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

9 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

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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

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