A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke
BackgroundThe global inclination of stroke onset in earlier years of life and increased lifespan have resulted in an increased chronic post-stroke-related disability. The precise and simplistic approach such as the correlation of Fugl-Meyer Assessment (FMA) with Transcranial Magnetic Stimulation (TM...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.832121/full |
| _version_ | 1811312938093379584 |
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| author | Megha Saini Neha Singh Nand Kumar M. V. Padma Srivastava Amit Mehndiratta Amit Mehndiratta |
| author_facet | Megha Saini Neha Singh Nand Kumar M. V. Padma Srivastava Amit Mehndiratta Amit Mehndiratta |
| author_sort | Megha Saini |
| collection | DOAJ |
| description | BackgroundThe global inclination of stroke onset in earlier years of life and increased lifespan have resulted in an increased chronic post-stroke-related disability. The precise and simplistic approach such as the correlation of Fugl-Meyer Assessment (FMA) with Transcranial Magnetic Stimulation (TMS) parameters, Resting Motor Threshold (RMT) and Motor Evoked Potential (MEP), in patients with stroke might play a critical role, given the prognostic value of MEP, a measure of cortical excitability, and might be the key point in prescribing appropriate therapeutic strategies.ObjectiveThe study aimed to determine the correlation of FMA-based impairment in the upper extremity function specifically of the wrist and hand with respect to the neurophysiological parameters of corticospinal tract integrity.Materials and methodsThe Institutional Review Board approved the study and 67 (n) patients with stroke were enrolled in the Department of Neurology, AIIMS, New Delhi, India. The motor assessment was performed on patients by the upper extremity subset of Fugl-Meyer Assessment (FMA) and the clinical history was obtained. RMT and MEP of Extensor Digitorum Communis (EDC) muscle were measured via TMS.ResultsA significant positive correlation was observed between Fugl-Meyer Assessment Wrist/Hand (FMA W/H) and MEP scores (r = 0.560, <0.001). Also, Fugl-Meyer Assessment Upper Extremity (FMA UE) scores demonstrated a moderate positive association with MEP responsiveness (r = 0.421, <0.001).ConclusionMEP of the EDC muscle was found to be associated with sensorimotor control as measured by FMA. Moreover, FMA W/H score values might be a better prognostic indicator of EDC MEP responsiveness. Interestingly, a novel element comprising the range of FMA UE and FMA W/H components was observed to be a potential indicator of MEP responsiveness and could also indicate establishing FMA as a surrogate for TMS in resource-limited settings for prognostification. |
| first_indexed | 2024-04-13T10:45:25Z |
| format | Article |
| id | doaj.art-14dfea00a1884a119495024d9037d4d9 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-13T10:45:25Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-14dfea00a1884a119495024d9037d4d92022-12-22T02:49:48ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-07-011610.3389/fnins.2022.832121832121A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic strokeMegha Saini0Neha Singh1Nand Kumar2M. V. Padma Srivastava3Amit Mehndiratta4Amit Mehndiratta5Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, IndiaCentre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, IndiaDepartment of Psychiatry, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaCentre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, IndiaDepartment of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, IndiaBackgroundThe global inclination of stroke onset in earlier years of life and increased lifespan have resulted in an increased chronic post-stroke-related disability. The precise and simplistic approach such as the correlation of Fugl-Meyer Assessment (FMA) with Transcranial Magnetic Stimulation (TMS) parameters, Resting Motor Threshold (RMT) and Motor Evoked Potential (MEP), in patients with stroke might play a critical role, given the prognostic value of MEP, a measure of cortical excitability, and might be the key point in prescribing appropriate therapeutic strategies.ObjectiveThe study aimed to determine the correlation of FMA-based impairment in the upper extremity function specifically of the wrist and hand with respect to the neurophysiological parameters of corticospinal tract integrity.Materials and methodsThe Institutional Review Board approved the study and 67 (n) patients with stroke were enrolled in the Department of Neurology, AIIMS, New Delhi, India. The motor assessment was performed on patients by the upper extremity subset of Fugl-Meyer Assessment (FMA) and the clinical history was obtained. RMT and MEP of Extensor Digitorum Communis (EDC) muscle were measured via TMS.ResultsA significant positive correlation was observed between Fugl-Meyer Assessment Wrist/Hand (FMA W/H) and MEP scores (r = 0.560, <0.001). Also, Fugl-Meyer Assessment Upper Extremity (FMA UE) scores demonstrated a moderate positive association with MEP responsiveness (r = 0.421, <0.001).ConclusionMEP of the EDC muscle was found to be associated with sensorimotor control as measured by FMA. Moreover, FMA W/H score values might be a better prognostic indicator of EDC MEP responsiveness. Interestingly, a novel element comprising the range of FMA UE and FMA W/H components was observed to be a potential indicator of MEP responsiveness and could also indicate establishing FMA as a surrogate for TMS in resource-limited settings for prognostification.https://www.frontiersin.org/articles/10.3389/fnins.2022.832121/fullstrokeFugl-Meyer scalemotor evoked potentialneurophysiological parametersTranscranial Magnetic Stimulationcorticospinal tract |
| spellingShingle | Megha Saini Neha Singh Nand Kumar M. V. Padma Srivastava Amit Mehndiratta Amit Mehndiratta A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke Frontiers in Neuroscience stroke Fugl-Meyer scale motor evoked potential neurophysiological parameters Transcranial Magnetic Stimulation corticospinal tract |
| title | A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke |
| title_full | A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke |
| title_fullStr | A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke |
| title_full_unstemmed | A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke |
| title_short | A novel perspective of associativity of upper limb motor impairment and cortical excitability in sub-acute and chronic stroke |
| title_sort | novel perspective of associativity of upper limb motor impairment and cortical excitability in sub acute and chronic stroke |
| topic | stroke Fugl-Meyer scale motor evoked potential neurophysiological parameters Transcranial Magnetic Stimulation corticospinal tract |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.832121/full |
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