Motor Cortex Plasticity Predicts Recovery in Acute Stroke
Motor Cortex Plasticity Predicts Recovery in Acute Stroke
复制标题
DOI：
10.1093/cercor/bhp216
复制
发表时间：
2010-07-01
期刊：
影响因子：
3.7
通讯作者：
Dileone, M.
中科院分区：
文献类型：
--
作者：
Di Lazzaro, Vincenzo;Profice, P.;Dileone, M.
重复经颅磁刺激大脑作为间歇性θ爆发刺激（iTBS）可以诱导长时程增强（LTP）样变化的刺激半球和长时程抑郁（LTD）样变化的对侧半球。我们评估了iTBS在急性卒中中产生的LTP和LTD样变化是否与6个月时的结局相关。通过测定17例急性缺血性脑卒中患者在基础状态下和iTBS后患侧半球（AH）和健侧半球（UH）的运动阈值和运动诱发电位（MEP）幅度，评价AH和UH的兴奋性。AH诱发的MEP的基线振幅显著小于UH诱发的MEP，AH诱发的MEP的基线运动阈值较高。UH患者MEP基线值较高与预后不良相关。iTBS使AH的MEP振幅显著增加，这与恢复显著相关。在UH中观察到MEP振幅的非显著性降低。当UH MEP振幅的降低被添加到回归模型中时，相关性甚至更高。功能恢复与AH的LTP样变化和UH的LTD样变化直接相关，与UH的基线兴奋性负相关。
Repetitive transcranial magnetic stimulation of the brain given as intermittent theta burst stimulation (iTBS) can induce long-term potentiation (LTP)-like changes in the stimulated hemisphere and long-term depression (LTD)-like changes in the opposite hemisphere. We evaluated whether LTP- and LTD-like changes produced by iTBS in acute stroke correlate with outcome at 6 months. We evaluated the excitability of affected hemisphere (AH) and unaffected hemisphere (UH) by measuring motor threshold and motor-evoked potential (MEP) amplitude under baseline conditions and after iTBS of AH in 17 patients with acute ischemic stroke. Baseline amplitude of MEPs elicited from AH was significantly smaller than that of MEPs elicited from UH, and baseline motor threshold was higher for the AH. Higher baseline MEP values in UH correlated with poor prognosis. iTBS produced a significant increase in MEP amplitude for AH that was significantly correlated with recovery. A nonsignificant decrease in MEP amplitude was observed for the UH. When the decrease in the amplitude of UH MEPs was added to the regression model, the correlation was even higher. Functional recovery is directly correlated with LTP-like changes in AH and LTD-like changes in UH and inversely correlated with the baseline excitability of UH.