Evidence for interhemispheric imbalance in stroke patients as revealed by combining transcranial magnetic stimulation and electroencephalography.

Autor: Casula EP; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy.; Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK., Pellicciari MC; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Bonnì S; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Spanò B; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy., Ponzo V; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Salsano I; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy., Giulietti G; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy., Martino Cinnera A; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Maiella M; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Borghi I; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Rocchi L; Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK., Bozzali M; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy.; Brighton and Sussex Medical School, University of Sussex, Brighton, UK., Sallustio F; Stroke Unit, Department of Neuroscience, Tor Vergata Polyclinic, Rome, Italy., Caltagirone C; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy., Koch G; Non-Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation, Rome, Italy.; Stroke Unit, Department of Neuroscience, Tor Vergata Polyclinic, Rome, Italy.
Jazyk: angličtina
Zdroj: Human brain mapping [Hum Brain Mapp] 2021 Apr 01; Vol. 42 (5), pp. 1343-1358. Date of Electronic Publication: 2021 Jan 13.
DOI: 10.1002/hbm.25297
Abstrakt: Interhemispheric interactions in stroke patients are frequently characterized by abnormalities, in terms of balance and inhibition. Previous results showed an impressive variability, mostly given to the instability of motor-evoked potentials when evoked from the affected hemisphere. We aim to find reliable interhemispheric measures in stroke patients with a not-evocable motor-evoked potential from the affected hemisphere, by combining transcranial magnetic stimulation (TMS) and electroencephalography. Ninteen stroke patients (seven females; 61.26 ± 9.8 years) were studied for 6 months after a first-ever stroke in the middle cerebral artery territory. Patients underwent four evaluations: clinical, cortical, corticospinal, and structural. To test the reliability of our measures, the evaluations were repeated after 3 weeks. To test the sensitivity, 14 age-matched healthy controls were compared to stroke patients. In stroke patients, stimulation of the affected hemisphere did not result in any inhibition onto the unaffected. The stimulation of the unaffected hemisphere revealed a preservation of the inhibition mechanism onto the affected. This resulted in a remarkable interhemispheric imbalance, whereas this mechanism was steadily symmetric in healthy controls. This result was stable when cortical evaluation was repeated after 3 weeks. Importantly, patients with a better recovery of the affected hand strength were the ones with a more stable interhemispheric balance. Finally, we found an association between microstructural integrity of callosal fibers, suppression of interhemispheric TMS-evoked activity and interhemispheric connectivity. We provide direct and sensitive cortical measures of interhemispheric imbalance in stroke patients. These measures offer a reliable means of distinguishing healthy and pathological interhemispheric dynamics.
(© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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