Correlation of motor evoked potentials to motor deficit during the recovery of ischaemic stroke

Zgur, T; Prevec, Tine S.; Goljar, Nika

doi:10.1016/0013-4694(93)91331-t

Cited by 7 publications

(7 citation statements)

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“…Many studies have dealt with transcranial motor cortex stimulation in stroke patients. 13,18,19,23,27,28 The CMCTs were grouped in these studies as normal, delayed, and absent, and the change in CMCT was assessed according to this classification. According to their reports, no significant change of the CMCT was observed in the acute phase of ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Effects of Spontaneous Recanalization on Functional and Electrophysiological Recovery in Acute Ischemic Stroke

Vang

Dunbabin

Kilpatrick

1999

Stroke

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Background and Purpose-Transcranial Doppler ultrasound (TCD) studies have shown that spontaneous recanalization results in a better clinical improvement after the onset of stroke. However, its effect on electrophysiological recovery is still unknown. The aim of this study was to determine the effects of spontaneous recanalization on the change in central motor conduction time (CMCT) in acute ischemic stroke. Methods-Seventeen healthy subjects and 38 consecutive patients with a first acute ischemic stroke involving the middle cerebral artery territory were included. TCD was used to detect spontaneous recanalization. Transcranial magnetic stimulation was used to determine the change in CMCT on days 1 and 14. Improvement of the CMCT at day 14 was indicated if it decreased in comparison with previous data recorded at day 1 or when a nonrecordable motor response at day 1 reappeared at day 14. No CMCT improvement was indicated when there was no recordable motor response at day 1 and day 14 or the CMCT at day 14 worsened, becoming absent or more delayed. The Pearson 2 test was used to assess the statistical significance of the results in this study. Results-Spontaneous recanalization was observed in 62% of the patients: 24% before 24 hours and 38% after this period.No recanalization was observed in 14 patients. The CMCT improved in 87% of the patients who had recanalized before 24 hours and 62% in the recanalized after 24 hours group (Pϭ0.005). In contrast, CMCT improved in only 17% of the patients in the non-recanalized group Conclusions-These data show that spontaneous recanalization results in a better recovery of the central motor pathway leading to a better CMCT improvement in acute ischemic stroke. (Stroke. 1999;30:2119-2125.)

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Section: Discussionmentioning

confidence: 99%

Effects of Spontaneous Recanalization on Functional and Electrophysiological Recovery in Acute Ischemic Stroke

Vang

Dunbabin

Kilpatrick

1999

Stroke

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“…7,8,11,12,17,18 The CMCTs were grouped in these studies as normal, delayed, and absent, and the change in CMCT was assessed according to this classification. According to their reports, no significant change of the CMCT was observed in the acute phase of ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Functional and Electrophysiological Recovery in Acute Ischemic Stroke

Vang

Dunbabin

Kilpatrick

1999

Stroke

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Background and Purpose-There is still controversy about the prognostic value of motor evoked potentials (MEPs) in the assessment of hemiplegia. The aims of this study are to determine the relationship between functional and electrophysiological recovery and thus the value of MEP as a prognostic indicator of clinical outcome in acute ischemic stroke. Methods-Seventeen healthy subjects and 38 stroke patients were included in this study. Functional recovery was assessed with the Modified Canadian Neurological Scale (MCNS), the Barthel Activities of Daily Living Index (BI), and the Rankin scale. Transcranial magnetic stimulation was used to determine the change in central motor conduction time (CMCT). Stroke outcome was assessed at the end of 2 weeks. One-way ANOVA with post hoc comparisons using the Scheffé procedure as well as t tests were used to assess the significance of the results in this study. Results-Unpaired t test showed significantly higher mean scores of the MCNS (2Pϭ0.001), BI (2Pϭ0.002), and Rankin scale (PϽ0.001) at day 14 in the group of patients with recordable MEP at day 1. A better clinical improvement with a higher mean score of the MCNS (2PϽ0.001), BI (2PϽ0.001), and the Rankin scale (2PϽ0.001) was also observed in the patients in whom the CMCT improved. Conclusions-These data show that there is a close relationship between clinical and electrophysiological improvement and that MEP is a useful prognostic indicator of clinical outcome.

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“…16 The recent development of a non-invasive method of transcranial magnetic stimulation20 allows evaluation of the central motor pathways. Since 1989, studies have been conducted to assess the value of motor evoked potentials (MEPs) in patients with stroke, mainly in the prediction of overall functional outcome10 13 15 16 21-27 but also of motor19 21 22 25 28 or functional25 29recovery of the upper limb. There is no consensus on the results.…”

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confidence: 99%

Value of somatosensory and motor evoked potentials in predicting arm recovery after a stroke

Feys

Hees²,

Bruyninckx³

et al. 2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Objectives-Prediction of motor recovery in the arm in patients with stroke is generally based on clinical examination. However, neurophysiological measures may also have a predictive value. The aims of this study were to assess the role of somatosensory (SSEPs) and motor (MEPs) evoked potentials in the prediction of arm motor recovery and to determine whether these measures added further predictive information to that gained from clinical examination. Methods-Sixty four patients who had had a stroke and presented with obvious motor deficit of the arm were examined in terms of three clinical variables (motor performance, muscle tone, and overall disability) and for SSEPs and MEPs. Clinical and neurophysiological examinations were done at entry to the study (2 to 5 weeks poststroke), and at about 2 months after stroke. Further clinical follow up was conducted at 6 and 12 months after stroke. Results-Neurophysiological measures made in the acute phase were of little use alone in predicting motor recovery of the arm at 2, 6, and 12 months after stroke. At 2 months, the absence of SSEPs and MEPs indicated a very poor outcome. Conversely, if the responses were preserved, a great variation in motor outcome was found. Multiple regression analysis showed that the addition of SSEPs and MEPs to the clinical examination increased the possibility of predicting arm recovery in the long term. In the acute phase, the combination of the motor score and SSEPs were best able to predict outcome. The long term outcome based on variables taken at 2 months, was best predicted through incorporating the three clinical measures and MEPs. Conclusions-Neurophysiological measures alone are of limited value in predicting long term outcome. However, predictive accuracy is substantially improved through the combined use of both of these measures and clinical variables. (J Neurol Neurosurg Psychiatry 2000;68:323-331)

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Correlation of motor evoked potentials to motor deficit during the recovery of ischaemic stroke

Cited by 7 publications

References 0 publications

Effects of Spontaneous Recanalization on Functional and Electrophysiological Recovery in Acute Ischemic Stroke

Effects of Spontaneous Recanalization on Functional and Electrophysiological Recovery in Acute Ischemic Stroke

Correlation Between Functional and Electrophysiological Recovery in Acute Ischemic Stroke

Value of somatosensory and motor evoked potentials in predicting arm recovery after a stroke

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