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Stroke subtype and motor impairment influence contralesional excitability

Lookup NU author(s): Professor Hermano Krebs


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Objective:The nonlesioned motor cortex (M1(NL)) is thought to be hyperexcitable in patients with subacute or chronic stroke and offers a promising therapeutic target. However, whether M1(NL) excitability behaves the same for subcortical and cortical strokes is unknown. The aim of the present study was to determine whether cortical, or purely subcortical, strokes have a different effect on M1(NL) excitability.Methods:We looked for correlations between the Fugl-Meyer (FM) score and M1(NL) resting motor threshold (RMTNL) in 34 stroke survivors classified according to lesion location (cortico-subcortical or purely subcortical). In addition to the FM, the Wolf Motor Score and motor power were measured.Results:FM correlated with RMTNL for subcortical (r = 0.82; p = 0.001) but not for cortical strokes (r = 0.11; p = 0.62). Likewise, Wolf Motor Score (r = -0.62; p = 0.03) and motor power (r = 0.64; p = 0.023) were correlated with RMTNL for the subcortical group, but not for the cortical group.Conclusion:We show that the impact on M1(NL) depends on lesion location and conclude that protocols aimed at reducing M1(NL) cortical excitability may be worth exploring for subcortical but not for cortical stroke.

Publication metadata

Author(s): Thickbroom GW, Cortes M, Rykman A, Volpe BT, Fregni F, Krebs HI, Pascual-Leone A, Edwards DJ

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2015

Volume: 85

Issue: 6

Pages: 517-520

Print publication date: 11/08/2015

Online publication date: 17/07/2015

Acceptance date: 10/04/2015

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0000000000001828


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Funder referenceFunder name
Harvard Catalyst | The Harvard Clinical and Translational Science Center (NCRR)
Sidney R. Baer Jr. Foundation
R01HD069776NICHD of the NIH
R21 HD07616NIH
R21 MH099196NIH
UL1 RR025758Harvard Catalyst | The Harvard Clinical and Translational Science Center (NCATS NIH)
R21 NS082870NIH
R21 NS085491NIH