Prognostic value of motor evoked potentials in stroke motor outcome

Abstract

Functional study technologies of the central nervous system (CNS) are fast developing, yielding further objective data for evidence based neurological rehabilitation. Transcranial magnetic stimulation is a safe and non invasive technique of functional investigation of several aspects of the CNS. During the past few years many studies have focused on motor evoked potentials (MEPs) in the investigation of central nervous system and particularly of central motor pathways. Among the various issues of rehabilitative concern in this context, the prognostic value of MEPs of motor outcome after stroke is the most interesting one. The aim of this review, conducted on Medline database, is to find out the current agreement in the literature about this topic and to outline clinical criteria of use of the test. Many of the retrieved papers suggest an added value of MEPs on motor prognosis after first ischemic sylvian stroke, highlighting higher specificity in clinical cases with paralysis or severe paresis in the acute stage. A clinical use of MEPs in specific stroke subgroups might help to plan a more individual rehabilitative project through realistic motor recovery goals and selected techniques of treatment; a more reliable motor prognosis may also be useful for rehabilitation effectiveness research and for a more aimed use of resources.