Resting motor threshold in the course of hand motor recovery after stroke: a systematic review

Abstract Background Resting motor threshold is an objective measure of cortical excitability. Numerous studies indicate that the success of motor recovery after stroke is significantly determined by the direction and extent of cortical excitability changes. A better understanding of this topic (part...

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Autores principales:	Jitka Veldema, Dennis Alexander Nowak, Alireza Gharabaghi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Resting motor threshold Hand motor recovery Stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/fe31834311ad44179bdde650a9feeedd
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spelling	oai:doaj.org-article:fe31834311ad44179bdde650a9feeedd2021-11-08T11:15:55ZResting motor threshold in the course of hand motor recovery after stroke: a systematic review10.1186/s12984-021-00947-81743-0003https://doaj.org/article/fe31834311ad44179bdde650a9feeedd2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12984-021-00947-8https://doaj.org/toc/1743-0003Abstract Background Resting motor threshold is an objective measure of cortical excitability. Numerous studies indicate that the success of motor recovery after stroke is significantly determined by the direction and extent of cortical excitability changes. A better understanding of this topic (particularly with regard to the level of motor impairment and the contribution of either cortical hemisphere) may contribute to the development of effective therapeutical strategies in this cohort. Objectives This systematic review collects and analyses the available evidence on resting motor threshold and hand motor recovery in stroke patients. Methods PubMed was searched from its inception through to 31/10/2020 on studies investigating resting motor threshold of the affected and/or the non-affected hemisphere and motor function of the affected hand in stroke cohorts. Results Overall, 92 appropriate studies (including 1978 stroke patients and 377 healthy controls) were identified. The analysis of the data indicates that severe hand impairment is associated with suppressed cortical excitability within both hemispheres and with great between-hemispheric imbalance of cortical excitability. Favorable motor recovery is associated with an increase of ipsilesional motor cortex excitability and reduction of between-hemispheric imbalance. The direction of change of contralesional motor cortex excitability depends on the amount of hand motor impairment. Severely disabled patients show an increase of contralesional motor cortex excitability during motor recovery. In contrast, recovery of moderate to mild hand motor impairment is associated with a decrease of contralesional motor cortex excitability. Conclusions This data encourages a differential use of rehabilitation strategies to modulate cortical excitability. Facilitation of the ipsilesional hemisphere may support recovery in general, whereas facilitation and inhibition of the contralesional hemisphere may enhance recovery in severe and less severely impaired patients, respectively.Jitka VeldemaDennis Alexander NowakAlireza GharabaghiBMCarticleResting motor thresholdHand motor recoveryStrokeNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENJournal of NeuroEngineering and Rehabilitation, Vol 18, Iss 1, Pp 1-28 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Resting motor threshold Hand motor recovery Stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Resting motor threshold Hand motor recovery Stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Jitka Veldema Dennis Alexander Nowak Alireza Gharabaghi Resting motor threshold in the course of hand motor recovery after stroke: a systematic review
description	Abstract Background Resting motor threshold is an objective measure of cortical excitability. Numerous studies indicate that the success of motor recovery after stroke is significantly determined by the direction and extent of cortical excitability changes. A better understanding of this topic (particularly with regard to the level of motor impairment and the contribution of either cortical hemisphere) may contribute to the development of effective therapeutical strategies in this cohort. Objectives This systematic review collects and analyses the available evidence on resting motor threshold and hand motor recovery in stroke patients. Methods PubMed was searched from its inception through to 31/10/2020 on studies investigating resting motor threshold of the affected and/or the non-affected hemisphere and motor function of the affected hand in stroke cohorts. Results Overall, 92 appropriate studies (including 1978 stroke patients and 377 healthy controls) were identified. The analysis of the data indicates that severe hand impairment is associated with suppressed cortical excitability within both hemispheres and with great between-hemispheric imbalance of cortical excitability. Favorable motor recovery is associated with an increase of ipsilesional motor cortex excitability and reduction of between-hemispheric imbalance. The direction of change of contralesional motor cortex excitability depends on the amount of hand motor impairment. Severely disabled patients show an increase of contralesional motor cortex excitability during motor recovery. In contrast, recovery of moderate to mild hand motor impairment is associated with a decrease of contralesional motor cortex excitability. Conclusions This data encourages a differential use of rehabilitation strategies to modulate cortical excitability. Facilitation of the ipsilesional hemisphere may support recovery in general, whereas facilitation and inhibition of the contralesional hemisphere may enhance recovery in severe and less severely impaired patients, respectively.
format	article
author	Jitka Veldema Dennis Alexander Nowak Alireza Gharabaghi
author_facet	Jitka Veldema Dennis Alexander Nowak Alireza Gharabaghi
author_sort	Jitka Veldema
title	Resting motor threshold in the course of hand motor recovery after stroke: a systematic review
title_short	Resting motor threshold in the course of hand motor recovery after stroke: a systematic review
title_full	Resting motor threshold in the course of hand motor recovery after stroke: a systematic review
title_fullStr	Resting motor threshold in the course of hand motor recovery after stroke: a systematic review
title_full_unstemmed	Resting motor threshold in the course of hand motor recovery after stroke: a systematic review
title_sort	resting motor threshold in the course of hand motor recovery after stroke: a systematic review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/fe31834311ad44179bdde650a9feeedd
work_keys_str_mv	AT jitkaveldema restingmotorthresholdinthecourseofhandmotorrecoveryafterstrokeasystematicreview AT dennisalexandernowak restingmotorthresholdinthecourseofhandmotorrecoveryafterstrokeasystematicreview AT alirezagharabaghi restingmotorthresholdinthecourseofhandmotorrecoveryafterstrokeasystematicreview
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Resting motor threshold in the course of hand motor recovery after stroke: a systematic review

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