OBJECTIVE: The primary aim of this study was to compare the predictive value of motor evoked potentials (MEPs) and early clinical assessment with regard to long-term hand motor recovery in patients with profound hemiplegia after stroke. METHODS: The sample was an inception cohort of 39 stroke patients with an acute, ischemic, supratentorial stroke and an initial upper-extremity paralysis admitted to an academic hospital. Hand motor function recovery was defined at 26 weeks poststroke as a Fugl-Meyer Motor Assessment (FMA) hand score>3 points. The following prognostic factors were compared at week 1 and week 3 poststroke: motor functions as assessed by the FMA upper-extremity and lower-extremity subscores, and the presence of an MEP in the abductor digiti minimi and biceps brachii muscle. RESULTS: Both the presence of an abductor digiti minimi-MEP and any motor recovery in the FMA upper-extremity subscore showed a positive predictive value of 1.00 at weeks 1 and 3. The FMA lower-extremity subscore showed the best negative predictive value (0.90; 95% CI 0.78-1.00 at week 1 and 0.95; 95% CI 0.87-1.00 at week 3). CONCLUSIONS: 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.
OBJECTIVE: The primary aim of this study was to compare the predictive value of motor evoked potentials (MEPs) and early clinical assessment with regard to long-term hand motor recovery in patients with profound hemiplegia after stroke. METHODS: The sample was an inception cohort of 39 strokepatients with an acute, ischemic, supratentorial stroke and an initial upper-extremity paralysis admitted to an academic hospital. Hand motor function recovery was defined at 26 weeks poststroke as a Fugl-Meyer Motor Assessment (FMA) hand score>3 points. The following prognostic factors were compared at week 1 and week 3 poststroke: motor functions as assessed by the FMA upper-extremity and lower-extremity subscores, and the presence of an MEP in the abductor digiti minimi and biceps brachii muscle. RESULTS: Both the presence of an abductor digiti minimi-MEP and any motor recovery in the FMA upper-extremity subscore showed a positive predictive value of 1.00 at weeks 1 and 3. The FMA lower-extremity subscore showed the best negative predictive value (0.90; 95% CI 0.78-1.00 at week 1 and 0.95; 95% CI 0.87-1.00 at week 3). CONCLUSIONS: In strokepatients 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.
Authors: Jacqueline A Palmer; Ryan Zarzycki; Susanne M Morton; Trisha M Kesar; Stuart A Binder-Macleod Journal: J Neurophysiol Date: 2017-01-11 Impact factor: 2.714
Authors: Bokkyu Kim; Beth E Fisher; Nicolas Schweighofer; Richard M Leahy; Justin P Haldar; Soyoung Choi; Dorsa B Kay; James Gordon; Carolee J Winstein Journal: J Neurosci Methods Date: 2018-04-21 Impact factor: 2.390
Authors: J Puig; S Pedraza; G Blasco; J Daunis-I-Estadella; F Prados; S Remollo; A Prats-Galino; G Soria; I Boada; M Castellanos; J Serena Journal: AJNR Am J Neuroradiol Date: 2011-04-07 Impact factor: 3.825
Authors: Eric Zarahn; Leeor Alon; Sophia L Ryan; Ronald M Lazar; Magnus-Sebastian Vry; Cornelius Weiller; Randolph S Marshall; John W Krakauer Journal: Cereb Cortex Date: 2011-04-28 Impact factor: 5.357