Neurophysiological measurements of affected and unaffected motor cortex from a cross-sectional, multi-center individual stroke patient data analysis study

Autor(es):Mostrar menos -

Simis, Marcel ^{[1, 2, 3, 4]} ; Di Lazzaro, Vincenzo ^[5] ; Kirton, Adam ^[6] ; Pennisi, Giovanni ^[7] ; Bella, Rita ^[7] ; Kim, Yun-Hee ^[8] ; Takeuchi, Naoyuki ^[9] ; Khedr, Eman M. ^[10] ; Rogers, Lynn M. ^{[11, 12]} ; Harvey, Richard ^{[11, 12]} ; Koganemaru, Satoko ^[13] ; Turman, Bulent ^[14] ; Tarlaci, Sultan ^[15] ; Gagliardi, Rubens J. ^[4] ; Fregni, Felipe ^{[2, 3]}

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^[1] Univ Sao Paulo, Sch Med, Gen Hosp, Phys & Rehabil Med Inst, Sao Paulo - Brazil

^[2] Harvard Univ, Spaulding Rehabil Hosp, Boston, MA 02115 - USA

^[3] Harvard Univ, Massachusetts Gen Hosp, Lab Neuromodulat, Boston, MA 02115 - USA

^[4] Santa Casa Med Sch, Div Neurol, Sao Paulo - Brazil

^[5] Univ Campus Biomed, Inst Neurol, Rome - Italy

^[6] Univ Calgary, Alberta Childrens Hosp Res Inst, Calgary Pediat Stroke Program, Calgary, AB - Canada

^[7] Univ Catania, Sect Neurosci, Dept GF Ingrassia, Catania - Italy

^[8] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Heart Vasc Stroke Inst, Dept Phys & Rehabil Med, Seoul - South Korea

^[9] Tohoku Univ, Grad Sch Med, Dept Phys Med & Rehabil, Sendai, Miyagi 980 - Japan

^[10] Assiut Univ Hosp, Fac Med, Dept Neurol, Assiut - Egypt

^[11] Rehabil Inst Chicago, Sensory Motor Performance Program, Chicago, IL 60611 - USA

^[12] Northwestern Univ, Feinberg Sch Med, Dept Phys Med & Rehabil, Chicago, IL 60611 - USA

^[13] Kyoto Univ, Grad Sch Med, Human Brain Res Ctr, Kyoto - Japan

^[14] Bond Univ, Sch Med, Robina - Australia

^[15] Sifa Univ, Izmir - Turkey

• Tipo de documento: Artigo Científico
• Fonte: NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY; v. 46, n. 1, p. 53-61, FEB 2016.
• Citações Web of Science: 5

Resumo

Objectives. - Transcranial magnetic stimulation (TMS) has been used to measure cortical excitability as a functional measurement of corticomotor pathways. Given its potential application as an assessment tool in stroke, we aimed to analyze the correlation of TMS parameters with clinical features in stroke using data from 10 different centers. Methods. - Data of 341 patients with a clinical diagnosis of stroke were collected from studies assessing cortical excitability using TMS. We used a multivariate regression model in which the baseline cortical excitability parameter ``resting Motor Threshold (rMT){''} was the. main outcome and the demographic, anatomic and clinical characteristics were included as independent variables. Results. - The variable ``severity of motor deficit{''} consistently remained significant in predicting rMT in the affected hemisphere, with a positive beta coefficient, in the multivariate models after sensitive analyses and adjusting for important confounders such as site center. Additionally, we found that the correlations between ``age{''} or ``time since stroke{''} and the rMT in the affected hemisphere were significant, as well as the interaction between ``time since stroke{''} and ``severity of motor deficit{''}. Conclusions. - We have shown that severity of motor deficit is an important predictor for rMT in the affected hemisphere. Additionally, time since stroke seems to be an effect modifier for the correlation between motor deficit and rMT. In the unaffected motor cortex, these correlations were not significant. We discuss these findings in the context of stroke rehabilitation. (C) 2016 Published by Elsevier Masson SAS. (AU)

• Processo FAPESP: 09/02059-7 - Estudo dos efeitos motores e da fala após estimulação transcraniana por corrente contínua (ETCC) de baixa intensidade em pacientes com acidente vascular cerebral isquêmico (AVCI)
• Beneficiário: Rubens José Gagliardi
• Modalidade de apoio: Auxílio à Pesquisa - Regular