Modulation of cortical and spinal inhibition with functional recovery of upper extremity motor function among patients with chronic stroke

Toshiyuki Fujiwara, Kaoru Honaga, Michiyuki Kawakami, Atsuko Nishimoto, Kaoru Abe, Katsuhiro Mizuno, Mitsuhiko Kodama, Yoshihisa Masakado, Tetsuya Tsuji, Meigen Liu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose:We hypothesized that recovery of upper extremity motor function is associated with reduction of intracortical inhibition and improved reciprocal inhibition. This study examines the relationships of functional recovery in chronic stroke with the intracortical inhibition and spinal reciprocal inhibition. Methods: Participants were 61 patients with chronic hemiparetic stroke. The participants were applied hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for 3 weeks. The Fugl-Meyer test upper extremity motor score (FM) and modified Ashworth scale (MAS) were assessed before (T0), immediately after (T1) and 3 months after (T2) the end of HANDS therapy. A paired pulse TMS paradigm was applied to assess short intracortical inhibition (SICI). Reciprocal inhibition (RI) was assessed with H reflex conditioning-test paradigm. Results: FM and MAS were improved until T2. The change of FM from T0 to T2 was positively correlated with the change in affected SICI from T0 toT1. The change of wrist MAS from T0 to T1 was positively correlated with the change of RI. Conclusions: In chronic stroke patients with moderate or severe hemiparesis, well-recovered patients showed disinhibition of ipsilesional hemisphere and increased resiprocal inhibition of forearm.

Original languageEnglish
Pages (from-to)883-894
Number of pages12
JournalRestorative Neurology and Neuroscience
Volume33
Issue number6
DOIs
Publication statusPublished - 2015 Nov 16

Fingerprint

Upper Extremity
Stroke
H-Reflex
Paresis
Wrist
Forearm
Therapeutics
3-monoiodothyronine

Keywords

  • electrical stimulation
  • intracortical inhibition
  • motor cortex
  • motor function
  • reciprocal inhibition
  • rehabilitation
  • spinal cord
  • Stroke
  • transcranial magnetic stimulation
  • upper extremity function

ASJC Scopus subject areas

  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Modulation of cortical and spinal inhibition with functional recovery of upper extremity motor function among patients with chronic stroke. / Fujiwara, Toshiyuki; Honaga, Kaoru; Kawakami, Michiyuki; Nishimoto, Atsuko; Abe, Kaoru; Mizuno, Katsuhiro; Kodama, Mitsuhiko; Masakado, Yoshihisa; Tsuji, Tetsuya; Liu, Meigen.

In: Restorative Neurology and Neuroscience, Vol. 33, No. 6, 16.11.2015, p. 883-894.

Research output: Contribution to journalArticle

Fujiwara, Toshiyuki ; Honaga, Kaoru ; Kawakami, Michiyuki ; Nishimoto, Atsuko ; Abe, Kaoru ; Mizuno, Katsuhiro ; Kodama, Mitsuhiko ; Masakado, Yoshihisa ; Tsuji, Tetsuya ; Liu, Meigen. / Modulation of cortical and spinal inhibition with functional recovery of upper extremity motor function among patients with chronic stroke. In: Restorative Neurology and Neuroscience. 2015 ; Vol. 33, No. 6. pp. 883-894.
@article{fcecb993935d4931bb3806537c21f66e,
title = "Modulation of cortical and spinal inhibition with functional recovery of upper extremity motor function among patients with chronic stroke",
abstract = "Purpose:We hypothesized that recovery of upper extremity motor function is associated with reduction of intracortical inhibition and improved reciprocal inhibition. This study examines the relationships of functional recovery in chronic stroke with the intracortical inhibition and spinal reciprocal inhibition. Methods: Participants were 61 patients with chronic hemiparetic stroke. The participants were applied hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for 3 weeks. The Fugl-Meyer test upper extremity motor score (FM) and modified Ashworth scale (MAS) were assessed before (T0), immediately after (T1) and 3 months after (T2) the end of HANDS therapy. A paired pulse TMS paradigm was applied to assess short intracortical inhibition (SICI). Reciprocal inhibition (RI) was assessed with H reflex conditioning-test paradigm. Results: FM and MAS were improved until T2. The change of FM from T0 to T2 was positively correlated with the change in affected SICI from T0 toT1. The change of wrist MAS from T0 to T1 was positively correlated with the change of RI. Conclusions: In chronic stroke patients with moderate or severe hemiparesis, well-recovered patients showed disinhibition of ipsilesional hemisphere and increased resiprocal inhibition of forearm.",
keywords = "electrical stimulation, intracortical inhibition, motor cortex, motor function, reciprocal inhibition, rehabilitation, spinal cord, Stroke, transcranial magnetic stimulation, upper extremity function",
author = "Toshiyuki Fujiwara and Kaoru Honaga and Michiyuki Kawakami and Atsuko Nishimoto and Kaoru Abe and Katsuhiro Mizuno and Mitsuhiko Kodama and Yoshihisa Masakado and Tetsuya Tsuji and Meigen Liu",
year = "2015",
month = "11",
day = "16",
doi = "10.3233/RNN-150547",
language = "English",
volume = "33",
pages = "883--894",
journal = "Restorative Neurology and Neuroscience",
issn = "0922-6028",
publisher = "IOS Press",
number = "6",

}

TY - JOUR

T1 - Modulation of cortical and spinal inhibition with functional recovery of upper extremity motor function among patients with chronic stroke

AU - Fujiwara, Toshiyuki

AU - Honaga, Kaoru

AU - Kawakami, Michiyuki

AU - Nishimoto, Atsuko

AU - Abe, Kaoru

AU - Mizuno, Katsuhiro

AU - Kodama, Mitsuhiko

AU - Masakado, Yoshihisa

AU - Tsuji, Tetsuya

AU - Liu, Meigen

PY - 2015/11/16

Y1 - 2015/11/16

N2 - Purpose:We hypothesized that recovery of upper extremity motor function is associated with reduction of intracortical inhibition and improved reciprocal inhibition. This study examines the relationships of functional recovery in chronic stroke with the intracortical inhibition and spinal reciprocal inhibition. Methods: Participants were 61 patients with chronic hemiparetic stroke. The participants were applied hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for 3 weeks. The Fugl-Meyer test upper extremity motor score (FM) and modified Ashworth scale (MAS) were assessed before (T0), immediately after (T1) and 3 months after (T2) the end of HANDS therapy. A paired pulse TMS paradigm was applied to assess short intracortical inhibition (SICI). Reciprocal inhibition (RI) was assessed with H reflex conditioning-test paradigm. Results: FM and MAS were improved until T2. The change of FM from T0 to T2 was positively correlated with the change in affected SICI from T0 toT1. The change of wrist MAS from T0 to T1 was positively correlated with the change of RI. Conclusions: In chronic stroke patients with moderate or severe hemiparesis, well-recovered patients showed disinhibition of ipsilesional hemisphere and increased resiprocal inhibition of forearm.

AB - Purpose:We hypothesized that recovery of upper extremity motor function is associated with reduction of intracortical inhibition and improved reciprocal inhibition. This study examines the relationships of functional recovery in chronic stroke with the intracortical inhibition and spinal reciprocal inhibition. Methods: Participants were 61 patients with chronic hemiparetic stroke. The participants were applied hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for 3 weeks. The Fugl-Meyer test upper extremity motor score (FM) and modified Ashworth scale (MAS) were assessed before (T0), immediately after (T1) and 3 months after (T2) the end of HANDS therapy. A paired pulse TMS paradigm was applied to assess short intracortical inhibition (SICI). Reciprocal inhibition (RI) was assessed with H reflex conditioning-test paradigm. Results: FM and MAS were improved until T2. The change of FM from T0 to T2 was positively correlated with the change in affected SICI from T0 toT1. The change of wrist MAS from T0 to T1 was positively correlated with the change of RI. Conclusions: In chronic stroke patients with moderate or severe hemiparesis, well-recovered patients showed disinhibition of ipsilesional hemisphere and increased resiprocal inhibition of forearm.

KW - electrical stimulation

KW - intracortical inhibition

KW - motor cortex

KW - motor function

KW - reciprocal inhibition

KW - rehabilitation

KW - spinal cord

KW - Stroke

KW - transcranial magnetic stimulation

KW - upper extremity function

UR - http://www.scopus.com/inward/record.url?scp=84947577313&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947577313&partnerID=8YFLogxK

U2 - 10.3233/RNN-150547

DO - 10.3233/RNN-150547

M3 - Article

C2 - 26578060

AN - SCOPUS:84947577313

VL - 33

SP - 883

EP - 894

JO - Restorative Neurology and Neuroscience

JF - Restorative Neurology and Neuroscience

SN - 0922-6028

IS - 6

ER -