Standing Neurophysiological Assessment of Lower Extremity Muscles Post-Stroke.
Standing Neurophysiological Assessment of Lower Extremity Muscles Post-Stroke.
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DOI：
10.3791/62601
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发表时间：
2021-07-26
期刊：
影响因子：
--
通讯作者：
Bowden MG
中科院分区：
文献类型：
--
作者：
Kindred JH;Finetto C;Cash JJ;Bowden MG
经颅磁刺激（TMS）是一种常用的工具，用于测量健康和神经功能受损人群的运动回路的行为。经颅磁刺激被广泛用于研究运动控制和上肢神经康复的反应。然而，TMS在下肢姿势和行走特定运动控制的研究中较少使用。下肢TMS评估的有限使用和额外的方法学挑战导致文献中下肢TMS程序缺乏一致性。受下肢经颅磁刺激运动诱发电位（MEP）记录能力下降的启发，本方法报告详细介绍了在站立姿势下进行卒中后经颅磁刺激评估的步骤。站立姿势允许神经肌肉系统的激活，反映了更类似于姿势和行走任务期间的系统状态的状态。使用双顶测力板，我们指导参与者将体重平均分配在轻瘫和非轻瘫腿之间。提供了参与者体重分布的视觉反馈。使用图像引导软件，我们通过双锥形线圈向参与者的病变和非病变半球输送单个TMS脉冲，并测量麻痹和非麻痹胫骨前肌和比目鱼肌的皮质运动反应。与标准坐姿/休息位相比，在站立位进行评估增加了TMS反应率，并允许使用较低的刺激强度。当对姿势和步态障碍的神经康复感兴趣时，使用该TMS方案可以提供评估卒中后下肢皮质运动反应的通用方法。本方案描述了在卒中后患者中使用TMS在站立位对下肢肌肉、胫骨前肌和比目鱼肌进行神经生理学评估的过程。该位置提供了引发卒中后TMS反应的更大可能性，并允许在神经生理学评估期间使用降低的刺激器功率。
Transcranial magnetic stimulation (TMS) is a common tool used to measure the behavior of motor circuits in healthy and neurologically impaired populations. TMS is used extensively to study motor control and the response to neurorehabilitation of the upper extremities. However, TMS has been less utilized in the study of lower extremity postural and walking-specific motor control. The limited use and the additional methodological challenges of lower extremity TMS assessments have contributed to the lack of consistency in lower extremity TMS procedures within the literature. Inspired by the decreased ability to record lower extremity TMS motor evoked potentials (MEP), this methodological report details steps to enable post-stroke TMS assessments in a standing posture. The standing posture allows for the activation of the neuromuscular system, reflecting a state more akin to the system’s state during postural and walking tasks. Using dual-top force plates, we instructed participants to equally distribute their weight between their paretic and non-paretic legs. Visual feedback of the participants’ weight distribution was provided. Using image guidance software, we delivered single TMS pulses via a double-cone coil to the participants’ lesioned and non-lesioned hemispheres and measured the corticomotor response of the paretic and non-paretic tibialis anterior and soleus muscles. Performing assessments in the standing position increased the TMS response rate and allowed for the use of the lower stimulation intensities compared to the standard sitting/resting position. Utilization of this TMS protocol can provide a common approach to assess the lower extremity corticomotor response post-stroke when the neurorehabilitation of postural and gait impairments are of interest. This protocol describes the process for performing a neurophysiological assessment of the lower extremity muscles, tibialis anterior and soleus, in a standing position using TMS in people post-stroke. This position provides a greater probability of eliciting a post-stroke TMS response and allows for the use of reduced stimulator power during neurophysiological assessments.
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影响因子：
2.5
作者：
Hermens, HJ;Freriks, B;Rau, G
通讯作者：
Rau, G
深部经颅磁刺激过程中不同线圈配置的感应场比较
影响因子：
3.7
作者：
Lu M;Ueno S
通讯作者：
Ueno S
影响因子：
2.5
作者：
Mishory, A;Molnar, C;George, MS
通讯作者：
George, MS
影响因子：
4.6
作者：
Ammann C;Guida P;Caballero-Insaurriaga J;Pineda-Pardo JA;Oliviero A;Foffani G
通讯作者：
Foffani G
影响因子：
3.3
作者：
Mouthon, A.;Taube, W.
通讯作者：
Taube, W.