Liu Hao, Au-Yeung Stephanie S Y
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong; Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
J Neurol Sci. 2014 Jun 15;341(1-2):105-9. doi: 10.1016/j.jns.2014.04.012. Epub 2014 Apr 13.
Transcranial magnetic stimulation (TMS) has been used to evaluate neuroplastic changes in the brain in clinical trials. The purpose of this study was to establish the test-retest reliability of 4 TMS measures of corticomotor excitability - (1) resting motor threshold, (2) slope of input-output curve, (3) peak motor evoked potential amplitude, and (4) cortical silent period duration for the corticospinal projections to the first dorsal interosseous of the contralateral hand. Fourteen healthy subjects (mean age 27.4 years) and 27 subjects with stroke-induced upper limb hemiparesis (mean age 61.3 years) completed 2 repeated sessions of assessment of 1 week apart. Good to excellent test-retest reliability of the TMS measurements was confirmed in the stroke subjects for both hemispheres with the ICC ≥ 0.88. Measurement reliability was good (ICC ≥ 0.75) for the 4 outcome measures in healthy subjects. Contrary to the similarity in standard error of measurements in both hemispheres for outcome measures (1) to (3) in the stroke subjects, that of the cortical silent period duration was larger in magnitude in the lesioned hemisphere. The test-retest reliability coefficients determined for the four corticomotor excitability measurements allowed the estimation of 95% minimal detectable changes of these outcome variables for the respective subject group in future clinical trials.
在临床试验中,经颅磁刺激(TMS)已被用于评估大脑中的神经可塑性变化。本研究的目的是确定4种皮质运动兴奋性TMS测量指标的重测信度,这4种指标分别为:(1)静息运动阈值;(2)输入-输出曲线斜率;(3)运动诱发电位峰值幅度;(4)皮质脊髓投射至对侧手第一背侧骨间肌的皮质静息期时长。14名健康受试者(平均年龄27.4岁)和27名中风后上肢偏瘫受试者(平均年龄61.3岁)完成了间隔1周的2次重复评估。在中风受试者中,两个半球的TMS测量重测信度均良好至优秀,组内相关系数(ICC)≥0.88。在健康受试者中,这4种测量指标的测量信度良好(ICC≥0.75)。与中风受试者中(1)至(3)项测量指标在两个半球的测量标准误差相似相反,皮质静息期时长在受损半球的测量标准误差幅度更大。为这4种皮质运动兴奋性测量指标确定的重测信度系数,有助于在未来的临床试验中估算各受试者组这些测量指标95%的最小可检测变化量。