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Regular version of the site

Article

Multimodal neuroimaging study of hand motor recovery prognosis in chronic ischemic stroke patients

European Journal of Neurology, Supplement. 2015. Vol. 22. No. S1. P. 34-35.
Nazarova M., Piradov M. A., Novikov P., Konovalov R. N., Blagoveshchensky E., Nikulin V.

Hand motor recovery prognosis in stroke patients is crucial to develop a realistic individual rehabilitation plan. The aim of this study was to perform a multimodal assessment in chronic ischemic stroke patients and to compare predictive role of corticospinal tract (CST) integrity measured by diffusion tensor imaging (DTI) and navigated TMS (nTMS), and functional condition of the motor cortex measured by functional MRI (fMRI) and multi-muscle nTMS cortical mapping for hand motor recovery.Total of 30 patients with the only chronic supratentorial ischemic stroke and various severity of hand paresis were enrolled (12 females, medium age 50,0±8,0). The assessment included fractional anisotropy FA (index, %) measurement in internal capsule (ic), cerebral peduncle (pc) and pons. Functional assessment included analysis of BOLD response induced by passive motor task, assessment of intracortical inhibition (SICI) and intracortical facilitation (ICF) phenomena in Abductor Pollicis Brevis (APB) and nTMS mapping of APB and Extensor Digitorum Communis (EDC) cortical representations in both hemispheres. A group of 14 healthy volunteers (7 females, mean age 36,6±15,2) completed fMRI and nTMS investigation. A strong correlation between clinical outcome and FA let to consider FA as an available clinical measurement for hand motor prognosis. Significantly higher disinhibition in the unaffected hemisphere (UH) in well recovered and normal SICI in the UH in poorly recovered patients allow to suppose that interhemispheric interaction might change extensively by chronic phase. A software for multi-muscle nTMS mapping was developed, though this approach need deeper exploration.