Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke?
Background: Resting Motor threshold (rMT) is one of the measurement obtained by Transcranial Magnetic Stimulation (TMS) that reflects corticospinal excitability. As a functional marker of the corticospinal pathway, the question arises whether rMT is a suitable biomarker for predicting post-stroke up...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.01020/full |
| _version_ | 1818963206159204352 |
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| author | Charlotte Rosso Charlotte Rosso Jean-Charles Lamy |
| author_facet | Charlotte Rosso Charlotte Rosso Jean-Charles Lamy |
| author_sort | Charlotte Rosso |
| collection | DOAJ |
| description | Background: Resting Motor threshold (rMT) is one of the measurement obtained by Transcranial Magnetic Stimulation (TMS) that reflects corticospinal excitability. As a functional marker of the corticospinal pathway, the question arises whether rMT is a suitable biomarker for predicting post-stroke upper limb function. To that aim, we conducted a systematic review of relevant studies that investigated the clinical significance of rMT in stroke survivors by using correlations between upper limb motor scores and rMT.Methods: Studies that reported correlations between upper limb motor function and rMT as a measure of corticospinal excitability in distal arm muscle were identified via a literature search in stroke patients. Two authors extracted the data using a home-made specific form. Subgroup analyses were carried out with patients classified with respect to time post-stroke onset (early vs. chronic stage) and stroke location (cortical, subcortical, or cortico-subcortical). Methodological quality of the study was also evaluated by a published checklist.Results: Eighteen studies with 22 groups (n = 508 stroke patients) were included in this systematic review. Mean methodological quality score was 14.75/24. rMT was often correlated with motor function or hand dexterity (n = 15/22, 68%), explaining on average 31% of the variance of the motor score. Moreover, the results did not seem impacted if patients were examined at the early or chronic stages of stroke. Two findings could not be properly interpreted: (i) the fact that the rMT is an independent predictor of motor function as several confounding factors are well-established, and, (ii) whether the stroke location impacts this prediction.Conclusion: Most of the studies found a correlation between rMT and upper limb motor function after stroke. However, it is still unclear if rMT is an independent predictor of upper limb motor function when taking into account for age, time post stroke onset and level of corticospinal tract damage as confounding factors. Clear-cut conclusions could not be drawn at that time but our results suggest that rMT could be a suitable candidate although future investigations are needed.Systematic Review Registration Number: (https://www.crd.york.ac.uk/prospero/): ID 114317. |
| first_indexed | 2024-12-20T12:41:32Z |
| format | Article |
| id | doaj.art-9fbbb2aa1ecf4717a8ca24d3dfcda122 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T12:41:32Z |
| publishDate | 2018-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-9fbbb2aa1ecf4717a8ca24d3dfcda1222022-12-21T19:40:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-11-01910.3389/fneur.2018.01020420080Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke?Charlotte Rosso0Charlotte Rosso1Jean-Charles Lamy2Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, FranceAPHP, Urgences Cérébro-Vasculaires, Hôpital Pitié-Salpêtrière, Paris, FranceInstitut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, FranceBackground: Resting Motor threshold (rMT) is one of the measurement obtained by Transcranial Magnetic Stimulation (TMS) that reflects corticospinal excitability. As a functional marker of the corticospinal pathway, the question arises whether rMT is a suitable biomarker for predicting post-stroke upper limb function. To that aim, we conducted a systematic review of relevant studies that investigated the clinical significance of rMT in stroke survivors by using correlations between upper limb motor scores and rMT.Methods: Studies that reported correlations between upper limb motor function and rMT as a measure of corticospinal excitability in distal arm muscle were identified via a literature search in stroke patients. Two authors extracted the data using a home-made specific form. Subgroup analyses were carried out with patients classified with respect to time post-stroke onset (early vs. chronic stage) and stroke location (cortical, subcortical, or cortico-subcortical). Methodological quality of the study was also evaluated by a published checklist.Results: Eighteen studies with 22 groups (n = 508 stroke patients) were included in this systematic review. Mean methodological quality score was 14.75/24. rMT was often correlated with motor function or hand dexterity (n = 15/22, 68%), explaining on average 31% of the variance of the motor score. Moreover, the results did not seem impacted if patients were examined at the early or chronic stages of stroke. Two findings could not be properly interpreted: (i) the fact that the rMT is an independent predictor of motor function as several confounding factors are well-established, and, (ii) whether the stroke location impacts this prediction.Conclusion: Most of the studies found a correlation between rMT and upper limb motor function after stroke. However, it is still unclear if rMT is an independent predictor of upper limb motor function when taking into account for age, time post stroke onset and level of corticospinal tract damage as confounding factors. Clear-cut conclusions could not be drawn at that time but our results suggest that rMT could be a suitable candidate although future investigations are needed.Systematic Review Registration Number: (https://www.crd.york.ac.uk/prospero/): ID 114317.https://www.frontiersin.org/article/10.3389/fneur.2018.01020/fullstrokeTranscranial Magnetic Stimulationcorticopinal excitabilitymotor functionoutcome |
| spellingShingle | Charlotte Rosso Charlotte Rosso Jean-Charles Lamy Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke? Frontiers in Neurology stroke Transcranial Magnetic Stimulation corticopinal excitability motor function outcome |
| title | Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke? |
| title_full | Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke? |
| title_fullStr | Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke? |
| title_full_unstemmed | Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke? |
| title_short | Does Resting Motor Threshold Predict Motor Hand Recovery After Stroke? |
| title_sort | does resting motor threshold predict motor hand recovery after stroke |
| topic | stroke Transcranial Magnetic Stimulation corticopinal excitability motor function outcome |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.01020/full |
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