Development of movement-related intracortical inhibition in acute to chronic subcortical stroke
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Development of movement-related intracortical inhibition in acute to chronic subcortical stroke. / Liuzzi, Gianpiero; Hörniß, Vanessa; Lechner, Patricia; Hoppe, Julia; Heise, Kirstin-Friederike; Zimerman, Maximo; Gerloff, Christian; Hummel, Friedhelm C.
In: NEUROLOGY, Vol. 82, No. 3, 21.01.2014, p. 198-205.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Development of movement-related intracortical inhibition in acute to chronic subcortical stroke
AU - Liuzzi, Gianpiero
AU - Hörniß, Vanessa
AU - Lechner, Patricia
AU - Hoppe, Julia
AU - Heise, Kirstin-Friederike
AU - Zimerman, Maximo
AU - Gerloff, Christian
AU - Hummel, Friedhelm C
PY - 2014/1/21
Y1 - 2014/1/21
N2 - OBJECTIVE: A prospective longitudinal cohort study in stroke patients was performed to better understand the role of γ-aminobutyric acid-dependent intracortical inhibition (ICI) for recovery after stroke.METHODS: Patients with acute first-ever subcortical stroke and hand paresis were recruited, and motor function as well as ICI were measured up to 1 year after stroke. Motor recovery was defined as the change in hand motor function from the acute to the chronic stage (Δ = recovery over 1 year). Primary outcome measures for hand motor function were the recovery of grip strength (ΔGS) and finger-tapping speed (ΔFT). Using double-pulse transcranial magnetic stimulation, we studied ICI in the ipsilesional primary motor cortex during the preparation of a movement with the paretic hand at different time points during recovery (first week, 7 weeks, 3 months, and 1 year after stroke).RESULTS: Eleven patients were enrolled (mean age 62.9 ± 3.8 years). The results of a multiple regression analysis showed a significant association of movement-related ICI in the acute stage only (first week) with motor recovery over 1 year (ΔGS: R(2) = 0.75, F = 17.6, p = 0.006; ΔFT: R(2) = 0.55, F = 7.3, p = 0.035). More disinhibition of ICI in the acute phase of stroke predicted more improvement in ΔGS (β = -0.86, p = 0.006) and ΔFT (β = -0.74, p = 0.035), independent of the initial motor deficit.CONCLUSIONS: Movement-related ICI one week after a subcortical stroke is associated with better outcome of hand motor function. Disinhibition in the ipsilesional primary motor cortex could be a mechanism of how the brain attempts to promote motor recovery after stroke.
AB - OBJECTIVE: A prospective longitudinal cohort study in stroke patients was performed to better understand the role of γ-aminobutyric acid-dependent intracortical inhibition (ICI) for recovery after stroke.METHODS: Patients with acute first-ever subcortical stroke and hand paresis were recruited, and motor function as well as ICI were measured up to 1 year after stroke. Motor recovery was defined as the change in hand motor function from the acute to the chronic stage (Δ = recovery over 1 year). Primary outcome measures for hand motor function were the recovery of grip strength (ΔGS) and finger-tapping speed (ΔFT). Using double-pulse transcranial magnetic stimulation, we studied ICI in the ipsilesional primary motor cortex during the preparation of a movement with the paretic hand at different time points during recovery (first week, 7 weeks, 3 months, and 1 year after stroke).RESULTS: Eleven patients were enrolled (mean age 62.9 ± 3.8 years). The results of a multiple regression analysis showed a significant association of movement-related ICI in the acute stage only (first week) with motor recovery over 1 year (ΔGS: R(2) = 0.75, F = 17.6, p = 0.006; ΔFT: R(2) = 0.55, F = 7.3, p = 0.035). More disinhibition of ICI in the acute phase of stroke predicted more improvement in ΔGS (β = -0.86, p = 0.006) and ΔFT (β = -0.74, p = 0.035), independent of the initial motor deficit.CONCLUSIONS: Movement-related ICI one week after a subcortical stroke is associated with better outcome of hand motor function. Disinhibition in the ipsilesional primary motor cortex could be a mechanism of how the brain attempts to promote motor recovery after stroke.
KW - Acute Disease
KW - Adult
KW - Aged
KW - Cerebral Infarction
KW - Chronic Disease
KW - Female
KW - Hand
KW - Humans
KW - Male
KW - Middle Aged
KW - Motor Cortex
KW - Movement
KW - Neural Inhibition
KW - Paresis
KW - Prospective Studies
KW - Recovery of Function
KW - Transcranial Magnetic Stimulation
U2 - 10.1212/WNL.0000000000000028
DO - 10.1212/WNL.0000000000000028
M3 - SCORING: Journal article
C2 - 24353337
VL - 82
SP - 198
EP - 205
JO - NEUROLOGY
JF - NEUROLOGY
SN - 0028-3878
IS - 3
ER -