Hand function and motor cortical output poststroke: Are they related?
Hand function and motor cortical output poststroke: Are they related?
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DOI：
10.1016/j.apmr.2006.02.006
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发表时间：
2006-05-01
影响因子：
4.3
通讯作者：
Schryburt-Brown, K
中科院分区：
文献类型：
--
作者：
Brouwer, BJ;Schryburt-Brown, K
目的：描述慢性和亚急性中风恢复期的手功能和皮质兴奋性，并描述这些指标之间的关系。设计：观察，病例对照。地点：运动功能实验室。参与者：14名社区生活的慢性和14名亚急性住院卒中幸存者自愿参加。14名年龄相仿的健康受试者作为对照组。干预措施：不适用。主要结果措施：手指轻敲，钉放置，和力量被测量为手功能的指标。运动诱发电位（MEP）的幅度和潜伏期和沉默期的持续时间在第一背侧骨间肌引起的经颅磁刺激（TMS）反映的兴奋性和抑制性皮层circuits.Results的完整性：手功能减退，小MEP，和延长沉默期的持续时间与对照组相比，中风是明显的。MEP潜伏期越长，波幅越小，亚急性卒中与慢性卒中的区别就越大。对于所有TMS结果，亚急性组的侧对侧不对称性最大。尽管这随着时间的推移而减少，但在排出时重新测试子样品。更大的侧到侧MEP幅度对称性和较低的运动阈值（病变侧）与更好的手功能病亚急性和慢性stroke，respectively.Conclusions：皮层兴奋性是所有重要的决定因素中风后的手功能，并随着时间的推移，因为中风事件的演变。在亚急性和慢性中风中明显的手功能的独特神经相关性可能反映了神经肌肉恢复的不同阶段。
Objectives: To characterize hand function and cortical excitability in chronic and subacute stages of stroke recovery and to describe the relations between these measures.Design: Observational, case-control. and cohort pre-post inpatient rehabilitation.Setting: Motor performance laboratory.Participants: Fourteen community-living chronic and 14 subacute inpatient stroke survivors volunteered. Fourteen similarly aged healthy Subjects served as a control group.Interventions: Not applicable.Main Outcome Measures: Finger tapping, peg placing, and strength were measured as indicators of hand function. The amplitude and latency of motor-evoked potentials (MEPs) and the duration of the silent period in the first dorsal interosseous muscle elicited by transcranial magnetic Stimulation (TMS) reflected the integrity of excitatory and inhibitory cortical circuits.Results: Diminished hand function, small MEPs, and prolonged silent-period durations were evident in stroke compared with control subjects. Longer MEP latencies and smaller amplitudes distinguished subacute from chronic stroke. Side-to-side asymmetries were greatest in the subacute group for all TMS outcomes. although this lessened over time based oil the subsample retested at discharge. Greater side-to-side MEP amplitude symmetry and lower motor threshold (lesioned side) were associated with better hand function ill Subacute and chronic stroke, respectively.Conclusions: Cortical excitability is all important determinant of hand function poststroke and evolves with the time elapsed since the stroke event. The unique neural correlates of hand function evident in subacute and chronic stroke may reflect different phases of neuromuscular recovery.