Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Ann Med. 2023 Dec;55(1):2225144. doi: 10.1080/07853890.2023.2225144.
Motor recovery following a stroke is related to the initial stroke severity and corticospinal tract integrity. One of the outcomes representing corticospinal tract integrity is the motor evoked potential (MEP). This study aimed to investigate the predictive value of MEP for motor recovery in patients with acute ischemic stroke.
Patients with hemiparesis secondary to initial acute ischemic stroke were enrolled. MEPs of the upper limb were assessed as preserved (MEP+) or absent (MEP-) response ≤10 days post-stroke. Fugl-Meyer assessment (FMA) was performed at baseline and post-stroke at 30 and 90 days. A modified Rankin scale (mRS) was conducted at 90 days post-stroke. Patients were divided into two groups according to the highest FMA score of MEP- patients. Generalized estimating equations and logistic regression were used for our study analysis.
Sixty-one participants were included in this study. The highest FMA score of MEP- patients ≤10 days after stroke was 38. Among patients with an initial FMA score ≤38, FMA scores at 30 and 90 days post-stroke were significantly higher in MEP + patients than in MEP- patients. Proportional recovery at 30 and 90 days post-stroke was significantly higher in MEP + patients than in MEP- patients. MEP + patients had a higher percentage of good functional outcomes than MEP- patients, without statistical difference. Among patients with initial FMA score >38, FMA scores were 60.4 ± 4.8 and 63.9 ± 2.9 and proportional recovery was 65.2 ± 27.0% and 83.7 ± 24.6% at 30 and 90 days post-stroke, respectively.
Among patients with moderate-to-severe ischemic stroke, MEP + patients had better motor recoveries (approximately 70%) than MEP- patients at 90 days post-stroke. MEP + patients had better functional outcomes than MEP- patients.
中风后的运动恢复与初始中风严重程度和皮质脊髓束完整性有关。代表皮质脊髓束完整性的结果之一是运动诱发电位（MEP）。本研究旨在探讨 MEP 对急性缺血性中风患者运动恢复的预测价值。
纳入了因初始急性缺血性中风而导致偏瘫的患者。上肢 MEP 被评估为保留（MEP+）或不存在（MEP-）反应≤10 天。在基线和中风后 30 天和 90 天进行 Fugl-Meyer 评估（FMA）。在中风后 90 天进行改良 Rankin 量表（mRS）评估。根据 MEP-患者的最高 FMA 评分，将患者分为两组。使用广义估计方程和逻辑回归进行我们的研究分析。
本研究纳入了 61 名参与者。中风后 10 天内 MEP-患者的最高 FMA 评分≤38。在初始 FMA 评分≤38 的患者中，MEP+患者在中风后 30 天和 90 天的 FMA 评分显著高于 MEP-患者。MEP+患者在中风后 30 天和 90 天的比例恢复显著高于 MEP-患者。MEP+患者的良好功能结局百分比高于 MEP-患者，但无统计学差异。在初始 FMA 评分>38 的患者中，FMA 评分分别为 60.4±4.8 和 63.9±2.9，比例恢复分别为 65.2±27.0%和 83.7±24.6%，在中风后 30 天和 90 天。
在中重度缺血性中风患者中，MEP+患者在中风后 90 天的运动恢复（约 70%）优于 MEP-患者。MEP+患者的功能结局优于 MEP-患者。
