Transcranial magnetic stimulation as a prognostic tool in stroke
Transcranial magnetic stimulation as a prognostic tool in stroke
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DOI：
10.1016/s0022-510x(96)05312-9
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发表时间：
1997-03-20
影响因子：
4.4
通讯作者：
Seoane, JL
中科院分区：
文献类型：
--
作者：
DOlhaberriague, L;Gamissans, JME;Seoane, JL
我们的目的是评价磁运动诱发电位(MMEP)在缺血性卒中中的预后价值，研究MMEP异常的演变以及MMEP异常与脑梗塞地形的关系。我们前瞻性地分析了50名连续观察1年的缺血性中风患者。分别于卒中后1、3、30和90d记录MMEP，测量小鱼际肌、肱二头肌、腓肠肌和股四头肌MMEP的波幅和潜伏期/中枢运动传导时间(CMCTs)。对临床和MMEPs数据进行单变量和多变量分析。1岁时Rankin 0~3级患者较Rankin 4~5级或死亡患者MMEP潜伏期短、波幅高。血压升高与存活率增加有关，而心率增加和高血糖则与死亡率增加相关。在判别分析中，第二次CT、年龄和第一天CMCT-S1上的变量对1年的预后进行了正确分类。MMEPS值的纳入将正确分类的概率从76%提高到84%。我们的结论是，在非致残性卒中患者中，MMEP可能在预测预后方面具有独立的价值，增加了使用临床和实验室数据进行预后计算的准确性。分析卒中后MMEP异常时，应考虑病变的地形图。(C)1997年爱思唯尔科学公司。
Our aims were to evaluate the prognostic usefulness of magnetic motor evoked potentials (MMEPs) in ischemic stroke, to study the evolution of MMEP abnormalities and the relationships between MMEP abnormalities and infarction topography. We prospectively analyzed 50 consecutive ischemic stroke patients who were followed up to 1 year. MMEPs were recorded 1, 3, 30 and 90 days after stroke and we measured amplitudes and latencies/central motor conduction times (CMCTs) of MMEPs from hypothenar, biceps brachiallis, gastrocnemius and quadriceps. Univariate and multivariate analyses of the clinical and MMEPs data were performed. Patients with Rankin 0-3 at 1 year had had acutely MMEPs with shorter latencies and higher amplitudes than patients with Rankin 4-5 or deceased patients. Increased blood pressure con-elated with increased survival, whereas increased heart rate and hyperglycemia correlated with increased mortality. The variables infarction size on second CT, age, and first day CMCT-Sl correctly classified 1 year outcome on discriminant analysis. The inclusion of MMEPs values increased the probability of correct classification from 76% to 84%. We conclude that in patients with nondisabling strokes MMEPs may have an independent value in the prediction of prognosis, increasing the accuracy of prognosis calculations made employing clinical and laboratory data. Topography of lesions should be considered when analyzing MMEP abnormalities after stroke. (C) 1997 Elsevier Science B.V.