Electroencephalogram (EEG) With or Without Transcranial Magnetic Stimulation (TMS) as Biomarkers for Post-stroke Recovery: A Narrative Review.
Electroencephalogram (EEG) With or Without Transcranial Magnetic Stimulation (TMS) as Biomarkers for Post-stroke Recovery: A Narrative Review.
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DOI：
10.3389/fneur.2022.827866
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发表时间：
2022
影响因子：
3.4
通讯作者：
Lundstrom BN
中科院分区：
文献类型：
--
作者：
Keser Z;Buchl SC;Seven NA;Markota M;Clark HM;Jones DT;Lanzino G;Brown RD Jr;Worrell GA;Lundstrom BN
中风是导致死亡和残疾的主要原因之一。尽管中风发病率很高，但描述中风后的急性神经恢复模式并预测长期恢复仍然具有挑战性。仍然缺乏量化和表征神经损伤的客观方法。由于神经影像方法的时间分辨率较差，脑电图已被用作描述中风后各种缺陷（包括运动、语言和认知）恢复机制以及预测对实验疗法的治疗反应的方法。此外，经颅磁刺激（TMS）是一种非侵入性脑刺激形式，已与脑电图（TMS-EEG）结合使用，以评估各种适应症的神经生理学。 TMS-EEG 在利用局灶性 TMS 诱发电位和振荡探索大脑连接方面具有巨大潜力，这可能允许对中风后恢复模式进行系统特定的描绘。在这篇综述中，我们总结了脑电图单独使用或与 TMS 结合在中风后运动、语言、认知和功能/整体恢复中的应用。总体而言，中风导致受损半球的高频活动（≥8 Hz）和半球内连接性减少，从而造成未受损半球和受损半球之间的活动不平衡。未病变半球的代偿活动大多会导致不利的结果并进一步加剧半球间的不平衡。受损网络中半球间活动的平衡和半球内一致性的增加与中风后恢复的改善相关。 TMS-EEG 研究揭示了感觉运动皮层内的皮层反应性和功能连接对于中风后运动恢复的临床重要性。尽管中风后运动研究支持 TMS-EEG 的预后价值，但还需要更多的研究来确定其作为语言、认知和半空间忽视等领域恢复的生物标志物的效用。作为基于 MRI 的技术的补充，基于脑电图的技术是中风神经病学中易于使用且有价值的非侵入性临床工具。
Stroke is one of the leading causes of death and disability. Despite the high prevalence of stroke, characterizing the acute neural recovery patterns that follow stroke and predicting long-term recovery remains challenging. Objective methods to quantify and characterize neural injury are still lacking. Since neuroimaging methods have a poor temporal resolution, EEG has been used as a method for characterizing post-stroke recovery mechanisms for various deficits including motor, language, and cognition as well as predicting treatment response to experimental therapies. In addition, transcranial magnetic stimulation (TMS), a form of non-invasive brain stimulation, has been used in conjunction with EEG (TMS-EEG) to evaluate neurophysiology for a variety of indications. TMS-EEG has significant potential for exploring brain connectivity using focal TMS-evoked potentials and oscillations, which may allow for the system-specific delineation of recovery patterns after stroke. In this review, we summarize the use of EEG alone or in combination with TMS in post-stroke motor, language, cognition, and functional/global recovery. Overall, stroke leads to a reduction in higher frequency activity (≥8 Hz) and intra-hemispheric connectivity in the lesioned hemisphere, which creates an activity imbalance between non-lesioned and lesioned hemispheres. Compensatory activity in the non-lesioned hemisphere leads mostly to unfavorable outcomes and further aggravated interhemispheric imbalance. Balanced interhemispheric activity with increased intrahemispheric coherence in the lesioned networks correlates with improved post-stroke recovery. TMS-EEG studies reveal the clinical importance of cortical reactivity and functional connectivity within the sensorimotor cortex for motor recovery after stroke. Although post-stroke motor studies support the prognostic value of TMS-EEG, more studies are needed to determine its utility as a biomarker for recovery across domains including language, cognition, and hemispatial neglect. As a complement to MRI-based technologies, EEG-based technologies are accessible and valuable non-invasive clinical tools in stroke neurology.
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影响因子：
4.2
作者：
Boenstrup, M.;Schulz, R.;Gerloff, C.
通讯作者：
Gerloff, C.
影响因子：
2
作者：
Cuspineda, E.;Machado, C.;Avila, Y.
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Avila, Y.
影响因子：
64.8
作者：
Cohen, LG;Celnik, P;Hallett, M
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Hallett, M
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8.3
作者：
CILLESSEN, JPM;VANHUFFELEN, AC;VANGIJN, J
通讯作者：
VANGIJN, J
影响因子：
5.7
作者：
Casali, Adenauer G.;Casarotto, Silvia;Massimini, Marcello
通讯作者：
Massimini, Marcello