FEASIBILITY OF PROBING CORTICOSPINAL EXCITABILITY IN SEVERAL UPPER LIMB MUSCLES IN STROKE PATIENTS WITH UPPER LIMB MOTOR DEFICIT (ID 1963)
- Maria Nazarova (Russian Federation)
- Victoria Tsivilyova (Russian Federation)
- Timur Ivanov (Russian Federation)
- Yulia Voronkova (Russian Federation)
- Tatyana Abramova (Russian Federation)
- Elena Kovragzkina (Russian Federation)
- Sergey A. Gulyaev (Russian Federation)
- Alexandra Trofimova (Russian Federation)
- Iliya Gubskii (Russian Federation)
- Tatiana Rostovtseva (Russian Federation)
- Anait Nikogosova (Russian Federation)
- Maria Bulatova (Russian Federation)
- Boris Polyaev (Russian Federation)
- Aminat Dolova (Russian Federation)
- Pavel Novikov (Russian Federation)
- Vadim Nikulin (Germany)
- Vladimir Lelyuk (Russian Federation)
- Galina Ivanova (Russian Federation)
Abstract
Background And Aims
The possibility to evoke a motor response (MEP) in a hand muscle by transcranial magnetic stimulation (TMS) is a common proxy of the corticospinal tract integrity after a motor stroke. However, it is still not clear how many muscles should be studied, and which muscles are preferable to probe. Here we aimed to investigate corticospinal excitability in several muscles in stroke patients with upper limb motor deficit.
Methods
We enrolled 31 stroke patients (15 females, mean 54 [38–83] y.o, 4 [1–11] months poststroke) with a single clinical episode of stroke and unilateral hand weakness, assessed by Fugl-Meyer Upper Extremity Scale. We measured corticospinal excitability in three hand muscles of the paretic limb and in one muscle in the unaffected hand.
Results
7 out of 24 patients (29%) with MEPs in the affected hand had MEPs in just one or two muscles, no significant difference was found among resting motor thresholds (RMTs) of the affected hand muscles. While MEP negative patients were all severely affected, patients with MEPs varied extensively in their paresis level. RMT ratio between affected and unaffected hemispheres was the most correlated parameter with the motor deficit (CI:-0.75 to−0.16; P=0.005).
Conclusions
Our preliminary results highlight the importance of several muscles investigation for the purpose of MEP finding to increase the amount of MEP positive stroke patients, which is crucial for neurorehabilitation trials. Longitudinal studies are needed to elucidate whether the difference in corticospinal excitability among muscles has an added value for recovery prediction.
