A novel TMS framework for assessing neurophysiological recovery at the subacute stage after stroke

被引：0
作者：
Shanks, Maxine J. [1 ,2 ]
Cirillo, John [1 ,3 ]
Stinear, Cathy M. [2 ,4 ]
Byblow, Winston D. [1 ,2 ,5 ]
机构：
[1] Univ Auckland, Dept Exercise Sci, Private Bag 92019, Auckland, New Zealand
[2] Univ Auckland, Ctr Brain Res, Auckland, New Zealand
[3] Univ Adelaide, Sch Biomed, Discipline Physiol, Adelaide, Australia
[4] Univ Auckland, Dept Med, Auckland, New Zealand
[5] Univ Auckland, Dept Exercise Sci, Private Bag 92019, Auckland 1142, New Zealand
来源：
CLINICAL NEUROPHYSIOLOGY | 2025年 / 171卷
关键词：
Human; Manual dexterity; Motor evoked potential; Stroke; Transcranial magnetic stimulation; Upper limb; TRANSCRANIAL MAGNETIC STIMULATION; MOTOR CORTEX EXCITABILITY; UPPER EXTREMITY FUNCTION; TIME FOLLOWING STROKE; WHITE-MATTER STROKE; UPPER-LIMB FUNCTION; CORTICOSPINAL PROJECTIONS; PROPORTIONAL RECOVERY; COMPOSITIONAL DATA; BRAIN-STIMULATION;
D O I：
10.1016/j.clinph.2025.01.010
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Objective: To use peri-threshold transcranial magnetic stimulation (TMS) intensities to elicit motor evoked potentials (MEPs) during the subacute stage after stroke and assess their association with upper limb motor recovery. Methods: Twenty-five MEP+ patients participated in three sessions at 1, 3, and 6 months post-stroke. Single-pulse TMS across a range of stimulation intensities was used to elicit MEPs in four muscles of the paretic and non- paretic upper limb. At each timepoint, threshold matrices were constructed based on MEP amplitude and persistence. A matrix element was suprathreshold if five out of ten stimulations elicited MEPs >= 50 mu V. A subthreshold element produced MEPs below this criterion. Dexterity was assessed using the nine hole peg test. Results: There were fewer suprathreshold, and more subthreshold elements on the paretic compared to the non- paretic side. The number of suprathreshold elements on the paretic side increased between 1 and 6 months post- stroke. Neither subnor supra-threshold elements were associated with dexterity recovery. Conclusion: The proportion of suband supra-threshold elements reflect neurophysiological recovery during the subacute stage after stroke. A threshold matrix framework can identify patients with stable versus dynamic neurophysiology post-stroke. Significance: A compositional analysis framework can quantify neurophysiological recovery after stroke.
引用
收藏
页码：82 / 94
页数：13
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