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

J Neurol. 2018 May;265(5):1071-1078. doi: 10.1007/s00415-018-8802-2. Epub 2018 Feb 28.

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.

Keywords: Cortico-spinal excitability; Hand motor function; Stroke.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged, 80 and over
  • Evoked Potentials, Motor
  • Female
  • Follow-Up Studies
  • Hand / physiopathology*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Muscle, Skeletal / physiopathology
  • Paresis / etiology
  • Paresis / physiopathology
  • Paresis / rehabilitation
  • Pyramidal Tracts / physiopathology*
  • Recovery of Function*
  • Severity of Illness Index
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation
  • Transcranial Magnetic Stimulation
  • Treatment Outcome