Document Detail

How reproducible are transcranial magnetic stimulation induced Motor Evoked Potentials in subacute stroke?
MedLine Citation:
PMID:  25233245     Owner:  NLM     Status:  Publisher    
OBJECTIVE:: Motor evoked potentials (MEPs) and total motor conduction time (TMCT) induced by transcranial magnetic stimulation (TMS) are used to make assumptions about the prognosis of motor outcome after stroke. Understanding the different sources of variability is fundamental to the concept of reliability. Reliability testing of TMS-MEPs and TMCTs within and between two independent examiners in healthy and stroke subjects is still an unexplored field in the clinical neurophysiology. Assessing the reproducibility of transcranial magnetic stimulation (TMS) measurements requires studies to investigate the test-retest reliability of TMS induced motor evoked potentials (MEPs) and total motor conduction time (TMCT). We set out to test the reliability of these TMS measurements.
METHODS:: Eighteen stroke patients and eight healthy volunteers were tested twice within a one-week period by two examiners using TMS to determine MEPs and TMCT for the abductor pollicis brevis (APB) muscle of their affected and unaffected hands.
RESULTS:: We found moderate to perfect reliability of TMS-induced MEPs in healthy volunteers, non-infarcted hemispheres (perfect agreement) and infarcted hemispheres (Kappa= .45 - .87). Reliability of TMCT was good to excellent in the volunteers (ICC= .77 - .97), excellent in the non-infarcted hemispheres (ICC= .97 - 1.00) and poor to excellent in the infarcted hemispheres (ICC = .44 - .90).
CONCLUSION:: The reliability of TMS- induced MEPs and TMCT measurements in healthy volunteers and the non-infarcted hemisphere of stroke patients with an upper paretic limb was good to excellent. In contrast, TMS measurements in the infarcted hemisphere were less consistent. Based on the lower reproducibility of TMCT measurements in the infarcted hemisphere, we recommend to repeat the TMCT measurements to improve the reliability of tests.
Maurits H W J Hoonhorst; Boudewijn J Kollen; Peter S P van den Berg; Cornelis H Emmelot; Gert Kwakkel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-17
Journal Detail:
Title:  Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society     Volume:  -     ISSN:  1537-1603     ISO Abbreviation:  J Clin Neurophysiol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506708     Medline TA:  J Clin Neurophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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