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Relationship between spasticity and spinal neural circuits in patients with chronic hemiparetic stroke

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Abstract

Spasticity is a common problem in patients with stroke that contributes to motor dysfunction. However, the pathophysiological mechanisms underlying spasticity are not fully understood. The purpose of the present study was to explain the relationship between features of spinal neural circuits assessed using electrophysiological techniques and the clinical manifestations of stroke. The participants were 71 patients with chronic hemiparetic stroke. To assess spinal neural circuits, Hmax/Mmax of the forearm flexor muscles and reciprocal inhibition (RI) between forearm extensor and flexor muscles with the H reflex conditioning-test paradigm were measured. The relationships between electrophysiological parameters and clinical variables (age, time from stroke onset, upper extremity functional scores, and spasticity) were then analyzed. It was found that the third phase of RI (RI-3) correlated with the modified Ashworth scores of the wrist and finger flexors. No other correlations were found between electrophysiological and clinical measures. These results suggest that RI-3 is associated with spasticity and may be helpful to understand the basis of post-stroke spasticity.

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Abbreviations

EMG:

Electromyography

ECR:

Extensor carpi radialis

FCR:

Flexor carpi radialis

FMA–UE:

Fugl–Meyer assessment upper extremity motor score

ISI:

Interstimulus interval

MAS:

Modified Ashworth Scale

MT:

Motor threshold

PSS:

Post-stroke spasticity

RI:

Reciprocal inhibition

RI-1:

First phase of reciprocal inhibition

RI-2:

Second phase of reciprocal inhibition

RI-3:

Third phase of reciprocal inhibition

RST:

Reticulospinal tract

SD:

Standard deviation

UMIN:

University Hospital Medical Information Network

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Acknowledgements

The authors would like to thank the study participants for their time and effort. They also would like to thank Ms. Sawako Otaki for her assistance in the project.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kohei Okuyama, Michiyuki Kawakami, Miho Hiramoto, Kaori Muraoka & Meigen Liu

  2. Department of Physical Medicine and Rehabilitation, Juntendo University, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan

    Toshiyuki Fujiwara

Authors
  1. Kohei Okuyama
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  2. Michiyuki Kawakami
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  3. Miho Hiramoto
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  4. Kaori Muraoka
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  5. Toshiyuki Fujiwara
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  6. Meigen Liu
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Contributions

MK and KO contributed to the conception and study design, data acquisition, analysis, and interpretation, and drafting of the manuscript. MH and KM contributed to data acquisition and analysis. TF and ML contributed to drafting of the manuscript.

Corresponding author

Correspondence to Michiyuki Kawakami.

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None of the authors has potential conflicts of interest to be disclosed.

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Okuyama, K., Kawakami, M., Hiramoto, M. et al. Relationship between spasticity and spinal neural circuits in patients with chronic hemiparetic stroke. Exp Brain Res 236, 207–213 (2018). https://doi.org/10.1007/s00221-017-5119-9

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  • DOI: https://doi.org/10.1007/s00221-017-5119-9

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