Changes in Intracortical Excitability of Affected and Unaffected Hemispheres After Stroke Evaluated by Paired-Pulse Transcranial Magnetic Stimulation.
10.5535/arm.2018.42.4.495
- Author:
Ho Youn SEO
1
;
Gi Wook KIM
;
Yu Hui WON
;
Sung Hee PARK
;
Jeong Hwan SEO
;
Myoung Hwan KO
Author Information
1. Department of Physical Medicine and Rehabilitation, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. mhko@jbnu.ac.kr
- Publication Type:Original Article
- Keywords:
Transcranial magnetic stimulation;
Cortical excitability;
Stroke
- MeSH:
Evoked Potentials, Motor;
Humans;
Stroke*;
Transcranial Magnetic Stimulation*
- From:Annals of Rehabilitation Medicine
2018;42(4):495-501
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To assess the altered pattern of intracortical excitability of the affected and unaffected hemispheres in stroke patients using paired-pulse transcranial magnetic stimulation (TMS). METHODS: We evaluated intracortical inhibition (ICI) and intracortical facilitation (ICF) in both hemispheres at acute and subacute stages of 103 stroke patients using paired-pulse TMS. The patients were divided into two groups: mild-to-moderate patients whose motor evoked potential (MEP) was recorded in the affected hemisphere; and severe patients whose MEP was not recorded in the affected hemisphere. RESULTS: In mild-to-moderate patients, the value of ICI in the affected hemisphere was increased from 70.3% to 77.9% and the value of ICI in the unaffected hemisphere was decreased from 74.8% to 70.3% with eventual progression in acute to subacute stages of stroke. In severe patients, the value of ICI in the unaffected hemisphere was increased from 65.4% to 75.6%. The changes in ICF were not significantly different in this study. CONCLUSION: We conclude that the unaffected hemisphere was more disinhibited than the affected hemisphere in acute phase of mild-to-moderate stroke, and the affected hemisphere was more disinhibited in the subacute stage. The unaffected hemisphere was inhibited in severe cases in acute-to-subacute phases of stroke. This finding facilitates appropriate neuromodulation of acute-to-subacute phases in mild-to-severe stroke patients.
