Sarasso S, D'Ambrosio S, Russo S, Bernardelli L, Hassan G, Comanducci A, De Giampaulis P, Dalla Vecchia L A, Lanzone J, Massimini M
Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.
Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy; Department of Clinical and Experimental Epilepsy, University College London, London, United Kingdom.
Clin Neurophysiol. 2025 Jul;175:2110746. doi: 10.1016/j.clinph.2025.2110746. Epub 2025 May 19.
Recent studies indicate that brain injuries often lead to the occurrence of sleep-like slow waves in perilesional cortical areas. These slow waves may disrupt local cortico-cortical interactions and contribute to behavioral impairments but are, in principle, reversible. This study employs Transcranial Magnetic Stimulation (TMS) combined with Electroencephalography (EEG) to monitor changes in perilesional slow waves and local cortical interactions examining their relation to changes in stroke severity.
Twelve patients with post-acute/chronic unilateral ischemic cortical stroke participated in a longitudinal study with two assessment points. Each assessment included a neurological evaluation using the National Institutes of Health Stroke Scale (NIHSS) and TMS-EEG recordings targeting perilesional cortical areas. Neurophysiological parameters, such as slow wave amplitude (SWa), high-frequency power (HFp) suppression, and the Perturbational Complexity Index-state transition (PCIst), were extracted from the perilesional EEG responses to TMS to quantify local sleep-like slow waves andcortical interactions.
We observed a perilesional reduction in sleep-like slow waves and a restoration of local cortical interactions. Notably, these changes significantly correlated with patients' clinical evolution as assessed by the NIHSS score.
These findings highlight the potential of TMS-EEG as an objective tool for tracking neurological evolution post-stroke.
Targeting sleep-like cortical dynamics may be relevant for devising post-stroke rehabilitation strategies.
近期研究表明，脑损伤常导致损伤周围皮质区域出现类似睡眠的慢波。这些慢波可能会破坏局部皮质 - 皮质间的相互作用，并导致行为障碍，但原则上是可逆的。本研究采用经颅磁刺激（TMS）结合脑电图（EEG）来监测损伤周围慢波的变化以及局部皮质相互作用，以研究它们与中风严重程度变化的关系。
12例急性/慢性单侧缺血性皮质中风患者参与了一项有两个评估点的纵向研究。每次评估包括使用美国国立卫生研究院卒中量表（NIHSS）进行神经学评估以及针对损伤周围皮质区域的TMS - EEG记录。从损伤周围对TMS的EEG反应中提取神经生理参数，如慢波振幅（SWa）、高频功率（HFp）抑制和微扰复杂性指数 - 状态转换（PCIst），以量化局部类似睡眠的慢波和皮质相互作用。
我们观察到损伤周围类似睡眠的慢波减少，局部皮质相互作用得到恢复。值得注意的是，这些变化与通过NIHSS评分评估的患者临床进展显著相关。
这些发现突出了TMS - EEG作为跟踪中风后神经学进展的客观工具的潜力。
针对类似睡眠的皮质动力学可能与制定中风后康复策略相关。
