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Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients.
Neurorehabil Neural Repair. 2008 Jan-Feb; 22(1):4-21.NN

Abstract

BACKGROUND

Studies of stroke patients using functional imaging and transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) demonstrated increased recruitment and abnormally decreased short interval cortical inhibition (SICI) of the M1 contralateral to the lesioned hemisphere (contralesional M1) within the first month after infarction of the M1 or its corticospinal projections.

OBJECTIVE

The authors sought to identify mechanisms underlying decreased SICI of the contralesional M1.

METHODS

In patients within 6 weeks of their first ever infarction of the M1 or its corticospinal projections, SICI in the M1 of the lesioned and nonlesioned hemisphere was studied using paired-pulse TMS. Interhemispheric inhibition (IHI) was measured by applying TMS to the M1 of the lesioned hemisphere and a second pulse to the homotopic M1 of the nonlesioned hemisphere and vice versa with the patient at rest. The results were compared to M1 stimulation of age-matched healthy controls.

RESULTS

SICI was decreased in the M1 of lesioned and nonlesioned hemispheres regardless of cortical or subcortical infarct location. IHI was abnormally decreased from the M1 of the lesioned on nonlesioned hemisphere. In contrast, IHI was normal from the M1 of the nonlesioned on the lesioned hemisphere. Abnormal IHI and SICI were correlated in patients with cortical but not with subcortical lesions.

CONCLUSIONS

In subacute stroke patients, abnormally decreased SICI of a contralesional M1 can only partially be explained by loss of IHI from the lesioned on nonlesioned hemisphere. As decreased SICI of the contralesional M1 did not result in excessive IHI from the nonlesioned on lesioned hemisphere with subsequent suppression of ipsilesional M1 excitability and all patients showed excellent recovery of motor function, decreased SICI of the contralesional M1 may represent an adaptive process supporting recovery.

Links

Publisher Full Text

Authors+Show Affiliations

Bütefisch CM
Neurological Therapeutic Center, Heinrich-Heine University Dusseldorf, Germany. cbuetefisch@hsc.wvu.edu
Wessling M
No affiliation info available
Netz J
No affiliation info available
Seitz RJ
No affiliation info available
Hömberg V
No affiliation info available

MeSH

Acute DiseaseAdaptation, PhysiologicalAdultAgedCorpus CallosumFemaleFunctional LateralityHumansMaleMiddle AgedMotor CortexMovementNeural InhibitionNeural PathwaysParesisPyramidal TractsReaction TimeRecovery of FunctionStrokeTranscranial Magnetic Stimulation

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17507644

Citation

Bütefisch, Cathrin M., et al. "Relationship Between Interhemispheric Inhibition and Motor Cortex Excitability in Subacute Stroke Patients." Neurorehabilitation and Neural Repair, vol. 22, no. 1, 2008, pp. 4-21.
Bütefisch CM, Wessling M, Netz J, et al. Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients. Neurorehabil Neural Repair. 2008;22(1):4-21.
Bütefisch, C. M., Wessling, M., Netz, J., Seitz, R. J., & Hömberg, V. (2008). Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients. Neurorehabilitation and Neural Repair, 22(1), 4-21.
Bütefisch CM, et al. Relationship Between Interhemispheric Inhibition and Motor Cortex Excitability in Subacute Stroke Patients. Neurorehabil Neural Repair. 2008 Jan-Feb;22(1):4-21. PubMed PMID: 17507644.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients. AU - Bütefisch,Cathrin M, AU - Wessling,Marion, AU - Netz,Johannes, AU - Seitz,Rüdiger J, AU - Hömberg,Volker, Y1 - 2007/05/16/ PY - 2007/5/18/pubmed PY - 2008/2/20/medline PY - 2007/5/18/entrez SP - 4 EP - 21 JF - Neurorehabilitation and neural repair JO - Neurorehabil Neural Repair VL - 22 IS - 1 N2 - BACKGROUND: Studies of stroke patients using functional imaging and transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) demonstrated increased recruitment and abnormally decreased short interval cortical inhibition (SICI) of the M1 contralateral to the lesioned hemisphere (contralesional M1) within the first month after infarction of the M1 or its corticospinal projections. OBJECTIVE: The authors sought to identify mechanisms underlying decreased SICI of the contralesional M1. METHODS: In patients within 6 weeks of their first ever infarction of the M1 or its corticospinal projections, SICI in the M1 of the lesioned and nonlesioned hemisphere was studied using paired-pulse TMS. Interhemispheric inhibition (IHI) was measured by applying TMS to the M1 of the lesioned hemisphere and a second pulse to the homotopic M1 of the nonlesioned hemisphere and vice versa with the patient at rest. The results were compared to M1 stimulation of age-matched healthy controls. RESULTS: SICI was decreased in the M1 of lesioned and nonlesioned hemispheres regardless of cortical or subcortical infarct location. IHI was abnormally decreased from the M1 of the lesioned on nonlesioned hemisphere. In contrast, IHI was normal from the M1 of the nonlesioned on the lesioned hemisphere. Abnormal IHI and SICI were correlated in patients with cortical but not with subcortical lesions. CONCLUSIONS: In subacute stroke patients, abnormally decreased SICI of a contralesional M1 can only partially be explained by loss of IHI from the lesioned on nonlesioned hemisphere. As decreased SICI of the contralesional M1 did not result in excessive IHI from the nonlesioned on lesioned hemisphere with subsequent suppression of ipsilesional M1 excitability and all patients showed excellent recovery of motor function, decreased SICI of the contralesional M1 may represent an adaptive process supporting recovery. SN - 1545-9683 UR - https://www.unboundmedicine.com/medline/citation/17507644/Relationship_between_interhemispheric_inhibition_and_motor_cortex_excitability_in_subacute_stroke_patients_ L2 - https://journals.sagepub.com/doi/10.1177/1545968307301769?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -