Atypical cortical drive during activation of the paretic and nonparetic tibialis anterior is related to gait deficits in chronic stroke
Atypical cortical drive during activation of the paretic and nonparetic tibialis anterior is related to gait deficits in chronic stroke
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DOI：
10.1016/j.clinph.2015.06.013
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发表时间：
2016-01-01
影响因子：
4.7
通讯作者：
Binder-Macleod, Stuart A.
中科院分区：
文献类型：
--
作者：
Palmer, Jacqueline A.;Needle, Alan R.;Binder-Macleod, Stuart A.
目的：皮层驱动在下肢卒中恢复中的作用仍然不明确。本研究的目的是探讨大脑皮层驱动和步态速度之间的关系，在一组中风survivor.Methods：18个人与中风被二分法分为快速或慢速行走组。经颅磁刺激（TMS）被用来收集运动诱发电位（MEP）从胫骨前的每个下肢在休息，轻瘫肌肉收缩，和非轻瘫肌肉收缩。使用运动阈值计算不对称指数（AI），并在组间进行比较。在TMS在最大强度（MEP 100）为每个条件下的平均MEP的麻痹腿进行了比较组内和组间。结果：AI和步行速度之间存在显着的正相关。慢走者在非麻痹性收缩期间的MEP（100）s大于在麻痹性收缩或休息条件下。相比之下，快速步行者有最大的MEP（100）s在轻瘫contractions.Conclusions：皮质运动兴奋性的平衡发生在下肢的运动恢复差的个人中风后的改变。这种非典型的皮质驱动器是依赖于激活的未受影响的半球和收缩的nonparative leg.Significance：了解潜在的运动功能的机制，可以帮助确定特定的患者缺陷，损害功能。(C)2015年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: The role of cortical drive in stroke recovery for the lower extremity remains ambiguous. The purpose of this study was to investigate the relationship between cortical drive and gait speed in a group of stroke survivors.Methods: Eighteen individuals with stroke were dichotomized into fast or slow walking groups. Transcranial magnetic stimulation (TMS) was used to collect motor evoked potentials (MEPs) from the tibialis anterior of each lower extremity during rest, paretic muscle contractions, and nonparetic muscle contractions. An asymmetry-index (AI) was calculated using motor thresholds and compared between groups. The average MEP of the paretic leg during TMS at maximal intensity (MEP100) for each condition was compared within and between groups.Results: A significant positive correlation was found between AI and walking speed. Slow-walkers had greater MEP(100)s during the nonparetic contraction than during the paretic contraction or rest conditions. In contrast, fast-walkers had greatest MEP(100)s during the paretic contraction.Conclusions: Alterations in the balance of corticomotor excitability occur in the lower extremity of individuals with poor motor recovery post-stroke. This atypical cortical drive is dependent on activation of the unaffected hemisphere and contraction of the nonparetic leg.Significance: Understanding mechanisms underlying motor function can help to identify specific patient deficits that impair function. (C) 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.