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The relationships of motor-evoked potentials to hand dexterity, motor function, and spasticity in chronic stroke patients: a transcranial magnetic stimulation study

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Abstract

The standardization of patient evaluation and monitoring methods has a special importance in evaluating the effectiveness of therapeutic methods using drugs or rehabilitative techniques in stroke rehabilitation. The aim of this study was to investigate the relationships between clinical instruments and transcranial magnetic stimulation (TMS)-evoked neurophysiological parameters in stroke patients. This study included 22 chronic post-stroke patients who were clinically assessed using the Motricity Index (MI), finger-tapping test (FTT), Motor Activity Log (MAL) 28, Brunnstrom motor staging and Ashworth Scale (ASH). Motor-evoked potential (MEP) latency and amplitude, resting motor threshold (rMT) and central motor conduction time (CMCT) were measured with TMS. Shorter MEP-latency, shorter CMCT, higher motor-evoked potential amplitude, and diminished rMT exhibited significant correlations with clinical measures evaluating motor stage, dexterity, and daily life functionality. rMT exhibited a negative correlation with hand and lower extremity Brunnstrom stages (r = −0.64, r = −0.51, respectively), MI score (r = −0.48), FTT score (r = −0.69), and also with amount of use scale and quality of movement scale of MAL 28 scores (r = −0.61, r = −0.62, respectively). Higher MEP amplitude and diminished rMT showed positive correlations with reduced ASH score (r = −0.65, r = 0.44, respectively). The TMS-evoked neurophysiologic parameters including MEP latency, amplitude, rMT and CMCT generally have positive correlation with clinical measures which evaluate motor stage, dexterity and daily life functionality. Additionally, spasticity has also remarkable relationships with MEP amplitude and rMT. These results suggest that TMS-evoked neurophysiological parameters were useful measures for monitoring post-stroke patients.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Istanbul Medipol University School of Medicine, Istanbul, Turkey

    Engin Cakar & Oguz Durmus

  2. Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

    Engin Cakar, Gulseren Akyuz, Ilker Yagci, Evrim Karadag-Saygi & Osman Hakan Gunduz

  3. Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey

    Engin Cakar

  4. Clinical Trials Statistical & Data Management Center, University of Iowa, Iowa City, IA, USA

    Levent Bayman

Authors
  1. Engin Cakar
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  2. Gulseren Akyuz
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  3. Oguz Durmus
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  4. Levent Bayman
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  5. Ilker Yagci
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  6. Evrim Karadag-Saygi
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  7. Osman Hakan Gunduz
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Correspondence to Oguz Durmus.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the local Ethics Committee and performed according to the tenets of the declaration of Helsinki.

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Informed consent was obtained from all individual participants.

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Cakar, E., Akyuz, G., Durmus, O. et al. The relationships of motor-evoked potentials to hand dexterity, motor function, and spasticity in chronic stroke patients: a transcranial magnetic stimulation study. Acta Neurol Belg 116, 481–487 (2016). https://doi.org/10.1007/s13760-016-0633-2

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  • DOI: https://doi.org/10.1007/s13760-016-0633-2

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