Lacerda Guilherme J M, Silva Fernanda M Q, Pacheco-Barrios Kevin, Battistella Linamara Rizzo, Fregni Felipe
Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02138, USA.
Instituto de Medicina Física e Reabilitação, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 04101-300, SP, Brazil.
Brain Sci. 2024 Dec 15;14(12):1257. doi: 10.3390/brainsci14121257.
This study aimed to explore longitudinal relationships between neurophysiological biomarkers and upper limb motor function recovery in stroke patients, focusing on electroencephalography (EEG) and transcranial magnetic stimulation (TMS) metrics.
This longitudinal cohort study analyzed neurophysiological, clinical, and demographic data from 102 stroke patients enrolled in the DEFINE cohort. We investigated the associations between baseline and post-intervention changes in the EEG theta/alpha ratio (TAR) and TMS metrics with upper limb motor functionality, assessed using the outcomes of five tests: the Fugl-Meyer Assessment (FMA), Handgrip Strength Test (HST), Pinch Strength Test (PST), Finger Tapping Test (FTT), and Nine-Hole Peg Test (9HPT).
Our multivariate models identified that a higher baseline TAR in the lesioned hemisphere was consistently associated with poorer motor outcomes across all five assessments. Conversely, a higher improvement in the TAR was positively associated with improvements in FMA and 9HPT. Additionally, an increased TMS motor-evoked potential (MEP) amplitude in the non-lesioned hemisphere correlated with greater FMA-diff, while a lower TMS Short Intracortical Inhibition (SICI) in the non-lesioned hemisphere was linked to better PST improvements. These findings suggest the potential of the TAR and TMS metrics as biomarkers for predicting motor recovery in stroke patients.
Our findings highlight the significance of the TAR in the lesioned hemisphere as a predictor of motor function recovery post-stroke and also a potential signature for compensatory oscillations. The observed relationships between the TAR and motor improvements, as well as the associations with TMS metrics, underscore the potential of these neurophysiological measures in guiding personalized rehabilitation strategies for stroke patients.
本研究旨在探讨中风患者神经生理生物标志物与上肢运动功能恢复之间的纵向关系，重点关注脑电图（EEG）和经颅磁刺激（TMS）指标。
这项纵向队列研究分析了DEFINE队列中102名中风患者的神经生理、临床和人口统计学数据。我们研究了EEG θ/α比率（TAR）和TMS指标的基线与干预后变化与上肢运动功能之间的关联，使用五项测试的结果进行评估：Fugl-Meyer评估（FMA）、握力测试（HST）、捏力测试（PST）、手指敲击测试（FTT）和九孔插钉测试（9HPT）。
我们的多变量模型确定，病变半球中较高的基线TAR在所有五项评估中均与较差的运动结果一致相关。相反，TAR的较大改善与FMA和9HPT的改善呈正相关。此外，非病变半球中TMS运动诱发电位（MEP）幅度的增加与更大的FMA差异相关，而非病变半球中较低的TMS短皮质内抑制（SICI）与更好的PST改善相关。这些发现表明TAR和TMS指标作为中风患者运动恢复预测生物标志物的潜力。
我们的研究结果强调了病变半球中TAR作为中风后运动功能恢复预测指标的重要性，也是代偿性振荡的潜在特征。观察到的TAR与运动改善之间的关系以及与TMS指标的关联，强调了这些神经生理测量在指导中风患者个性化康复策略方面的潜力。
