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Interhemispheric asymmetry of the motor cortex excitability in stroke: relationship with sensory-motor impairment and injury chronicity

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Abstract

Objective

To compare the interhemispheric asymmetry of the motor cortex excitability of chronic stroke patients with healthy and to observe if the magnitude of this asymmetry is associated to sensory-motor impairment and stroke chronicity.

Methods

This cross-sectional study was performed with chronic stroke and aged and sex-matched healthy individuals. The interhemispheric asymmetry index was calculated by the difference of rest motor threshold (rMT) of the brain hemispheres. The rMT was assessed by transcranial magnetic stimulation over the cortical representation of the first dorsal interosseous muscle. To investigate the relationship of the asymmetry with sensory-motor impairment and injury chronicity, the stroke patients were grouped according to the level of sensory-motor impairment (mild/moderate, moderate/severe, and severe) and different chronicity stages (> 3–12, 13–24, 25–60, and > 60 months since stroke).

Results

Fifty-six chronic stroke and twenty-six healthy were included. We found higher interhemispheric asymmetry in stroke patients (mean, 27.1 ± 20.9) compared to healthy (mean, 4.9 ± 4.7). The asymmetry was higher in patients with moderate/severe (mean, 35.4 ± 20.4) and severe (mean, 32.9 ± 22.7) impairment. No difference was found between patients with mild/moderate impairment (mean, 15.5 ± 12.5) and healthy. There were no differences of the interhemispheric asymmetry between patients with different times since stroke (> 3–12, mean, 32 ± 18.1; > 13–24, mean, 20.7 ± 16.2; > 25–60, mean, 29.6 ± 18.1; > 60 months, mean, 25.9 ± 17.5).

Conclusion

Stroke patients showed higher interhemispheric asymmetry of the motor cortex excitability when compared to healthy, and the magnitude of this asymmetry seems to be correlated with the severity of sensory-motor impairment, but not with stroke chronicity.

Significance

Higher interhemispheric asymmetry was found in stroke patients with greatest sensory-motor impairment.

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Funding

Marina Berenguer was supported by the Fundação de Amparo à Ciência e Tecnologia (FACEPE: IBPG-1473-4.08/16), Brazil. Adriana Baltar was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Sérgio Rocha was supported by the Fundação de Amparo à Ciência e Tecnologia (FACEPE: IBPG-1649-4.08/13). Lívia Shirahige is supported by the Fundação de Amparo à Ciência e Tecnologia (FACEPE: IBPG-1548-4.01/16). Monte-Silva K is supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (308291/2015-8), Brazil.

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Authors and Affiliations

  1. Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil

    Marina Berenguer-Rocha, Adriana Baltar, Sérgio Rocha, Lívia Shirahige, Rodrigo Brito & Kátia Monte-Silva

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  1. Marina Berenguer-Rocha
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  2. Adriana Baltar
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Correspondence to Kátia Monte-Silva.

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Highlights

• Interhemispheric asymmetry in stroke patients is related to with sensory-motor impairment.

• Sensory-motor severity of stroke is not dependent of lower activity on affected motor cortex.

• Sensory-motor severity of stroke is related to unaffected motor cortex.

• The stroke chronicity does not influence the interhemispheric asymmetry.

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Berenguer-Rocha, M., Baltar, A., Rocha, S. et al. Interhemispheric asymmetry of the motor cortex excitability in stroke: relationship with sensory-motor impairment and injury chronicity. Neurol Sci 41, 2591–2598 (2020). https://doi.org/10.1007/s10072-020-04350-4

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  • DOI: https://doi.org/10.1007/s10072-020-04350-4

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