Mapping early changes of cortical motor output after subcortical stroke: A transcranial magnetic stimulation study

Raffaella Chieffo, Alberto Inuggi, Laura Straffi, Elisabetta Coppi, Javier Gonzalez-Rosa, Francesca Spagnolo, Antonella Poggi, Giancarlo Comi, Mauro Comola, Letizia Leocani

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

After acute stroke several changes in cortical excitability occur involving affected (AH) and unaffected hemisphere (UH) but whether they contribute to motor recovery is still controversial. We performed transcranial magnetic stimulation mapping of several upper limb muscles over the two hemispheres in thirteen patients at 4-12 days from subcortical stroke and after 1 month. The occurrence of mirror movements (MMs) on the healthy side during contraction of paretic muscles was measured. At baseline, cortical excitability parameters over the AH decreased in comparison with controls, while excitability over the UH increased correlating with severity of motor deficits of the affected arm at baseline as well as with poor recovery. At follow-up, map parameters of the UH became closer to those of controls independently from recovery, while for the AH the number of responsive sites increased significantly. Ipsilateral motor evoked responses (iMEPs) in the affected arm were never elicited. We observed an early impairment in dexterity of the ipsilesional hand that recovered over-time but persistently differed in comparison with controls. MMs occurrence increased at baseline correlating with reduced cortical excitability of the AH as well as with increased map density over the UH. The acute increased excitability of the UH after stroke has a negative prognostic value on recovery and negatively affects motor performance of the ipsilesional hand. Moreover, the absence of iMEPs and the normalization of motor cortical excitability at follow-up indicate that the UH primary motor area does not contribute to recovery.

Original languageEnglish
Pages (from-to)322-329
Number of pages8
JournalBrain Stimulation
Volume6
Issue number3
DOIs
Publication statusPublished - May 2013

Fingerprint

Transcranial Magnetic Stimulation
Stroke
Arm
Hand
Motor Cortex
Muscle Contraction
Upper Extremity
Muscles
Cortical Excitability

Keywords

  • Acute stroke
  • Mirror movements
  • Plasticity
  • TMS

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Biophysics

Cite this

Mapping early changes of cortical motor output after subcortical stroke : A transcranial magnetic stimulation study. / Chieffo, Raffaella; Inuggi, Alberto; Straffi, Laura; Coppi, Elisabetta; Gonzalez-Rosa, Javier; Spagnolo, Francesca; Poggi, Antonella; Comi, Giancarlo; Comola, Mauro; Leocani, Letizia.

In: Brain Stimulation, Vol. 6, No. 3, 05.2013, p. 322-329.

Research output: Contribution to journalArticle

Chieffo, Raffaella ; Inuggi, Alberto ; Straffi, Laura ; Coppi, Elisabetta ; Gonzalez-Rosa, Javier ; Spagnolo, Francesca ; Poggi, Antonella ; Comi, Giancarlo ; Comola, Mauro ; Leocani, Letizia. / Mapping early changes of cortical motor output after subcortical stroke : A transcranial magnetic stimulation study. In: Brain Stimulation. 2013 ; Vol. 6, No. 3. pp. 322-329.
@article{2e018506f3a540ac99cd769594bfe742,
title = "Mapping early changes of cortical motor output after subcortical stroke: A transcranial magnetic stimulation study",
abstract = "After acute stroke several changes in cortical excitability occur involving affected (AH) and unaffected hemisphere (UH) but whether they contribute to motor recovery is still controversial. We performed transcranial magnetic stimulation mapping of several upper limb muscles over the two hemispheres in thirteen patients at 4-12 days from subcortical stroke and after 1 month. The occurrence of mirror movements (MMs) on the healthy side during contraction of paretic muscles was measured. At baseline, cortical excitability parameters over the AH decreased in comparison with controls, while excitability over the UH increased correlating with severity of motor deficits of the affected arm at baseline as well as with poor recovery. At follow-up, map parameters of the UH became closer to those of controls independently from recovery, while for the AH the number of responsive sites increased significantly. Ipsilateral motor evoked responses (iMEPs) in the affected arm were never elicited. We observed an early impairment in dexterity of the ipsilesional hand that recovered over-time but persistently differed in comparison with controls. MMs occurrence increased at baseline correlating with reduced cortical excitability of the AH as well as with increased map density over the UH. The acute increased excitability of the UH after stroke has a negative prognostic value on recovery and negatively affects motor performance of the ipsilesional hand. Moreover, the absence of iMEPs and the normalization of motor cortical excitability at follow-up indicate that the UH primary motor area does not contribute to recovery.",
keywords = "Acute stroke, Mirror movements, Plasticity, TMS",
author = "Raffaella Chieffo and Alberto Inuggi and Laura Straffi and Elisabetta Coppi and Javier Gonzalez-Rosa and Francesca Spagnolo and Antonella Poggi and Giancarlo Comi and Mauro Comola and Letizia Leocani",
year = "2013",
month = "5",
doi = "10.1016/j.brs.2012.06.003",
language = "English",
volume = "6",
pages = "322--329",
journal = "Brain Stimulation",
issn = "1935-861X",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Mapping early changes of cortical motor output after subcortical stroke

T2 - A transcranial magnetic stimulation study

AU - Chieffo, Raffaella

AU - Inuggi, Alberto

AU - Straffi, Laura

AU - Coppi, Elisabetta

AU - Gonzalez-Rosa, Javier

AU - Spagnolo, Francesca

AU - Poggi, Antonella

AU - Comi, Giancarlo

AU - Comola, Mauro

AU - Leocani, Letizia

PY - 2013/5

Y1 - 2013/5

N2 - After acute stroke several changes in cortical excitability occur involving affected (AH) and unaffected hemisphere (UH) but whether they contribute to motor recovery is still controversial. We performed transcranial magnetic stimulation mapping of several upper limb muscles over the two hemispheres in thirteen patients at 4-12 days from subcortical stroke and after 1 month. The occurrence of mirror movements (MMs) on the healthy side during contraction of paretic muscles was measured. At baseline, cortical excitability parameters over the AH decreased in comparison with controls, while excitability over the UH increased correlating with severity of motor deficits of the affected arm at baseline as well as with poor recovery. At follow-up, map parameters of the UH became closer to those of controls independently from recovery, while for the AH the number of responsive sites increased significantly. Ipsilateral motor evoked responses (iMEPs) in the affected arm were never elicited. We observed an early impairment in dexterity of the ipsilesional hand that recovered over-time but persistently differed in comparison with controls. MMs occurrence increased at baseline correlating with reduced cortical excitability of the AH as well as with increased map density over the UH. The acute increased excitability of the UH after stroke has a negative prognostic value on recovery and negatively affects motor performance of the ipsilesional hand. Moreover, the absence of iMEPs and the normalization of motor cortical excitability at follow-up indicate that the UH primary motor area does not contribute to recovery.

AB - After acute stroke several changes in cortical excitability occur involving affected (AH) and unaffected hemisphere (UH) but whether they contribute to motor recovery is still controversial. We performed transcranial magnetic stimulation mapping of several upper limb muscles over the two hemispheres in thirteen patients at 4-12 days from subcortical stroke and after 1 month. The occurrence of mirror movements (MMs) on the healthy side during contraction of paretic muscles was measured. At baseline, cortical excitability parameters over the AH decreased in comparison with controls, while excitability over the UH increased correlating with severity of motor deficits of the affected arm at baseline as well as with poor recovery. At follow-up, map parameters of the UH became closer to those of controls independently from recovery, while for the AH the number of responsive sites increased significantly. Ipsilateral motor evoked responses (iMEPs) in the affected arm were never elicited. We observed an early impairment in dexterity of the ipsilesional hand that recovered over-time but persistently differed in comparison with controls. MMs occurrence increased at baseline correlating with reduced cortical excitability of the AH as well as with increased map density over the UH. The acute increased excitability of the UH after stroke has a negative prognostic value on recovery and negatively affects motor performance of the ipsilesional hand. Moreover, the absence of iMEPs and the normalization of motor cortical excitability at follow-up indicate that the UH primary motor area does not contribute to recovery.

KW - Acute stroke

KW - Mirror movements

KW - Plasticity

KW - TMS

UR - http://www.scopus.com/inward/record.url?scp=84877752405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877752405&partnerID=8YFLogxK

U2 - 10.1016/j.brs.2012.06.003

DO - 10.1016/j.brs.2012.06.003

M3 - Article

C2 - 22776700

AN - SCOPUS:84877752405

VL - 6

SP - 322

EP - 329

JO - Brain Stimulation

JF - Brain Stimulation

SN - 1935-861X

IS - 3

ER -