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Reliability of intracortical and corticomotor excitability estimates obtained from the upper extremities in chronic stroke.
Neurosci Res. 2007 May; 58(1):19-31.NR

Abstract

We estimated the trial-to-trial variability and the test-retest reliability of several intracortical and corticomotor excitability parameters for the upper extremity in chronic stroke patients. Nine patients with hemiparesis of the upper extremity were enrolled 8-17 months after a unilateral stroke. Transcranial magnetic stimulation was used to obtain repeated measures over a two week interval of motor evoked potential (MEP) recruitment curves and cortical silent periods in the first dorsal interosseus muscle of each hand. Five trials would have provided accurate estimates of the MEP amplitude and silent period duration for the unlesioned side in all patients, but 25% of the datasets from the lesioned side provided poor estimates of MEP amplitude even with 10 trials. Intraclass correlations were >0.70 for all parameters obtained from the lesioned side and for the MEP amplitude, slope of the recruitment curve, silent period, and silent period slope from the unlesioned side. MEP amplitude varied across sessions within subject by 20% on both sides, whereas other parameters showed less variability on the unlesioned side relative to the lesioned side. The Fugl-Meyer upper extremity motor score and the time to complete the 6 fine-motor items from the Wolf Motor Function Test (WMFT) were also found to be highly reliable over this interval. We conclude that the functional and most of the excitability parameters are reliable across time in patients with variable lesions due to stroke. Due to high intrasubject variability, the use of some excitability parameters as indicators of functional neuroplasticity in response to treatment may be limited to interventions with large effect sizes.

Authors+Show Affiliations

Division of Geriatrics, Faculty of Medicine, Department of Neurology and Neurosurgery, McGill University, Canada. lisa.koski@mcgill.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17303273

Citation

Koski, Lisa, et al. "Reliability of Intracortical and Corticomotor Excitability Estimates Obtained From the Upper Extremities in Chronic Stroke." Neuroscience Research, vol. 58, no. 1, 2007, pp. 19-31.
Koski L, Lin JC, Wu AD, et al. Reliability of intracortical and corticomotor excitability estimates obtained from the upper extremities in chronic stroke. Neurosci Res. 2007;58(1):19-31.
Koski, L., Lin, J. C., Wu, A. D., & Winstein, C. J. (2007). Reliability of intracortical and corticomotor excitability estimates obtained from the upper extremities in chronic stroke. Neuroscience Research, 58(1), 19-31.
Koski L, et al. Reliability of Intracortical and Corticomotor Excitability Estimates Obtained From the Upper Extremities in Chronic Stroke. Neurosci Res. 2007;58(1):19-31. PubMed PMID: 17303273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reliability of intracortical and corticomotor excitability estimates obtained from the upper extremities in chronic stroke. AU - Koski,Lisa, AU - Lin,Janice Chien-Ho, AU - Wu,Allan D, AU - Winstein,Carolee J, Y1 - 2007/01/20/ PY - 2006/08/24/received PY - 2007/01/05/revised PY - 2007/01/15/accepted PY - 2007/2/17/pubmed PY - 2007/7/26/medline PY - 2007/2/17/entrez SP - 19 EP - 31 JF - Neuroscience research JO - Neurosci Res VL - 58 IS - 1 N2 - We estimated the trial-to-trial variability and the test-retest reliability of several intracortical and corticomotor excitability parameters for the upper extremity in chronic stroke patients. Nine patients with hemiparesis of the upper extremity were enrolled 8-17 months after a unilateral stroke. Transcranial magnetic stimulation was used to obtain repeated measures over a two week interval of motor evoked potential (MEP) recruitment curves and cortical silent periods in the first dorsal interosseus muscle of each hand. Five trials would have provided accurate estimates of the MEP amplitude and silent period duration for the unlesioned side in all patients, but 25% of the datasets from the lesioned side provided poor estimates of MEP amplitude even with 10 trials. Intraclass correlations were >0.70 for all parameters obtained from the lesioned side and for the MEP amplitude, slope of the recruitment curve, silent period, and silent period slope from the unlesioned side. MEP amplitude varied across sessions within subject by 20% on both sides, whereas other parameters showed less variability on the unlesioned side relative to the lesioned side. The Fugl-Meyer upper extremity motor score and the time to complete the 6 fine-motor items from the Wolf Motor Function Test (WMFT) were also found to be highly reliable over this interval. We conclude that the functional and most of the excitability parameters are reliable across time in patients with variable lesions due to stroke. Due to high intrasubject variability, the use of some excitability parameters as indicators of functional neuroplasticity in response to treatment may be limited to interventions with large effect sizes. SN - 0168-0102 UR - https://www.unboundmedicine.com/medline/citation/17303273/Reliability_of_intracortical_and_corticomotor_excitability_estimates_obtained_from_the_upper_extremities_in_chronic_stroke_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-0102(07)00032-6 DB - PRIME DP - Unbound Medicine ER -