Hwang Pyoungsik, Sohn Min Kyun, Kim Cuk-Seong, Jee Sungju
Daejeon Chungcheong Regional Rehabilitation Center, Chungnam National University Hospital, Republic of Korea.
Department of Physiology, School of Medicine, Chungnam National University, Munhwa-dong, Jung-gu, Daejeon 301-130, Republic of Korea.
J Clin Neurosci. 2016 Apr;26:122-5. doi: 10.1016/j.jocn.2015.05.070. Epub 2016 Jan 5.
Early prediction of expected recovery in stroke can help in planning appropriate medical and rehabilitation interventions. Recovery of ambulation is one of the essential endpoints in stroke rehabilitation. However, the correlation of somatosensory evoked potentials (SSEP) with clinical parameters and their predictive significance are not clearly defined. We aimed to examine the association between tibial nerve SSEP and ambulatory outcomes in subacute hemiplegic stroke patients. We reviewed medical records for hemiplegic patients with first-ever stroke who received inpatient rehabilitation from January 2009 to May 2013. We excluded patients with diabetes mellitus, quadriplegia, bilateral lesions, brainstem lesions, those aged over 80 years, and those with severe musculoskeletal problems. Tibial nerve SSEP were performed when they were transferred to the rehabilitation department. SSEP findings were divided into three groups; normal, abnormal and absent response. Berg balance scale and functional ambulation category (FAC) at discharge were compared with initial tibial SSEP findings using one-way analysis of variance. Thirty-one hemiplegic patients were included. Berg balance scale and FAC were significantly different according to the SSEP (P<0.001). Post hoc analysis showed a significant difference between normal and absent response in Berg balance scale (P<0.001) and FAC (P<0.001), and between abnormal and absent response in Berg balance scale (P=0.012) and FAC (P=0.019). Functional outcomes of the normal response group were better than the abnormal response group, but there was no statistical significance. These findings suggest that initial tibial nerve SSEP may be a useful biomarker for prognosticating functional outcomes in hemiplegic patients.
早期预测中风后的预期恢复情况有助于规划适当的医疗和康复干预措施。步行能力的恢复是中风康复的重要终点之一。然而，体感诱发电位（SSEP）与临床参数之间的相关性及其预测意义尚未明确界定。我们旨在研究亚急性偏瘫中风患者胫神经SSEP与步行结果之间的关联。我们回顾了2009年1月至2013年5月期间首次中风的偏瘫患者的住院康复病历。我们排除了患有糖尿病、四肢瘫痪、双侧病变、脑干病变、年龄超过80岁以及有严重肌肉骨骼问题的患者。患者转入康复科时进行胫神经SSEP检查。SSEP结果分为三组：正常、异常和无反应。使用单因素方差分析比较出院时的伯格平衡量表和功能步行分类（FAC）与初始胫神经SSEP结果。纳入了31例偏瘫患者。根据SSEP，伯格平衡量表和FAC有显著差异（P<0.001）。事后分析显示，伯格平衡量表（P<0.001）和FAC（P<0.001）中正常反应与无反应之间存在显著差异，伯格平衡量表（P=0.012）和FAC（P=0.019）中异常反应与无反应之间也存在显著差异。正常反应组的功能结局优于异常反应组，但无统计学意义。这些发现表明，初始胫神经SSEP可能是预测偏瘫患者功能结局的有用生物标志物。
