Annals of Indian Academy of Neurology
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SHORT COMMUNICATION
Year : 2013  |  Volume : 16  |  Issue : 3  |  Page : 394-397

Evaluation of the motor cortical excitability changes after ischemic stroke


1 Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
2 Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India

Correspondence Address:
Pramod Kr Pal
Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka
India
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Source of Support: Financial support provided by the Central Council for Ayurveda and Siddha (CCRAS), Conflict of Interest: None


DOI: 10.4103/0972-2327.116955

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Background: We evaluated progressive changes in excitability of motor cortex following ischemic stroke using Transcranial Magnetic Stimulation (TMS). Materials and Methods: Thirty-one patients (24 men, 7 women; age 37.3 ± 8.2 years) were recruited and TMS was performed using Magstim 200 stimulator and a figure-of-eight coil. Resting motor threshold (RMT) was recorded from affected and unaffected hemispheres and motor evoked potential (MEP) was recorded from contralateral FDI muscle. Central motor conduction time (CMCT) was calculated using F wave method. All measurements were done at baseline (2 nd ), 4 th , and 6 th week of stroke. Results: Affected hemisphere: MEP was recordable in 3 patients at baseline (all had prolonged CMCT). At 4 weeks, MEP was recordable in one additional patient and CMCT remained prolonged. At 6 weeks, CMCT normalized in one patient. RMT was recordable (increased) in 3 patients at baseline, in one additional patient at 4 weeks, and reduced marginally in these patients at 6 weeks. Unaffected hemisphere: MEP was recordable in all patients at baseline, and reduced significantly over time (2 nd week 43.52 ± 9.60, 4 th week 38.84 ± 7.83, and 6 th week 36.85 ± 7.27; P < 0.001). The CMCT was normal and remained unchanged over time. Conclusion: The increase in excitability of the unaffected motor cortex suggests plasticity in the post-stroke phase.


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