Comparison of Transcallosal Inhibition Between Hemispheres and Its Relationship with Motor Behavior in Patients with Severe Upper Extremity Impairment After Subacute Stroke |
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| Affiliation: | 1. Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;2. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran;3. Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;4. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;5. Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia;1. Department of Neurology, Institute of Post Graduate Medical Education & Research, Bangur Institute of Neurosciences, Kolkata, India;2. Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India;1. University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, United States;2. HealthPartners Neuroscience Center, United States;3. HealthPartners Institute, United States;1. Department of Vascular Surgery, Escuela de Medicina, Pontificia Universidad Católica de Chile;2. Department of Neurology, Escuela de Medicina, Pontificia Universidad Católica de Chile;3. Center for Endovascular Therapy, Pontificia Universidad Católica de Chile;4. Department of Radiology, Escuela de Medicina, Pontificia Universidad Católica de Chile;1. Department of Radiology, the Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Dalian, Liaoning 116027, China;2. Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Dalian, Liaoning 116027, China |
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| Abstract: | ObjectiveTo compare corticospinal excitability and transcallosal inhibition between contralesional primary motor cortex (M1) and ipsilesional M1. We also investigated the correlation between transcallosal inhibition and upper extremity motor behavior.Materials and methods19 individuals with unilateral ischemic subacute stroke who had severe upper extremity impairment participated in this study. Corticospinal excitability was assessed by measuring the resting motor threshold, active motor threshold and motor evoked potential amplitude. Transcallosal inhibition was investigated by measuring the duration and depth of the ipsilateral silent period (ISP). The data from the two hemispheres were compared and the relationships of transcallosal inhibition with upper extremity motor impairment, grip strength and pinch strength were analyzed.ResultsResting motor threshold (p = 0.001) and active motor threshold (p = 0.001) were lower and motor evoked potential amplitude was higher (p = 0.001) in the contralesional M1 compared to the ipsilesional M1. However, there were no differences between the two M1s in ISP duration (p = 0.297) or ISP depth (p =0. 229). Transcallosal inhibition from the contralesional M1 was positively associated with motor impairment (ISP duration, p = 0.003; ISP depth, p = 0.017) and grip strength (ISP duration, p = 0.016; ISP depth, p = 0.045).ConclusionsSymmetric transcallosal inhibition between hemispheres and positive association of transcallosal inhibition from contralesional M1 with upper extremity motor behavior indicate that recruitment of contralesional M1 may be necessary for recovery in patients with severe upper extremity impairment after subacute ischemic stroke. |
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