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Abstract
Objective: The nonlesioned motor cortex (M1NL) is thought to be hyperexcitable in patients with subacute or chronic stroke and offers a promising therapeutic target. However, whether M1NL 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 M1NL excitability.
Methods: We looked for correlations between the Fugl-Meyer (FM) score and M1NL 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 M1NL depends on lesion location and conclude that protocols aimed at reducing M1NL cortical excitability may be worth exploring for subcortical but not for cortical stroke.
GLOSSARY
- Cx=
- cortico-subcortical;
- FM=
- Fugl-Meyer;
- M1L=
- lesioned motor cortex;
- M1NL=
- nonlesioned primary motor cortex;
- MEPNL=
- nonlesioned motor evoked potential;
- MP=
- motor power;
- MSO=
- maximum stimulator output;
- RMTL=
- lesioned hemisphere resting motor threshold;
- RMTNL=
- nonlesioned hemisphere resting motor threshold;
- SC=
- subcortical;
- TCI=
- transcallosal inhibition;
- TOAST=
- Trial of Org 10172 in Acute Stroke Treatment;
- WMS=
- Wolf Motor Score
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received December 1, 2014.
- Accepted in final form April 10, 2015.
- © 2015 American Academy of Neurology
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