nach oben

Journal of Neurology

Erschienen in:

28.02.2018 | Original Communication

Cortico-spinal excitability and hand motor recovery in stroke: a longitudinal study

verfasst von: Jitka Veldema, Kathrin Bösl, Dennis Alexander Nowak

Erschienen in: Journal of Neurology | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

Objective

To describe the relationship between changes of cortico-spinal excitability and motor recovery of the affected hand after stroke.

Methods

Eighteen hemiparetic stroke patients with a severe-to-mild upper limb motor impairment were randomized. Cortico-spinal excitability measures (resting motor thresholds and motor evoked potentials) obtained from a distal (abductor pollicis brevis) and proximal (biceps brachii) upper limb muscle were assessed for both hemispheres. Motor function of the affected hand was tested by the Wolf Motor Function and Action Research Arm tests. The evaluations were performed at baseline and weekly over 7 weeks of in-patient neurological rehabilitation.

Results

Severe hand dysfunction was associated with a strong suppression of ipsilesional cortico-spinal excitability and a shift of excitability towards the contralesional hemisphere. Mild hand impairment was associated with a shift of cortico-spinal excitability towards the ipsilesional hemisphere. Favorable motor recovery correlated with an increase of ipsilesional cortico-spinal excitability.

Go AS, Mozaffarian D, Roger VL, Benjamin EJ et al (2013) Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation 127:e6–e245CrossRefPubMed

Van der Lee JH, De Groot V, Beckerman H et al (2001) The intra- and interrater reliability of the action research arm test: a practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil 82:14–19CrossRefPubMed

Medical Research Council (1981) Aids to the examination of the peripheral nervous system. Memorandum No. 45. Her Majesty’s Stationery Office, London

Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed

Van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19:604–607CrossRefPubMed

Brott T, Adams HP Jr, Olinger CP et al (1989) Measurements of acute cerebral infarction: a clinical examination scale. Stroke 20:864–870CrossRefPubMed

Nowak DA, Grefkes C, Dafotakis M et al (2007) Dexterity is impaired at both hands following unilateral subcortical middle cerebral artery stroke. Eur J Neurosci 25:3173–3184CrossRefPubMed

Wolf SL, Catlin PA, Ellis M et al (2001) Assessing Wolf motor function test as outcome measure for research in patients after stroke. Stroke 32(7):1635–1639CrossRefPubMed

Brouwer BJ, Schryburt-Brown K (2006) Hand function and motor cortical output poststroke: are they related? Arch Phys Med Rehabil 87:627–634CrossRefPubMed

10.

Takeuchi N, Tada T, Chuma T, Matsuo Y, Ikoma K (2007) Disinhibition of the premotor cortex contributes to a maladaptive change in the affected hand after stroke. Stroke 38:1551–1556CrossRefPubMed

11.

Traversa R, Cicinelli P, Oliveri M et al (2000) Neurophysiological follow-up of motor cortical output in stroke patients. Clin Neurophysiol 111:1695–1703CrossRefPubMed

12.

Fregni F, Boggio PS, Valle AC, Rocha RR et al (2006) A sham-controlled trial of a 5-day course of repetitive transcranial magnetic stimulation of the unaffected hemisphere in stroke patients. Stroke 37:2115–2122CrossRefPubMed

13.

Lüdemann-Podubecká J, Bösl K, Theilig S, Wiederer R, Nowak DA (2015) The effectiveness of 1 Hz rTMS over the primary motor area of the unaffected hemisphere to improve hand function after stroke depends on hemispheric dominance. Brain Stimul 8:823–830CrossRefPubMed

14.

Veldema J, Bösl K, Nowak DA (2017) Motor recovery of the affected hand in subacute stroke correlates with changes of contralesional cortical hand motor representation. Neural Plast 2017:6171903CrossRefPubMedPubMedCentral

15.

Wang CP, Tsai PY, Yang TF, Yang KY, Wang CC (2014) Differential effect of conditioning sequences in coupling inhibitory/facilitatory repetitive transcranial magnetic stimulation for poststroke motor recovery. CNS Neurosci Ther 20:355–363CrossRefPubMed

16.

Platz T, van Kaick S, Möller L et al (2005) Impairment-oriented training and adaptive motor cortex reorganisation after stroke: a fTMS study. J Neurol 252:1363–1371CrossRefPubMed

17.

Delvaux V, Alagona G, Gérard P et al (2003) Post-stroke reorganization of hand motor area: a 1-year prospective follow-up with focal transcranial magnetic stimulation. Clin Neurophysiol 114:1217–1225CrossRefPubMed

18.

Di Lazzaro V, Pilato F, Dileone M et al (2008) Modulating cortical excitability in acute stroke: a repetitive TMS study. Clin Neurophysiol 119:715–723CrossRefPubMed

19.

Huynh W, Vucic S, Krishnan AV, Lin CS, Kiernan MC (2016) Exploring the evolution of cortical excitability following acute stroke. Neurorehabil Neural Repair 30:244–257CrossRefPubMed

20.

Lüdemann-Podubecká J, Nowak DA (2016) Mapping cortical hand motor representation using TMS: a method to assess brain plasticity and a surrogate marker for recovery of function after stroke? Neurosci Biobehav Rev 69:239–251CrossRefPubMed

21.

Miltner WHR, Bauder H, Sommer M, Dettmers C, Taub E (1999) Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke. A replication. Stroke 30:586–592CrossRefPubMed

22.

Taub E, Miller NE, Novack TA et al (1993) Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil 74:347–354PubMed

23.

Grefkes C, Fink GR (2016) Noninvasive brain stimulation after stroke: it is time for large randomized controlled trials! Curr Opin Neurol 29:714–720CrossRefPubMed

24.

Wagle-Shukla A, Ni Z, Gunraj CA, Bahl N, Chen R (2009) Effects of short interval intracortical inhibition and intracortical facilitation on short interval intracortical facilitation in human primary motor cortex. J Physiol 587:5665–5678CrossRefPubMedPubMedCentral

25.

Stinear CM, Byblow WD, Ackerley SJ et al (2017) PREP2: a biomarker-based algorithm for predicting upper limb function after stroke. Ann Clin Transl Neurol 4:811–820CrossRefPubMedPubMedCentral

Titel: Cortico-spinal excitability and hand motor recovery in stroke: a longitudinal study
verfasst von: Jitka Veldema
Kathrin Bösl
Dennis Alexander Nowak
Publikationsdatum: 28.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 5/2018
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8802-2

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

25.04.2024 | Hypotonie | Nachrichten

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Cortico-spinal excitability and hand motor recovery in stroke: a longitudinal study

Abstract

Objective

Methods

Results

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Demenzkranke durch Antipsychotika vielfach gefährdet

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Update Neurologie

Springer Medizin

Abstract

Objective

Methods

Results

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2018

Why acute unilateral vestibular midbrain lesions rarely manifest with rotational vertigo: a clinical and modelling approach to head direction cell function

Hemi-seesaw nystagmus in a patient with acute infarction in the superior cerebellar artery territory

Caregiver burden and its related factors in advanced Parkinson’s disease: data from the PREDICT study

Secondary antibody deficiency: a complication of anti-CD20 therapy for neuroinflammation

Influence of on-going treatment with angiotensin-converting enzyme inhibitor or angiotensin receptor blocker on the outcome of patients treated with intravenous rt-PA for ischemic stroke

Within-patient fluctuation of brain volume estimates from short-term repeated MRI measurements using SIENA/FSL

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Demenzkranke durch Antipsychotika vielfach gefährdet

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Update Neurologie