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Correlation of motor function with transcallosal and intracortical inhibition after stroke
OBJECTIVE: The inhibitory role of neuronal networks in motor recovery after stroke remains to be elucidated. We examined the influence of transcallosal inhibition and short intracortical inhibition on motor recovery after stroke. We also investigated the correlation between transcallosal inhibition and mirror activity.
DESIGN: A cross-sectional study.
SUBJECTS: Thirty-eight chronic stroke patients.
METHODS: Transcallosal inhibition was evaluated using single transcranial magnetic stimulation, and short intracortical inhibition was assessed using paired-pulse transcranial magnetic stimulation. Mirror activity was measured during tonic contraction of the contralateral hand.
RESULTS: Transcallosal inhibition from the contralesional to the ipsilesional motor cortex correlated positively with motor function of the paretic hand; in contrast, transcallosal inhibition to the ipsilesional motor cortex correlated negatively with mirror activity of the paretic hand in both cortical and subcortical stroke patients. Short intracortical inhibition of the ipsilesional motor cortex correlated negatively with motor function of the paretic hand in only the subcortical stroke patients.
CONCLUSION: Transcallosal inhibition from the contralesional to the ipsilesional motor cortex may inhibit mirror movements in stroke patients with good motor function. The weak transcallosal inhibition in patients after stroke with poor motor function may be ineffective for inhibiting mirror movement; however, it may have the advantage of facilitating motor recovery.
Naoyuki Takeuchi, Takeo Tada, Masahiko Toshima, Katsunori Ikoma
- Talelli P, Greenwood R J, Rothwell J C. Arm function after stroke: neurophysiological correlates and recovery mechanisms assessed by transcranial magnetic stimulation. Clin Neurophysiol 2006; 117: 1641–1659.
- Manganotti P, Patuzzo S, Cortese F, Palermo A, Smania N, Fiaschi A. Motor disinhibition in affected and unaffected hemisphere in the early period of recovery after stroke. Clin Neurophysiol 2002; 113: 936–943.
- Shimizu T, Hosaki A, Hino T, Sato M, Komori T, Hirai S, et al. Motor cortical disinhibition in the unaffected hemisphere after unilateral cortical stroke. Brain 2002; 125: 1896–1907.
- Chen R, Cohen LG, Hallet M. Nervous system reorganization following injury. Neuroscience 2002; 111: 761–773.
- Murase N, Duque J, Mazzocchio R, Cohen LG. Influence of interhemispheric interactions on motor function in chronic stroke. Ann Neurol 2004; 55: 400–409.
- Bütefisch CM, Wessling M, Netz J, Seitz RJ, Hömberg V. Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients. Neurorehabil Neural Repair 2008; 22: 4–21.
- Bütefisch CM, Netz J, Wessling M, Seitz RJ, Hömberg V. Remote changes in cortical excitability after stroke. Brain 2003; 126: 470–481.
- Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med 1975; 7: 13–31.
- Takeuchi N, Chuma T, Matsuo Y, Watanabe I, Ikoma K. Repetitive transcranial magnetic stimulation of contralesional primary motor cortex improves hand function after stroke. Stroke 2005; 36: 2681–2686.
- Cicinelli P, Pasqualetti P, Zaccagnini M, Traversa R, Oliveri M, Rossini PM. Interhemispheric asymmetries of motor cortex excitability in the postacute stroke stage. A paired-pulse transcranial magnetic stimulation study. Stroke 2003; 34: 2653–2658.
- Liepert J. Motor cortex excitability in stroke before and after constraint-induced movement therapy. Cogn Behav Neurol 2006; 19: 41–47.
- Wittenberg GF, Bastings EP, Fowlkes AM, Morgan TM, Good DC, Pons TP. Dynamic course of intracortical TMS paired-pulse responses during recovery of motor function after stroke. Neurorehabil Neural Repair 2007; 21: 568–573.
- Chen R. Yung D, Li JY. Organization of ipsilateral excitatory and inhibitory pathways in the human motor cortex. J Neurophysiol 2003; 89: 1256–1264.
- Hübers A, Orekhov Y, Ziemann U. Interhemispheric motor inhibition: its role in controlling electromyographic mirror activity. Eur J Neurosci 2008; 28: 364–371.
- Liepert J, Haevernick K, Weiller C, Barzel A. The surround inhibition determines therapy-induced cortical reorganization. Neuroimage 2006; 32: 1216–1220.
- Ward NS, Newton JM, Swayne OB, Lee L, Thompson AJ, Greenwood RJ, et al. Motor system activation after subcortical stroke depends on corticospinal system integrity. Brain 2006; 129: 809–819.
- Ward NS, Cohen LG. Mechanisms underlying recovery of motor function after stroke. Arch Neurol 2004; 61: 1844–1848.
- Stinear JW, Byblow WD. Rhythmic bilateral movement training modulates corticomotor excitability and enhances upper limb motricity poststroke: a pilot study. J Clin Neurophysiol 2004; 21: 124–131.
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