Larsen Lisbeth Hoejkjaer, Zibrandtsen Ivan Chrilles, Wienecke Troels, Kjaer Troels Wesenberg, Christensen Mark Schram, Nielsen Jens Bo, Langberg Henning
CopenRehab, Department of Public Health, University of Copenhagen, 1014 Cph. K, Denmark; Section for Integrative Neuroscience, Department for Neuroscience, University of Copenhagen, 2200 Cph. N, Denmark.
Department of Neurology, Zealand University Hospital, University of Copenhagen, 4000 Roskilde, Denmark.
Clin Neurophysiol. 2017 Nov;128(11):2217-2226. doi: 10.1016/j.clinph.2017.08.033. Epub 2017 Sep 22.
Stroke is one of the leading causes of physical disability due to damage of the motor cortex or the corticospinal tract. In the present study we set out to investigate the role of adaptations in the corticospinal pathway for motor recovery during the subacute phase after stroke.
We examined 19 patients with clinically diagnosed stroke and 18 controls. The patients had unilateral mild to moderate weakness of the hand. Each patient attended two sessions at approximately 3days (acute) and 38days post stroke (subacute). Task-related changes in the communication between motor cortex and muscles were evaluated from coupling in the frequency domain between EEG and EMG during movement of the paretic hand.
Corticomuscular coherence (CMC) and intermuscular coherence (IMC) were reduced in patients as compared to controls. Paretic hand motor performance improved within 4-6weeks after stroke, but no change was observed in CMC or IMC.
CMC and IMC were reduced in patients in the early phase after stroke. However, changes in coherence do not appear to be an efficient marker for early recovery of hand function following stroke.
This is the first study to demonstrate sustained reduced coherence in acute and subacute stroke.
中风是导致身体残疾的主要原因之一,是由运动皮层或皮质脊髓束受损引起的。在本研究中,我们着手调查皮质脊髓通路适应性在中风后亚急性期运动恢复中的作用。
我们检查了19例临床诊断为中风的患者和18例对照者。这些患者患侧手有单侧轻度至中度无力。每位患者在中风后约3天(急性期)和38天(亚急性期)各参加两次测试。在患侧手运动期间,通过脑电图(EEG)和肌电图(EMG)在频域的耦合来评估运动皮层与肌肉之间通信的任务相关变化。
与对照者相比,患者的皮质肌肉相干性(CMC)和肌肉间相干性(IMC)降低。中风后4 - 6周内患侧手的运动表现有所改善,但CMC或IMC未观察到变化。
中风后早期患者的CMC和IMC降低。然而,相干性变化似乎不是中风后手功能早期恢复的有效指标。
这是第一项证明急性和亚急性中风中相干性持续降低的研究。