Comparison of transcallosal inhibition between hemispheres and its relationship with motor behavior in patients with severe upper extremity impairment after subacute stroke
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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DOI：
10.1016/j.jstrokecerebrovasdis.2022.106469
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发表时间：
2022-04-11
影响因子：
2.5
通讯作者：
Jaberzadeh, Shapour
中科院分区：
文献类型：
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作者：
Dehno, Nasrin Salehi;Kamali, Fahimeh;Jaberzadeh, Shapour
目的：比较损伤对侧和同侧初级运动皮层（M1）的皮质脊髓兴奋性和跨胼胝体抑制。我们还研究了经胼胝体抑制与上肢运动行为的相关性。材料和方法：19例单侧缺血性亚急性脑卒中患者，上肢功能严重受损。通过测量静息运动阈值、主动运动阈值和运动诱发电位振幅来评估皮质脊髓兴奋性。通过测量同侧沉默期（ISP）的持续时间和深度来研究经胼胝体抑制。比较两半球的数据，分析经胼胝体抑制与上肢运动障碍、握力和捏力的关系。结果如下：与同病灶M1相比，对侧病灶M1的静息运动阈值（p = 0.001）和主动运动阈值（p = 0.001）较低，运动诱发电位振幅较高（p = 0.001）。但是，两个M1之间在ISP持续时间（p = 0.297）或ISP深度（p = 0.297）方面没有差异。229）。对侧病灶M1的经胼胝体抑制与运动障碍（ISP持续时间，p = 0.003; ISP深度，p = 0.017）和握力（ISP持续时间，p = 0.016; ISP深度，p = 0.045）呈正相关。结论：半球之间对称的经胼胝体抑制以及对侧病变M1的经胼胝体抑制与上肢运动行为的正相关性表明，对侧病变M1的募集对于亚急性缺血性中风后上肢严重受损的患者的恢复可能是必要的。
Objective: To 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 methods: 19 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. Results: Resting 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). Conclusions: Symmetric 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.