Strength of ~20-Hz Rebound and Motor Recovery After Stroke

Parkkonen, Eeva; Laaksonen, Kristina; Piitulainen, Harri; Pekkola, Johanna; Parkkonen, Lauri; Tatlısumak, Turgut; Forss, Nina

doi:10.1177/1545968316688795

Cited by 20 publications

(44 citation statements)

References 58 publications

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“…In human stroke research, commonly studied rhythms are the sensorimotor alpha (8–13Hz) and beta (15–22Hz) rhythms. The strength of the beta rhythm rebound after sensory stimulation and passive movements of the affected hand is related to motor impairment and recovery therefrom. During active movements of the affected hand, a smaller beta desynchronization in contralateral M1 has consistently been found in chronic stroke patients that is related to the degree of impairment .…”

Section: Discussionmentioning

confidence: 99%

“…Lesion-induced plasticity in the human brain has been demonstrated in the form of a reorganization of task-specific networks, for example, the parietofrontal dorsolateral and dorsomedial network. 22,23 To date, integrity of the corticospinal tract, 41 a lateralized activation pattern in motor cortical regions, 42 M1-M1 interhemispheric connectivity, 43,44 and the strength of the beta rebound, 45,46 among others, 47 are known factors determining the degree of recovery of motor function in human stroke patients. Neural oscillations offer a functional perspective on poststroke plasticity, as they are linked to excitatory and inhibitory tone in cortical microcircuits, 10 receptor functioning 48 at the microscale level, and global brain network dynamics at the macroscopic level.…”

Section: Diminishment Of Movement-related Lfos In Stroke Pathophysiologymentioning

confidence: 99%

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Low‐Frequency Brain Oscillations Track Motor Recovery in Human Stroke

Bönstrup

Krawinkel

Schulz

et al. 2019

Annals of Neurology

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Objective The majority of patients with stroke survive the acute episode and live with enduring disability. Effective therapies to support recovery of motor function after stroke are yet to be developed. Key to this development is the identification of neurophysiologic signals that mark recovery and are suitable and susceptible to interventional therapies. Movement preparatory low‐frequency oscillations (LFOs) play a key role in cortical control of movement. Recent animal data point to a mechanistic role of motor cortical LFOs in stroke motor deficits and demonstrate neuromodulation intervention with therapeutic benefit. Their relevance in human stroke pathophysiology is unknown. Methods We studied the relationship between movement‐preparatory LFOs during the performance of a visuomotor grip task and motor function in a longitudinal (<5 days, 1 and 3 months) cohort study of 33 patients with motor stroke and in 19 healthy volunteers. Results Acute stroke–lesioned brains fail to generate the LFO signal. Whereas in healthy humans, a transient occurrence of LFOs preceded movement onset at predominantly contralateral frontoparietal motor regions, recordings in patients revealed that movement‐preparatory LFOs were substantially diminished to a level of 38% after acute stroke. LFOs progressively increased at 1 and 3 months. This re‐emergence closely tracked the recovery of motor function across several movement qualities including grip strength, fine motor skills, and synergies and was frequency band specific. Interpretation Our results provide the first human evidence for a link between movement‐preparatory LFOs and functional recovery after stroke, promoting their relevance for movement control. These results suggest that it may be interesting to explore targeted, LFOs‐restorative brain stimulation therapy in human stroke patients. ANN NEUROL 2019;86:853–865

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Section: Discussionmentioning

confidence: 99%

Section: Diminishment Of Movement-related Lfos In Stroke Pathophysiologymentioning

confidence: 99%

Low‐Frequency Brain Oscillations Track Motor Recovery in Human Stroke

Bönstrup

Krawinkel

Schulz

et al. 2019

Annals of Neurology

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“…The data of the control subjects and the passive movement-induced changes in the 20 Hz rhythm in the patients are obtained from our previous two studies [ 20 , 21 ]. Modulation of the 20 Hz rhythm to tactile stimuli, presented here for the first time, was recorded in the same sessions as passive movement data.…”

Section: Methodsmentioning

confidence: 99%

“…The movement duration was significantly shorter ( p < 0.01) in the patients versus controls in all measurement sessions. However, the movement duration of either hand of the patients did not differ between T 0 and T 1 [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…Both animal and human studies have shown that an acute stroke induces changes in motor-cortex excitability [ 14 – 18 ]. Our previous MEG studies in stroke patients using tactile [ 19 ] and proprioceptive [ 20 ] stimulation suggest that alterations in motor-cortex excitability after stroke are probably due to both changes in local excitatory–inhibitory circuits and disturbed afferent input, which lead to impaired sensorimotor integration. To further understand the mechanisms affecting motor-cortex excitability and recovery after stroke, we compared how two different types of afferent input modulate motor-cortex excitability during one-year recovery from stroke.…”

Section: Introductionmentioning

confidence: 99%

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Recovery of the 20 Hz Rebound to Tactile and Proprioceptive Stimulation after Stroke

et al. 2018

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Sensorimotor integration is closely linked to changes in motor-cortical excitability, observable in the modulation of the 20 Hz rhythm. After somatosensory stimulation, the rhythm transiently increases as a rebound that reflects motor-cortex inhibition. Stroke-induced alterations in afferent input likely affect motor-cortex excitability and motor recovery. To study the role of somatosensory afferents in motor-cortex excitability after stroke, we employed magnetoencephalographic recordings (MEG) at 1–7 days, one month, and 12 months in 23 patients with stroke in the middle cerebral artery territory and 22 healthy controls. The modulation of the 20 Hz motor-cortical rhythm was evaluated to two different somatosensory stimuli, tactile stimulation, and passive movement of the index fingers. The rebound strengths to both stimuli were diminished in the acute phase compared to the controls and increased significantly during the first month after stroke. However, only the rebound amplitudes to tactile stimuli fully recovered within the follow-up period. The rebound strengths in the affected hemisphere to both stimuli correlated strongly with the clinical scores across the follow-up. The results show that changes in the 20 Hz rebound to both stimuli behave similarly and occur predominantly during the first month. The 20 Hz rebound is a potential marker for predicting motor recovery after stroke.

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