Association of TMS-EEG interhemispheric imbalance with upper limb motor impairment in chronic stroke patients: An exploratory study

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY Clinical Neurophysiology Pub Date : 2025-03-01 Epub Date: 2025-01-20 DOI:10.1016/j.clinph.2024.12.027

Alex Martino Cinnera , Elias Paolo Casula , Valentina Pezzopane , Alessia D’Acunto , Michele Maiella , Sonia Bonnì , Matteo Ferraresi , Marcella Guacci , Marco Tramontano , Marco Iosa , Stefano Paolucci , Giovanni Morone , Giuseppe Vannozzi , Giacomo Koch

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Abstract

Objective

We aimed to investigate the involvement of interhemispheric cortical dynamics as measured by combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) in recovery of upper limb (UL) motor functions in chronic stroke patients.

Methods

Ten patients with a history of single ischemic chronic stroke were enrolled (4F, 63.8 ± 9.9 years). Each patient underwent TMS-EEG recordings to evaluate interhemispheric cortical dynamics as well as a reaching task recorded with inertial measurement units, and a series of clinical assessments. TMS-EEG neurophysiological data were analysed considering spatiotemporal, power response, and interhemispheric balance (IHB) dynamics.

Results

We found that IHB index (IHBi) and low-frequency power (LFP) (4–13 Hz) in the affected hemisphere were associated with the degree of UL impairment.

Conclusion

Increased IHBi due to stroke is an unfavourable factor of UL’ functions. Similarly, LFP of both hemispheres is strongly correlated with clinical and kinematic outcomes.

Significance

TMS-EEG biomarkers of interhemispheric unbalance could be used to estimate functional recovery and drive tailored neuromodulation and neurorehabilitation approaches.

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慢性脑卒中患者TMS-EEG半球间失衡与上肢运动障碍的相关性：一项探索性研究。

目的：探讨经颅磁刺激联合脑电图（TMS-EEG）测量的半球间皮质动力学在慢性脑卒中患者上肢运动功能恢复中的作用。方法：10例有单一缺血性慢性脑卒中病史的患者（4F, 63.8±9.9岁）。每位患者均接受TMS-EEG记录，以评估大脑半球间皮质动力学以及惯性测量单元记录的到达任务，并进行一系列临床评估。对TMS-EEG神经生理数据进行时空、功率响应和半球间平衡（IHB）动力学分析。结果：我们发现患脑半球IHB指数（IHBi）和低频功率（LFP）（4-13 Hz）与UL损伤程度相关。结论：脑卒中所致IHBi升高是影响UL功能的不利因素。同样，两个半球的LFP与临床和运动学结果密切相关。意义：脑半球间不平衡的TMS-EEG生物标志物可用于评估功能恢复，并驱动量身定制的神经调节和神经康复方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.