Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide 5000, Australia.
Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide 5000, Australia.
J Stroke Cerebrovasc Dis. 2022 Jul;31(7):106494. doi: 10.1016/j.jstrokecerebrovasdis.2022.106494. Epub 2022 Apr 23.
Interhemispheric inhibition is an important cortical mechanism to support motor control. Altered interhemispheric inhibition has been the target of neuromodulation interventions. This systematic review investigated the evidence for altered interhemispheric inhibition in adults with unilateral neurological conditions: stroke, amyotrophic lateral sclerosis, cerebral palsy, complex regional pain syndrome, traumatic brain injury, and cerebral palsy METHODS: We pre-registered the protocol and followed PRISMA guidelines. Five databases were systematically searched to identify studies reporting interhemispheric inhibition measures in unilateral neurological conditions and healthy controls. Data were grouped according to the measure (ipsilateral silent period and dual-coil), stimulated hemisphere, and stage of the condition (subacute and chronic).
1372 studies were identified, of which 14 were included (n = 226 adults with stroke and 161 age-matched controls). Ipsilateral silent period-duration was longer in people with stroke than in controls (stimulation of dominant hemisphere) regardless of stroke stage. Motor evoked potential was less suppressed in people with sub-acute stroke (stimulation of the unaffected hemisphere) than controls (stimulation of dominant hemisphere) and this reversed in chronic stroke.
Detection of altered interhemispheric inhibition appears to be dependent on the measure of interhemispheric inhibition and the stage of recovery.
Rebalancing interhemispheric inhibition using neuromodulation is considered a promising line of treatment for stroke rehabilitation. Our results did not find compelling evidence to support consistent alterations in interhemispheric inhibition in adults with stroke.
半球间抑制是支持运动控制的重要皮质机制。改变半球间抑制已成为神经调节干预的目标。本系统评价调查了单侧神经疾病（中风、肌萎缩性侧索硬化症、脑瘫、复杂性区域疼痛综合征、创伤性脑损伤和脑瘫）成人中改变的半球间抑制的证据。
我们预先注册了方案，并遵循 PRISMA 指南。系统地搜索了五个数据库，以确定报告单侧神经疾病和健康对照者半球间抑制测量值的研究。根据测量值（同侧静息期和双线圈）、刺激半球和疾病阶段（亚急性和慢性）对数据进行分组。
共确定了 1372 项研究，其中包括 14 项研究（n=226 例中风患者和 161 例年龄匹配的对照组）。与对照组相比，无论中风阶段如何，中风患者的同侧静息期持续时间更长（刺激优势半球）。与对照组（刺激优势半球）相比，亚急性中风患者（刺激未受影响的半球）的运动诱发电位抑制程度较低，而慢性中风患者则相反。
改变半球间抑制的检测似乎取决于半球间抑制的测量值和恢复阶段。
使用神经调节来重新平衡半球间抑制被认为是中风康复的一种有前途的治疗方法。我们的结果没有发现有力的证据支持中风成人中半球间抑制的一致改变。
