Movement related cortical potentials in severe chronic stroke.

Movement related cortical potentials (MRCPs) have been studied for many years and controlled using brain computer interfaces (BCIs). Furthermore, MRCPs have been proposed as reliable and immediate indicators of cortical reorganizations in motor learning and after stroke. In this study MRCPs preceding and during hand movements in severe chronic stroke were investigated. Eight severely impaired (no residual finger extension) chronic stoke patients underwent EEG and EMG recordings during a cue triggered hand movement paradigm. Four patients presented subcortical lesions only while the other four presented mixed (cortical and subcortical) lesions. MRCPs were measured before (slow cortical potentials SCPs) and at movement onset (motor potentials MPs). SCPs were observed during paretic hand movements only. Latencies were longer and reached their negativity peak earlier during paretic hand movement. When dividing the patients in subcortical only and mixed lesion patients, we observed significantly bigger MP peak amplitudes over the lesioned hemisphere during paretic and healthy hand movements in subcortical stroke patients. Furthermore, we observed a significant difference in MP peak latency between subcortical and mixed stroke patients during paretic hand movements. We demonstrated for the first time significant differences between subcortical only and mixed (cortical and subcortical) stroke patients' MRCPs during motor preparation and execution. Furthermore, we demonstrated how stroke produces a longer MRCP and that lesion location affects MP peak amplitude and latency. Finally, we propose the use MRCP based BCIs to reduce their duration (towards normal) and induce motor function recovery.