BACKGROUND AND PURPOSE: The early prognostic application of transcranial magnetic brain stimulation (TMS) for assessing motor and functional recovery in ischemic stroke patients has yielded contradictory results. We performed a prospective study of patients with acute ischemic stroke and motor deficit to evaluate the early prognostic value of TMS in motor and functional recovery. METHODS: Fifty patients with different degrees of hemiparesis were studied in the first week after ischemic stroke and evaluated by clinical scales (Medical Research Council Scale, Canadian Neurological Scale, Barthel Index), with clinical follow-up over 6 months. TMS (Magstim 200) was performed at the same time, recording the motor evoked potential (MEP) in the thenar eminence muscles, with facilitation by voluntary contraction. RESULTS: Of the total group of 50 patients, MEP was absent in 20 and present in 30 (17 with normal and 13 with delayed central conduction time [CCT]). The patients with MEP showed better motor and functional recovery than those without. The MEP provided information on patient recovery, regardless of the initial strength and/or Barthel values. The degree of recovery was better in those patients with normal CCT than in those with delayed CCT. CONCLUSIONS: MEP obtained by TMS in patients with hemiparesis after acute ischemic stroke is useful as an early prognostic indicator of motor and functional recovery. This technique would allow the early identification of those patients who will have a good recovery, particularly among those with severe initial paresis.
BACKGROUND AND PURPOSE: The early prognostic application of transcranial magnetic brain stimulation (TMS) for assessing motor and functional recovery in ischemic strokepatients has yielded contradictory results. We performed a prospective study of patients with acute ischemic stroke and motor deficit to evaluate the early prognostic value of TMS in motor and functional recovery. METHODS: Fifty patients with different degrees of hemiparesis were studied in the first week after ischemic stroke and evaluated by clinical scales (Medical Research Council Scale, Canadian Neurological Scale, Barthel Index), with clinical follow-up over 6 months. TMS (Magstim 200) was performed at the same time, recording the motor evoked potential (MEP) in the thenar eminence muscles, with facilitation by voluntary contraction. RESULTS: Of the total group of 50 patients, MEP was absent in 20 and present in 30 (17 with normal and 13 with delayed central conduction time [CCT]). The patients with MEP showed better motor and functional recovery than those without. The MEP provided information on patient recovery, regardless of the initial strength and/or Barthel values. The degree of recovery was better in those patients with normal CCT than in those with delayed CCT. CONCLUSIONS: MEP obtained by TMS in patients with hemiparesis after acute ischemic stroke is useful as an early prognostic indicator of motor and functional recovery. This technique would allow the early identification of those patients who will have a good recovery, particularly among those with severe initial paresis.
Authors: James C Eliassen; Erin L Boespflug; Martine Lamy; Jane Allendorfer; Wen-Jang Chu; Jerzy P Szaflarski Journal: Top Stroke Rehabil Date: 2008 Sep-Oct Impact factor: 2.119
Authors: Heidi M Schambra; Jing Xu; Meret Branscheidt; Martin Lindquist; Jasim Uddin; Levke Steiner; Benjamin Hertler; Nathan Kim; Jessica Berard; Michelle D Harran; Juan C Cortes; Tomoko Kitago; Andreas Luft; John W Krakauer; Pablo A Celnik Journal: Neurorehabil Neural Repair Date: 2019-06-06 Impact factor: 3.919
Authors: Wuwei Feng; Jasmine Wang; Pratik Y Chhatbar; Christopher Doughty; Douglas Landsittel; Vasileios-Arsenios Lioutas; Steven A Kautz; Gottfried Schlaug Journal: Ann Neurol Date: 2015-10-31 Impact factor: 10.422