Does the presence of a TMS-evoked MEP predict walking speeds in individuals with chronic stroke?

Madhavan, Sangeetha; Yerrapothu, M.; Williams, A.; Gradowska, Alan

doi:10.1016/j.brs.2017.01.058

Cited by 2 publications

(2 citation statements)

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“…For these reasons, the presence of MEP in chronic stroke patients seems to be a promising marker to tailor the best rehabilitative approach ( 75 ). However, the presence of lower limb MEP did not seem to predict more specific features, such as walking speed ( 87 , 88 ).…”

Section: Neurophysiological Changes During the Chronic Phasementioning

confidence: 78%

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review

Motolese¹,

Lanzone²,

Todisco³

et al. 2023

Front. Neurol.

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Ischemic stroke is characterized by a complex cascade of events starting from vessel occlusion. The term “penumbra” denotes the area of severely hypo-perfused brain tissue surrounding the ischemic core that can be potentially recovered if blood flow is reestablished. From the neurophysiological perspective, there are local alterations—reflecting the loss of function of the core and the penumbra—and widespread changes in neural networks functioning, since structural and functional connectivity is disrupted. These dynamic changes are closely related to blood flow in the affected area. However, the pathological process of stroke does not end after the acute phase, but it determines a long-term cascade of events, including changes of cortical excitability, that are quite precocious and might precede clinical evolution. Neurophysiological tools—such as Transcranial Magnetic Stimulation (TMS) or Electroencephalography (EEG)—have enough time resolution to efficiently reflect the pathological changes occurring after stroke. Even if they do not have a role in acute stroke management, EEG and TMS might be helpful for monitoring ischemia evolution—also in the sub-acute and chronic stages. The present review aims to describe the changes occurring in the infarcted area after stroke from the neurophysiological perspective, starting from the acute to the chronic phase.

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Section: Neurophysiological Changes During the Chronic Phasementioning

confidence: 78%

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review

Motolese¹,

Lanzone²,

Todisco³

et al. 2023

Front. Neurol.

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“…The motor-evoked potentials (MEP) is recorded from the target muscle as a result of stimulating the motor cortex with a single TMS (sTMS) pulse. The sTMS can quantitatively evaluate changes in corticospinal excitability and the MEP is influenced by some demographic and anthropometric indices [19,20]. Veldema et al (2018) related severe hand dysfunction to inhibition of the corticospinal system of the ipsilesional hemisphere by evaluating the contralateral MEP.…”

Section: Interhemispheric Imbalance In Stroke: Relationship With Sensmentioning

confidence: 99%

Promotion of Poststroke Motor-Function Recovery with Repetitive Transcranial Magnetic Stimulation by Regulating the Interhemispheric Imbalance

et al. 2020

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Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain-stimulation technique that transiently modulates cerebral cortex excitability, achieving overall positive results in poststroke motor-function recovery. Excessive inhibition of the ipsilesional-affected hemisphere by the contralesional-unaffected hemisphere has seriously hindered poststroke motor-function recovery. Hence, intracortical disinhibition can be used as an approach to managing poststroke brain injury. This technique promotes neural plasticity for faster motor-function recovery. rTMS relieves unilateral inhibition of the brain function by regulatinga interhemispheric-imbalanced inhibition. This paper summarized 12 studies from 2016 to date, focusing on rTMS on motor function after acute and chronic stroke by regulating the interhemispheric imbalance of inhibitory inputs. Although rTMS studies have shown promising outcomes on recovery of motor functions in stroke patients, different intervention methods may lead to discrepancies in results. A uniform optimal stimulus model cannot routinely be used, mainly due to the stimulus schemes, stroke types and outcome-measuring differences among studies. Thus, the effect of rTMS on poststroke motor-function recovery should be investigated further to standardize the rTMS program for optimal poststroke motor-function recovery. More randomized, placebo-controlled clinical trials with standardized rTMS protocols are needed to ensure the effectiveness of the treatment.

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Does the presence of a TMS-evoked MEP predict walking speeds in individuals with chronic stroke?

Cited by 2 publications

References 0 publications

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review

Promotion of Poststroke Motor-Function Recovery with Repetitive Transcranial Magnetic Stimulation by Regulating the Interhemispheric Imbalance

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