Abstract:
BACKGROUND:Functional neuroimaging studies show adaptive changes in areas adjacent and distant from the stroke. This longitudinal study assessed whether changes in cortical excitability in affected and unaffected motor areas after acute stroke correlates with functional and motor recovery. METHODS:We studied 13 patients with moderate to severe hemiparesis 5 to 7 days (T1), 30 days (T2), and 90 days (T3) after acute unilateral stroke, as well as 10 healthy controls. We used paired-pulse transcranial magnetic stimulation to study intracortical inhibition and facilitation, recording from the bilateral thenar eminences. F waves were also recorded. RESULTS:At T1, all patients showed significantly reduced intracortical inhibition in the unaffected hemisphere. At T2, in patients whose motor function recovered, intracortical inhibition in the unaffected hemisphere returned to normal. In patients with poor clinical motor recovery, abnormal disinhibition persisted in both hemispheres. At T3, in patients whose motor function progressively recovered, the abnormal disinhibition in the unaffected hemisphere decreased further, whereas in patients whose motor function remained poor, abnormal inhibition in the unaffected hemisphere persisted. No modification of F-wave latency and amplitude were found in patients and controls. CONCLUSIONS:During early days after stroke, motor cortical disinhibition involves both cerebral hemispheres. Longitudinal changes in motor disinhibition of the unaffected hemisphere may reflect the degree of clinical motor recovery.
journal_name
Neurorehabil Neural Repairjournal_title
Neurorehabilitation and neural repairauthors
Manganotti P,Acler M,Zanette GP,Smania N,Fiaschi Adoi
10.1177/1545968307313505subject
Has Abstractpub_date
2008-07-01 00:00:00pages
396-403issue
4eissn
1545-9683issn
1552-6844pii
1545968307313505journal_volume
22pub_type
杂志文章abstract::Current assessments do not provide reliable factors predictive of outcome from stroke for stroke survivors of intermediate age and severity of deficit. We sought to investigate whether early rate of functional improvement can facilitate prediction of functional outcome, length of stay, and disposition beyond that affo...
journal_title:Neurorehabilitation and neural repair
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