronen L, Haakana P, Kirveskari E, Avela J, Shulga A. Spinally targeted paired associative stimulation with high-frequency peripheral component induces spinal level plasticity in healthy subjects. Sci Rep 14, 31052 (2024), https://doi.org/10.1038/s41598-024-82271-4

Holopainen K, Sihvonen AJ, Kauramäki J, Särkämö T, Shulga A. The effects of music combined to paired associative stimulation on motor-evoked potentials and alertness in spinal cord injury patients and healthy subjects. Sci Rep 14, 10194 (2024). https://doi.org/10.1038/s41598-024-60984-w

Haakana P, Nätkynmäki A, Kirveskari E, Mäkelä JP, Kilgard MP, Tarvainen MP, Shulga A. Effects of auricular vagus nerve stimulation and electrical earlobe stimulation on motor-evoked potential changes induced by paired associative stimulation. Eur J Neurosci 2024 Sep 11. doi: 10.1111/ejn.16539

2023

Haakana P, Holopainen K, Nätkynmäki A, Kirveskari E, Tarvainen MP, Shulga A. The effect of paired associative stimulation with a high-intensity cortical component and a high-frequency peripheral component on heart rate and heart rate variability in healthy subjects. Front Rehabil Sci. 2023 Jul 26;4:1200958. doi: 10.3389/fresc.2023.1200958.

2022

Pohjonen M, Nyman A-L, Kirveskari E, Arokoski J, Shulga A. Optimal peripheral nerve stimulation intensity for paired associative stimulation with high-frequency peripheral component in healthy subjects. Sci Rep. 2022 Jul 21;12(1):12466. doi: 10.1038/s41598-022-16811-1.

Vanhanen J, Parkkonen L, Mäkelä JP, Tolmacheva A, Shulga A, Rodionov A, Kirveskari E. Effect of long-term paired associative stimulation on the modulation of cortical sensorimotor oscillations after spinal cord injury. Spinal Cord Ser Cases 2022 Apr 5;8(1):38. doi: 10.1038/s41394-022-00506-w

2021

Vaalto S, Nyman A-L, Shulga A. Analgesic effect of paired associative stimulation in a tetraplegic patient with severe drug-resistant neuropathic pain: a case report. Scand J Pain May 21, 2021, https://doi.org/10.1515/sjpain-2021-0012

Shulga A, Lioumis P, Kirveskari E, Savolainen S, Mäkelä J. A novel paired associative stimulation protocol with a high‐frequency peripheral component: A review on results in spinal cord injury rehabilitation. European J. Neurosci; 3/2021, https://doi.org/10.1111/ejn.15191

Pohjonen M, Savolainen S, Arokoski J, Shulga A. Omitting TMS component from paired associative stimulation with high-frequency PNS: A case series of tetraplegic patients. Clin Neurophys Practice; 2021; 6. doi:10.1016/j.cnp.2021.01.004

2020

Mezes M, Havu R, Tolmacheva A, Lioumis P, Mäkelä JP, Shulga A. The impact of TMS and PNS frequencies on MEP potentiation in PAS with high-frequency peripheral component. PLoS One. 2020;15(5):e0233999. Published 2020 May 29. doi:10.1371/journal.pone.0233999

Rodionov A, Savolainen S, Kirveskari E, Makela JP, Shulga A. Effects of Long-Term Paired Associative Stimulation on Strength of Leg Muscles and Walking in Chronic Tetraplegia: A Proof-of-Concept Pilot Study. Front. Neurol., 20 May 2020, doi:10.3389/fneur.2020.00397

Shulga A, Savolainen S, Kirveskari E, Mäkelä JP. Enabling and promoting walking rehabilitation by paired associative stimulation after incomplete paraplegia: a case report. Spinal Cord Ser Cases. 2020;6(1):72. Published 2020 Aug 13. doi:10.1038/s41394-020-0320-7

2019

Tolmacheva A, Mäkelä JP, Shulga A. Increasing the frequency of peripheral component in paired associative stimulation strengthens its efficacy. Sci Rep. 2019;9(1):3849. Published 2019 Mar 7. doi:10.1038/s41598-019-40474-0

Tolmacheva A, Savolainen S, Kirveskari E, Brandstack N, Mäkelä JP, Shulga A. Paired associative stimulation improves hand function after non-traumatic spinal cord injury: A case series. Clin Neurophysiol Pract. 2019;4:178-183. Published 2019 Aug 13. doi:10.1016/j.cnp.2019.07.002

Rodionov A, Savolainen S, Kirveskari E, Mäkelä JP, Shulga A. Restoration of hand function with long-term paired associative stimulation after chronic incomplete tetraplegia: a case study. Spinal Cord Ser Cases. 2019;5:81. Published 2019 Oct 1. doi:10.1038/s41394-019-0225-5

Rodionov A, Tolmacheva A, Kirveskari E, Mäkelä JP, Shulga A. The use of electronic coil location control for focal magnetic stimulation at the cervical level. 2019 Dec 1;328:1084 J Neurosci Methods. doi: 10.1016/j.jneumeth.2019.108444

2017

Tolmacheva A, Savolainen S, Kirveskari E, et al. Long-Term Paired Associative Stimulation Enhances Motor Output of the Tetraplegic Hand. J Neurotrauma. 2017;34(18):2668-2674. doi:10.1089/neu.2017.4996

2016

Shulga A, Lioumis P, Zubareva A, Brandstack N, Kirveskari E, Kuusela L, Savolainen S, Ylinen A, Mäkelä JP. Long-term paired associative stimulation can restore voluntary control over paralyzed muscles in incomplete chronic spinal cord injury patients. Spinal Cord Ser Cases 2, 16016 (2016). https://doi.org/10.1038/scsandc.2016.16

Shulga A, Zubareva A, Lioumis P, Mäkelä JP. Paired Associative Stimulation with High-Frequency Peripheral Component Leads to Enhancement of Corticospinal Transmission at Wide Range of Interstimulus Intervals. Front Hum Neurosci. 2016;10:470. Published 2016 Sep 23. doi:10.3389/fnhum.2016.00470.

2015

Shulga A, Lioumis P, Kirveskari E, Savolainen S, Mäkelä J, Ylinen A. The use of F-response in defining interstimulus intervals appropriate for LTP-like plasticity induction in lower limb spinal paired associative stimulation. J Neurosci Methods. 2015; Mar 15;242:112-7. doi: 0.1016/j.jneumeth.2015.01.012

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