Motor cortex disinhibition in acute stroke

Objectives: To test whether a disinhibition occurs in the human motor cortex after stroke. Methods: Patients with a mild to moderate hemiparesis after an acute unilateral ischemic stroke were compared with age-matched healthy controls. We used paired transcranial magnetic stimuli (TMS) to investigat...

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Bibliographic Details
Published in:Clinical neurophysiology 2000-04, Vol.111 (4), p.671-676
Main Authors: Liepert, J, Storch, P, Fritsch, A, Weiller, C
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Biological and medical sciences
Electric Stimulation
Evoked Potentials, Motor - physiology
Female
Humans
Intracortical inhibition
Magnetics
Male
Medical sciences
Middle Aged
Motor Cortex - physiopathology
Neural Inhibition - physiology
Neurology
Reaction Time - physiology
Recovery
Recovery of Function - physiology
Silent period
Stroke
Stroke - diagnosis
Stroke - physiopathology
Transcranial magnetic stimulation
Vascular diseases and vascular malformations of the nervous system
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Summary:Objectives: To test whether a disinhibition occurs in the human motor cortex after stroke. Methods: Patients with a mild to moderate hemiparesis after an acute unilateral ischemic stroke were compared with age-matched healthy controls. We used paired transcranial magnetic stimuli (TMS) to investigate intracortical inhibition and facilitation. Single TMS were applied to obtain a cortical silent period. Results: Intracortical inhibition was significantly reduced in the affected hemisphere at interstimulus intervals of 2, 3 and 4 ms. The cortical silent period was significantly prolonged when compared to the unaffected hemisphere of the patients and to the control group. Motor cortex disinhibition observed in stroke patients was associated either with minimal impairment at the onset of symptoms or with rapidly improving motor functions. Conclusions: Motor cortex disinhibition occurs in humans after stroke. We suggest that this disinhibition is indicative of compensatory mechanisms, which are involved in recovery-related reorganization.
ISSN:1388-2457
1872-8952
DOI:10.1016/S1388-2457(99)00312-0