Stratifying chronic stroke patients based on the influence of contralesional motor cortices: An inter-hemispheric inhibition study

Yin Liang Lin, Kelsey A. Potter-Baker, David A. Cunningham, Manshi Li, Vishwanath Sankarasubramanian, John Lee, Stephen Jones, Ken Sakaie, Xiaofeng Wang, Andre G. Machado, Ela B. Plow*

*此作品的通信作者

研究成果: Article同行評審

35 引文 斯高帕斯(Scopus)

摘要

Objective: A recent “bimodal-balance recovery” model suggests that contralesional influence varies based on the amount of ipsilesional reserve: inhibitory when there is a large reserve, but supportive when there is a low reserve. Here, we investigated the relationships between contralesional influence (inter-hemispheric inhibition, IHI) and ipsilesional reserve (corticospinal damage/impairment), and also defined a criterion separating subgroups based on the relationships. Methods: Twenty-four patients underwent assessment of IHI using Transcranial Magnetic Stimulation (ipsilateral silent period method), motor impairment using Upper Extremity Fugl-Meyer (UEFM), and corticospinal damage using Diffusion Tensor Imaging and active motor threshold. Assessments of UEFM and IHI were repeated after 5-week rehabilitation (n = 21). Results: Relationship between IHI and baseline UEFM was quadratic with criterion at UEFM 43 (95%conference interval: 40–46). Patients less impaired than UEFM = 43 showed stronger IHI with more impairment, whereas patients more impaired than UEFM = 43 showed lower IHI with more impairment. Of those made clinically-meaningful functional gains in rehabilitation (n = 14), more-impaired patients showed further IHI reduction. Conclusions: A criterion impairment-level can be derived to stratify patient-subgroups based on the bimodal influence of contralesional cortex. Contralesional influence also evolves differently across subgroups following rehabilitation. Significance: The criterion may be used to stratify patients to design targeted, precision treatments.

原文English
頁(從 - 到)2516-2525
頁數10
期刊Clinical Neurophysiology
131
發行號10
DOIs
出版狀態Published - 10月 2020

指紋

深入研究「Stratifying chronic stroke patients based on the influence of contralesional motor cortices: An inter-hemispheric inhibition study」主題。共同形成了獨特的指紋。

引用此