Primary Motor Cortex Excitability During Recovery After Stroke: Implications for Neuromodulation

Show simple item record Stinear, Cathy en Petoe, MA en Byblow, Winston en 2016-10-24T21:17:37Z en 2015-06-22 en 2015-11 en
dc.identifier.citation Brain stimulation, 2015, 8 (6), 1183 - 1190 en
dc.identifier.issn 1935-861X en
dc.identifier.uri en
dc.description.abstract Non-invasive brain stimulation techniques may be useful adjuvants to promote recovery after stroke. They are typically used to facilitate ipsilesional cortical excitability directly, or indirectly by suppressing contralesional cortical excitability and reducing interhemispheric inhibition from the contralesional to ipsilesional hemisphere. However, most of the evidence for this approach comes from studies of patients at the chronic stage of recovery.We hypothesized that corticomotor excitability and interhemispheric inhibition would initially be asymmetric, with greater interhemispheric inhibition from contralesional to ipsilesional M1. We also hypothesized that balancing of corticomotor excitability and interhemispheric inhibition would be associated with greater improvements in paretic upper-limb impairment and function.We conducted a retrospective analysis of longitudinal data collected from 46 patients during the first six months after stroke. Transcranial magnetic stimulation was used to measure rest motor threshold, stimulus-response curves, and ipsilateral silent periods from the extensor carpi radialis muscles of both upper limbs. Analyses of variance and linear regression modeling were used to evaluate the effect of time on corticomotor excitability and interhemispheric inhibition in both hemispheres, and associations between these effects and improvements in paretic upper-limb impairment and function.All participants had subcortical damage and only two had motor cortex involvement. As expected, ipsilesional corticomotor excitability was initially suppressed and increased over time, and this increase was associated with improved upper-limb impairment and function. However, interhemispheric inhibition was symmetrical and stable over time, and there was no evidence for a decrease in contralesional corticomotor excitability.Neuromodulation interventions applied during spontaneous recovery may be more beneficial if they facilitate ipsilesional corticomotor excitability directly. en
dc.description.uri en
dc.format.medium Print-Electronic en
dc.language English en
dc.publisher Elsevier en
dc.relation.ispartofseries Brain stimulation en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from en
dc.rights.uri en
dc.subject Upper Extremity en
dc.subject Motor Cortex en
dc.subject Humans en
dc.subject Electromyography en
dc.subject Retrospective Studies en
dc.subject Evoked Potentials, Motor en
dc.subject Neural Inhibition en
dc.subject Rest en
dc.subject Adult en
dc.subject Aged en
dc.subject Aged, 80 and over en
dc.subject Middle Aged en
dc.subject Female en
dc.subject Male en
dc.subject Transcranial Magnetic Stimulation en
dc.subject Stroke en
dc.title Primary Motor Cortex Excitability During Recovery After Stroke: Implications for Neuromodulation en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.brs.2015.06.015 en
pubs.issue 6 en
pubs.begin-page 1183 en
pubs.volume 8 en
dc.description.version AM - Accepted Manuscript en
dc.identifier.pmid 26195321 en en
pubs.end-page 1190 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 492057 en Medical and Health Sciences en School of Medicine en Medicine Department en Science en Exercise Sciences en
dc.identifier.eissn 1876-4754 en
pubs.record-created-at-source-date 2016-10-25 en 2015-07-17 en
pubs.dimensions-id 26195321 en

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