TY - JOUR
T1 - Neurophysiological measurements of affected and unaffected motor cortex from a cross-sectional, multi-center individual stroke patient data analysis study
AU - Simis, Marcel
AU - Di Lazzaro, Vincenzo
AU - Kirton, Adam
AU - Pennisi, Giovanni
AU - Bella, Rita
AU - Kim, Yun Hee
AU - Takeuchi, Naoyuki
AU - Khedr, Eman M.
AU - Rogers, Lynn M.
AU - Harvey, Richard
AU - Koganemaru, Satoko
AU - Turman, Bulent
AU - Tarlaci, Sultan
AU - Gagliardi, Rubens J.
AU - Fregni, Felipe
N1 - Funding Information:
Some data collection in this study was funded by Nexstim Corporation. Dr. Simis was funded by CAPES (9722/11-4) and Santa Casa de São Paulo Medical School received a grant from FAPESP (2009/02059-7). Yun-Hee Kim was supported by a KOSEF grant (M10644000022-06N4400-02210) funded by the Korean government and by the Samsung Medical Center Clinical Research Development Program (#CRDP CRS-110-05-1).
Publisher Copyright:
© 2016.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - 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.
AB - 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.
KW - Cerebrovascular disease
KW - Cortical excitability
KW - Transcranial magnetic stimulation
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U2 - 10.1016/j.neucli.2016.01.003
DO - 10.1016/j.neucli.2016.01.003
M3 - Article
C2 - 26970808
AN - SCOPUS:84961137549
VL - 46
SP - 53
EP - 61
JO - Neurophysiologie Clinique
JF - Neurophysiologie Clinique
SN - 0987-7053
IS - 1
ER -