Predicting Hand Motor Recovery in Severe Stroke: The Role of Motor Evoked Potentials in Relation to Early Clinical Assessment

Kuijk, Annette A. van; Pasman, J.W.; Hendricks, Henk T.; Zwarts, Machiel J.; Geurts, Alexander C. H.

doi:10.1177/1545968308317578

Cited by 99 publications

(84 citation statements)

References 26 publications

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“…27 To date, transcranial magnetic stimulation 25,28 and diffusion tensor imaging 25,29 studies further underpin this hypothesis. For example, van Kuijk et al 28 showed that in patients with an initial paralysis of the upper limb, the presence or absence of a motor-evoked potential in the abductor digiti minimi measured with transcranial magnetic stimulation at the end of the first week after stroke is highly predictive for final outcome of dexterity at 6 months. However, the presence or absence of a motor-evoked potential in the abductor digiti minimi has similar predictive values when compared to clinical assess- ment alone.…”

Section: Discussionmentioning

confidence: 99%

“…However, the presence or absence of a motor-evoked potential in the abductor digiti minimi has similar predictive values when compared to clinical assess- ment alone. 28 The present study suggests that transcranial magnetic stimulation measurements should investigate the predictive validity of motor-evoked potentials of finger extensors rather than finger flexors or the abductor digiti minimi alone. 30 The presence of shoulder abduction as a determinant for upper limb function may reflect the intralimb neural coupling between proximal and distal segments in motor control.…”

Section: Discussionmentioning

confidence: 99%

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Presence of Finger Extension and Shoulder Abduction Within 72 Hours After Stroke Predicts Functional Recovery

Nijland

Wegen

Wel

et al. 2010

Stroke

345

317

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on behalf of the EPOS InvestigatorsBackground and Purpose-The aim of the present study was to determine if outcome in terms of upper limb function at 6 months after stroke can be predicted in hospital stroke units using clinical parameters measured within 72 hours after stroke. In addition, the effect of the timing of assessment after stroke on the accuracy of prediction was investigated by measurements on days 5 and 9. Methods-Candidate determinants were measured in 188 stroke patients within 72 hours and at 5 and 9 days after stroke.Logistic regression analysis was used for model development to predict upper limb function at 6 months measured with the action research arm test (ARAT). Results-Patients with an upper limb motor deficit who exhibit some voluntary extension of the fingers and some abduction of the hemiplegic shoulder on day 2 have a probability of 0.98 to regain some dexterity at 6 months, whereas the probability was 0.25 for those without this voluntary motor activity. Sixty percent of patients with some early finger extension achieved full recovery at 6 months in terms of action research arm test score. Retesting the model on days 5 and 9 resulted in a gradual decline in probability from 0.25 to 0.14 for those without voluntary motor activity of shoulder abduction and finger extension, whereas the probability remained 0.98 for those with this motor activity. Conclusions-Based on 2 simple bedside tests, finger extension and shoulder abduction, functional recovery of the hemiplegic arm at 6 months can be predicted early in a hospital stroke unit within 72 hours after stroke onset. (Stroke. 2010;41:745-750.)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Presence of Finger Extension and Shoulder Abduction Within 72 Hours After Stroke Predicts Functional Recovery

Nijland

Wegen

Wel

et al. 2010

Stroke

345

317

View full text Add to dashboard Cite

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“…The sensory loss and loss of strength of intrinsic hand muscles are related to the involvement of upper limb movements in hemiparetics 14,15 . The expected recovery of manual control is particularly relevant because the rehabilitation strategy depends on motor recovery and the chance of developing complications secondary to paresis or spasticity 16 . For example, gripping and pinching maneuvers require the identification of the object's properties, including its curvature, size and fragility 17 .…”

mentioning

confidence: 99%

Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke

Scalha¹,

Miyasaki²,

Lima³

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: Describe the somatosensory function of the affected upper limb of hemiparetic stroke patients and investigate the correlations between measurements of motor and sensory functions in tasks with and without visual deprivation. Method: We applied the Fugl-Meyer Assessment (FMA), Nottingham Sensory Assessment (NSA), and several motor and sensory tests: Paper manipulation (PM), Motor Sequences (MS), Reaching and grasping (RG) Tests Functional (TF), Tactile Discrimination (TD), Weight Discrimination (WD) and Tactile Recognition of Objects (RO). Results: We found moderate correlations between the FMA motor subscale and the tactile sensation score of the NSA. Additionally, the FMA sensitivity was correlated with the NSA total; and performance on the WD test items correlated with the NSA. Conclusion: There was a correlation between the sensory and motor functions of the upper limb in chronic hemiparetic stroke patients. Additionally, there was a greater reliance on visual information to compensate for lost sensory-motor skills.

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“…[1][2][3]6 The CST is the main pathway that mediates voluntary movements, and neurophysiological and structural imaging studies have evidenced that motor outcome is heavily dependent on the integrity of the motor fibers. [6][7][8][9][10][11][12][13] Thus, the involvement of motor-related cortical regions, CR, and internal capsule progressively decrease the probability of upper limb functional recovery. 6,14 Recently, these findings were complemented by DTI studies that have demonstrated the usefulness of DTT for predicting poor motor outcome when infarct involves the CST.…”

mentioning

confidence: 99%

Acute Damage to the Posterior Limb of the Internal Capsule on Diffusion Tensor Tractography as an Early Imaging Predictor of Motor Outcome after Stroke

Puig¹,

Pedraza²,

Blasco³

et al. 2011

AJNR Am J Neuroradiol

145

124

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Predicting Hand Motor Recovery in Severe Stroke: The Role of Motor Evoked Potentials in Relation to Early Clinical Assessment

Abstract: In stroke patients with an initial paralysis of the upper extremity the presence or absence of an MEP has similar predictive value compared with early clinical assessment with regard to long-term hand motor recovery.

Cited by 99 publications

References 26 publications

Presence of Finger Extension and Shoulder Abduction Within 72 Hours After Stroke Predicts Functional Recovery

Presence of Finger Extension and Shoulder Abduction Within 72 Hours After Stroke Predicts Functional Recovery

Correlations between motor and sensory functions in upper limb chronic hemiparetics after stroke

Acute Damage to the Posterior Limb of the Internal Capsule on Diffusion Tensor Tractography as an Early Imaging Predictor of Motor Outcome after Stroke

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