Corticospinal Integrity and Motor Impairment Predict Outcomes After Excitatory Repetitive Transcranial Magnetic Stimulation: A Preliminary Study
| Autor: | Po-Yi Tsai, Fu-Gong Lin, Chih-Pin Wang, Shan-Hui Lin, Chih-Jou Lai, Chin-Yi Hsieh, Rai-Chi Chan |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Hemiplegia Physical Therapy Sports Therapy and Rehabilitation Functional Laterality Tertiary Care Centers Cerebellar Cortex Grip strength Double-Blind Method medicine Humans Neurostimulation Stroke Aged Rehabilitation Hand Strength medicine.diagnostic_test Stroke Rehabilitation Recovery of Function Middle Aged Evoked Potentials Motor medicine.disease Transcranial Magnetic Stimulation Transcranial magnetic stimulation medicine.anatomical_structure Corticospinal tract Physical therapy Female Psychology Functional magnetic resonance imaging Motor cortex |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 96:69-75 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2014.08.014 |
| Popis: | Objective To identify the effective predictors for therapeutic outcomes based on intermittent theta-burst stimulation (iTBS). Design A sham-controlled, double-blind parallel study design. Setting A tertiary hospital. Participants People with stroke (N=72) who presented with unilateral hemiplegia. Interventions Ten consecutive sessions of real or sham iTBS were implemented with the aim of enhancing hand function. Patients were categorized into 4 groups according to the presence (MEP+) or absence (MEP−) of motor-evoked potentials (MEPs) and grip strength according to the Medical Research Council (MRC) scale. Main Outcome Measures Cortical excitability, Wolf Motor Function Test (WMFT), finger-tapping task (FT), and simple reaction time were performed before and after the sessions. Results MEPs and the MRC scale were predictive of iTBS therapeutic outcomes. Group A (MEP+, MRC>1) exhibited the greatest WMFT change (7.6±2.3, P 1; 5.2±2.2 score change) and group C (MEP−, MRC=0; 2.3±1.5 score change). These improvements were correlated significantly with baseline motor function and ipsilesional maximum MEP amplitude. Conclusions The effectiveness of iTBS modulation for poststroke motor enhancement depends on baseline hand grip strength and the presence of MEPs. Our findings indicate that establishing neurostimulation strategies based on the proposed electrophysiological and clinical criteria can allow iTBS to be executed with substantial precision. Effective neuromodulatory strategies can be formulated by using electrophysiological features and clinical presentation information as guidelines. |
| Databáze: | OpenAIRE |
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