Effects of paired associated stimulation with different stimulation position on motor cortex excitability and upper limb motor function in patients with cerebral infarction |
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| Affiliation: | 1. Department of Rehabilitation Medicine, The Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, China;2. Department of Rehabilitation Medicine, The 5th Hospital of Zhengzhou University, Zhengzhou 470000, China;3. Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;1. Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, London, United Kingdom;2. Department of Translational Medicine, Section of Neurology, University of Piemonte Orientale ‘‘A. Avogadro’’, Novara, Italy;3. Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. Department of Neurology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan;1. Department of Neurosurgery, Changshu No.2 People’s Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu Province, China;2. Department of Radiology, Changshu No.2 People’s Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu Province, China;3. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China;4. Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China;1. Medical School of Nankai University, No. 94, Weijin Road, Naikai District, 300071 Tianjin, People’s Republic of China;2. Department of Neurosurgery, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, People’s Republic of China;1. Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy;2. nità di Psichiatria II, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy;3. Aldo Ravelli” Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Italy;4. Unità Operativa di Psichiatria, Presidio San Carlo, ASST Santi Paolo e Carlo, Milano, Italy;5. AOU Senese Policlinico Santa Maria alle Scotte, Italy;6. Clinica Neurologica III, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy;7. Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St George’s University of London, United Kingdom;1. Department of Neurosurgery, Changhai Hospital, Navy Military Medical University, Shanghai 200433, People’s Republic of China;2. Naval Medical Center of PLA, Navy Military Medical University, Shanghai 200050, People’s Republic of China;1. Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China |
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| Abstract: | ObjectiveTo investigate the effects of paired associated stimulation (PAS) with different stimulation position on motor cortex excitability and upper limb motor function in patients with cerebral infarction.MethodA total of 120 volunteers with cerebral infarction were randomly divided into four groups. Based on conventional rehabilitation treatment, the PAS stimulation group was given the corresponding position of PAS treatment once a day for 28 consecutive days. The MEP amplitude and RMT of both hemispheres were assessed before and after treatment, and a simple upper limb Function Examination Scale (STEF) score, simplified upper limb Fugl–Meyer score (FMA), and improved Barthel Index (MBI) were used to assess upper limb motor function in the four groups.ResultsFollowing PAS, the MEP amplitude decreased, and the RMT of abductor pollicis brevis (APB) increased on the contralesional side, while the MEP amplitude increased and the RMT of APB decreased on the ipsilesional side. After 28 consecutive days the scores of STEF, FMA, and MBI in the bilateral stimulation group were significantly better than those in the ipsilesional stimulation group and the contralesional stimulation group, but there was no significant difference in the scores of STEF, FMA, and MBI between the ipsilesional stimulation group and the contralesional stimulation group.ConclusionThe excitability of the motor cortex can be changed when the contralesional side or the ipsilesional side was given the corresponding PAS stimulation, while the bilateral PAS stimulation can more easily cause a change of excitability of the motor cortex, resulting in better recovery of the upper limb function. |
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| Keywords: | Cerebral infarction Paired associative stimulation Cortical plasticity Motor cortex excitability Motor function |
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