Corticomuscular coherence in acute and chronic stroke

Carlowitz-Ghori, Katherina von; Bayraktaroğlu, Zübeyir; Hohlefeld, Friederike U.; Losch, Florian; Curio, Gabriel; Nikulin, Vadim V.

doi:10.1016/j.clinph.2013.11.006

Cited by 83 publications

(82 citation statements)

References 63 publications

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“…In this patient group, functionally relevant biomarkers of neuronal plasticity need to be detected to refine therapeutic targets and generate novel treatment approaches for regaining motor control (Ward, 2015). However, not all post-stroke neuronal reorganization relates to functional restoration (von Carlowitz-Ghori et al, 2014). Cortico-muscular coherence (CMC) may serve as a measure to detect functionally relevant neuronal plasticity and to provide physiological and topographic insight related to the mechanisms of motor recovery.…”

Section: Introductionmentioning

confidence: 99%

“…Cortico-muscular coherence (CMC) may serve as a measure to detect functionally relevant neuronal plasticity and to provide physiological and topographic insight related to the mechanisms of motor recovery. As summarized by Carlowitz-Ghori and colleagues (von Carlowitz-Ghori et al, 2014), CMC indicates the amount of synchronization between cortical and spinal cord activity during the execution of a movement (Brown et al, 1998, Mima and Hallett, 1999, Salenius and Hari, 2003); it appears predominantly during periods of isometric contraction (Kilner et al, 2000, Riddle and Baker, 2006) and reaches its peak in the beta frequency range over the primary sensorimotor cortices contralateral to the innervated limb (Salenius et al, 1997, Tsujimoto et al, 2009, Witham et al, 2010). …”

Section: Introductionmentioning

confidence: 99%

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Plasticity of premotor cortico-muscular coherence in severely impaired stroke patients with hand paralysis

Belardinelli

Laer

Ortiz

et al. 2017

NeuroImage: Clinical

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Motor recovery in severely impaired stroke patients is often very limited. To refine therapeutic interventions for regaining motor control in this patient group, the functionally relevant mechanisms of neuronal plasticity need to be detected. Cortico-muscular coherence (CMC) may provide physiological and topographic insights to achieve this goal. Synchronizing limb movements to motor-related brain activation is hypothesized to reestablish cortico-motor control indexed by CMC.In the present study, right-handed, chronic stroke patients with right-hemispheric lesions and left hand paralysis participated in a four-week training for their left upper extremity. A brain-robot interface turned event-related beta-band desynchronization of the lesioned sensorimotor cortex during kinesthetic motor-imagery into the opening of the paralyzed hand by a robotic orthosis. Simultaneous MEG/EMG recordings and individual models from MRIs were used for CMC detection and source reconstruction of cortico-muscular connectivity to the affected finger extensors before and after the training program. The upper extremity-FMA of the patients improved significantly from 16.23 ± 6.79 to 19.52 ± 7.91 (p = 0.0015). All patients showed significantly increased CMC in the beta frequency-band, with a distributed, bi-hemispheric pattern and considerable inter-individual variability. The location of CMC changes was not correlated to the severity of the motor impairment, the motor improvement or the lesion volume. Group analysis of the cortical overlap revealed a common feature in all patients following the intervention: a significantly increased level of ipsilesional premotor CMC that extended from the superior to the middle and inferior frontal gyrus, along with a confined area of increased CMC in the contralesional premotor cortex.In conclusion, functionally relevant modulations of CMC can be detected in patients with long-term, severe motor deficits after a brain-robot assisted rehabilitation training. Premotor beta-band CMC may serve as a biomarker and therapeutic target for novel treatment approaches in this patient group.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Plasticity of premotor cortico-muscular coherence in severely impaired stroke patients with hand paralysis

Belardinelli

Laer

Ortiz

et al. 2017

NeuroImage: Clinical

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“…In the current study, we demonstrated that healthy people are able to voluntarily modulate their CMC based on neurofeedback. Building on the present results, CMC neurofeedback could provide a therapeutic approach in conditions where CMC was shown to be altered, such as in stroke (Mima et al, 2001;Braun et al, 2007;Fang et al, 2009;Meng et al, 2009;Graziadio et al, 2012;Rossiter et al, 2013;von Carlowitz-Ghori et al, 2014). CMC allows directly accessing functionally relevant contribution of cortical areas that undergo massive reorganization in stroke recovery.…”

Section: Clinical Potentialmentioning

confidence: 73%

“…The procedures were approved by the local ethics committee and all subjects gave informed consent. The selection of subjects was either based on a recording of an earlier CMC study (N = 5;von Carlowitz-Ghori et al, 2014) or a test recording (comparable to the force-feedback condition described below but using only few electrodes; N = 6) showing well detectable CMC.…”

Section: Experimental Procedures Subjectsmentioning

confidence: 99%

Voluntary control of corticomuscular coherence through neurofeedback: A proof-of-principle study in healthy subjects

et al. 2015

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“…The electroencephalography‐electromyography coherence, which refers to the synchronization of the oscillatory activities of the electromyography and electroencephalography signals, was used to assess the level of cortical and neuromuscular coupling. It has been reported that a low‐to‐high shift of the electroencephalography‐electromyography coherence frequency is a clinical indicator of motor recovery after stroke 50. Lai and colleagues13 showed that the electroencephalography‐electromyography coherence in the high‐frequency band (>30 Hz) had increased significantly after repetitive TENS.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower‐Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial

Kwong

Chung

et al. 2018

JAHA

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BackgroundTranscutaneous electrical nerve stimulation (TENS) has been used to augment the efficacy of task‐oriented training (TOT) after stroke. Bilateral intervention approaches have also been shown to be effective in augmenting motor function after stroke. The purpose of this study was to compare the efficacy of bilateral TENS combined with TOT versus unilateral TENS combined with TOT in improving lower‐limb motor function in subjects with chronic stroke.Methods and ResultsEighty subjects were randomly assigned to bilateral TENS+TOT or to unilateral TENS+TOT and underwent 20 sessions of training over a 10‐week period. The outcome measures included the maximal strength of the lower‐limb muscles and the results of the Lower Extremity Motor Coordination Test, Berg Balance Scale, Step Test, and Timed Up and Go test. Each participant was assessed at baseline, after 10 and 20 sessions of training and 3 months after the cessation of training. The subjects in the bilateral TENS+TOT group showed greater improvement in paretic ankle dorsiflexion strength (β=1.32; P=0.032) and in the completion time for the Timed Up and Go test (β=−1.54; P=0.004) than those in the unilateral TENS+TOT group. However, there were no significant between‐group differences for other outcome measures.ConclusionsThe application of bilateral TENS over the common peroneal nerve combined with TOT was superior to the application of unilateral TENS combined with TOT in improving paretic ankle dorsiflexion strength after 10 sessions of training and in improving the completion time for the Timed Up and Go test after 20 sessions of training.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02152813.

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Corticomuscular coherence in acute and chronic stroke

Cited by 83 publications

References 63 publications

Plasticity of premotor cortico-muscular coherence in severely impaired stroke patients with hand paralysis

Plasticity of premotor cortico-muscular coherence in severely impaired stroke patients with hand paralysis

Voluntary control of corticomuscular coherence through neurofeedback: A proof-of-principle study in healthy subjects

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower‐Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial

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