Document Detail

Can motor recovery in stroke patients be predicted by early transcranial magnetic stimulation?
MedLine Citation:
PMID:  8969779     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: We used transcranial magnetic stimulation of the motor cortex to evaluate the functional state of corticospinal pathways innervating the first dorsal interosseous muscle of the hand in 26 patients suffering from a first-ever ischemic stroke in the middle cerebral artery territory. METHODS: All patients had complete hand palsy and were tested within the first 24 hours from stroke onset. Patients were also tested clinically with the MRC, Rankin, and National Institutes of Health (NIH) stroke scales at day 1 and with MRC and NIH scales and the Barthel Index at day 14. Electrophysiological testing was repeated at day 14. Patients were divided into three subgroups according to the amplitude of the maximal response (motor evoked potential [MEP]) evoked at day 1. RESULTS: After 2 weeks, all 6 patients with initial MEPs > 5% maximum motor response (Mmax) showed some first dorsal interosseous muscle motor function recovery, whereas 19 of 20 patients with initially absent or small (< 5% Mmax) MEPs were left with complete hand palsy. There were strong positive correlations between MEP amplitude at day 1 and MRC and Barthel Index scores at day 14. However, measurement of central motor conduction time proved to be of little prognostic value. CONCLUSIONS: We conclude that early-performed transcranial magnetic stimulation is a valuable prognostic tool for motor recovery from stroke and that relatively preserved MEP amplitude shortly after stroke is a better prognostic factor than normal central motor conduction time.
G Rapisarda; E Bastings; A M de Noordhout; G Pennisi; P J Delwaide
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  27     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-09     Completed Date:  1997-01-09     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2191-6     Citation Subset:  IM    
University Department of Neurology, Università degli Studi di Catania, Italy.
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MeSH Terms
Aged, 80 and over
Brain Ischemia / complications*
Evoked Potentials*
Hand / innervation,  physiopathology
Middle Aged
Motor Cortex / physiopathology*
Muscle, Skeletal / innervation,  physiopathology
Paralysis / etiology,  physiopathology*
Transcranial Magnetic Stimulation / diagnostic use*

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