Marcel Simis1, Vincenzo Di Lazzaro2, Adam Kirton3, Giovanni Pennisi4, Rita Bella4, Yun-Hee Kim5, Naoyuki Takeuchi6, Eman M Khedr7, Lynn M Rogers8, Richard Harvey8, Satoko Koganemaru9, Bulent Turman10, Sultan Tarlacı11, Rubens J Gagliardi12, Felipe Fregni13. 1. Harvard Medical School, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Laboratory of Neuromodulation, Boston, USA; Santa Casa Medical School, Division of Neurology, Sao Paulo, Brazil; University of Sao Paulo Medical School General Hospital, Physical and Rehabilitation Medicine Institute, Sao Paulo, Brazil. 2. Università Campus Biomedico, Institute of Neurology, Rome, Italy. 3. University of Calgary, Alberta Children's Hospital Research Institute, Calgary Pediatric Stroke Program, Calgary, Alberta, Canada. 4. University of Catania, Section of Neurosciences, Department GF Ingrassia, Catania, Italy. 5. Sungkyunkwan University, School of Medicine, Samsung Medical Center, Heart Vascular Stroke Institute, Department of Physical and Rehabilitation Medicine, Seoul, Republic of Korea. 6. Tohoku University Graduates School of Medicine, Department of Physical Medicine and Rehabilitation, Sendai, Japan. 7. Assiut University Hospital, Faculty of Medicine, Department of Neurology, Assiut, Egypt. 8. Rehabilitation Institute of Chicago, Sensory Motor Performance Program, Chicago, USA; Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, Chicago, USA. 9. Kyoto University Graduate School of Medicine, Human Brain Research Center, Kyoto, Japan. 10. Bond University, School of Medicine, Robina, Australia. 11. Sifa University, Izmir, Turkey. 12. Santa Casa Medical School, Division of Neurology, Sao Paulo, Brazil. 13. Harvard Medical School, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Laboratory of Neuromodulation, Boston, USA. Electronic address: Fregni.Felipe@mgh.harvard.edu.
Abstract
OBJECTIVES: Transcranial magnetic stimulation (TMS) has been used to measure cortical excitability as a functional measurement of corticomotor pathways. Given its potential application as an assessment tool in stroke, we aimed to analyze the correlation of TMS parameters with clinical features in stroke using data from 10 different centers. METHODS: Data of 341 patients with a clinical diagnosis of stroke were collected from studies assessing cortical excitability using TMS. We used a multivariate regression model in which the baseline cortical excitability parameter "resting Motor Threshold (rMT)" was the main outcome and the demographic, anatomic and clinical characteristics were included as independent variables. RESULTS: The variable "severity of motor deficit" consistently remained significant in predicting rMT in the affected hemisphere, with a positive β coefficient, in the multivariate models after sensitive analyses and adjusting for important confounders such as site center. Additionally, we found that the correlations between "age" or "time since stroke" and the rMT in the affected hemisphere were significant, as well as the interaction between "time since stroke" and "severity of motor deficit". CONCLUSIONS: We have shown that severity of motor deficit is an important predictor for rMT in the affected hemisphere. Additionally, time since stroke seems to be an effect modifier for the correlation between motor deficit and rMT. In the unaffected motor cortex, these correlations were not significant. We discuss these findings in the context of stroke rehabilitation.
OBJECTIVES: Transcranial magnetic stimulation (TMS) has been used to measure cortical excitability as a functional measurement of corticomotor pathways. Given its potential application as an assessment tool in stroke, we aimed to analyze the correlation of TMS parameters with clinical features in stroke using data from 10 different centers. METHODS: Data of 341 patients with a clinical diagnosis of stroke were collected from studies assessing cortical excitability using TMS. We used a multivariate regression model in which the baseline cortical excitability parameter "resting Motor Threshold (rMT)" was the main outcome and the demographic, anatomic and clinical characteristics were included as independent variables. RESULTS: The variable "severity of motor deficit" consistently remained significant in predicting rMT in the affected hemisphere, with a positive β coefficient, in the multivariate models after sensitive analyses and adjusting for important confounders such as site center. Additionally, we found that the correlations between "age" or "time since stroke" and the rMT in the affected hemisphere were significant, as well as the interaction between "time since stroke" and "severity of motor deficit". CONCLUSIONS: We have shown that severity of motor deficit is an important predictor for rMT in the affected hemisphere. Additionally, time since stroke seems to be an effect modifier for the correlation between motor deficit and rMT. In the unaffected motor cortex, these correlations were not significant. We discuss these findings in the context of stroke rehabilitation.
Authors: Vishwanath Sankarasubramanian; Andre G Machado; Adriana B Conforto; Kelsey A Potter-Baker; David A Cunningham; Nicole M Varnerin; Xiaofeng Wang; Ken Sakaie; Ela B Plow Journal: Clin Neurophysiol Date: 2017-03-21 Impact factor: 3.708
Authors: Charlotte Rosso; Eric Jr Moulton; Claire Kemlin; Sara Leder; Jean-Christophe Corvol; Sophien Mehdi; Mickael A Obadia; Mickael Obadia; Marion Yger; Elena Meseguer; Vincent Perlbarg; Romain Valabregue; Serena Magno; Pavel Lindberg; Sabine Meunier; Jean-Charles Lamy Journal: Neurotherapeutics Date: 2022-02-28 Impact factor: 6.088
Authors: Deniz Doruk; Marcel Simis; Marta Imamura; André R Brunoni; Leon Morales-Quezada; Renato Anghinah; Felipe Fregni; Linamara R Battistella Journal: Front Hum Neurosci Date: 2016-08-30 Impact factor: 3.169