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. 2021 May 15;11(5):648.
doi: 10.3390/brainsci11050648.

TMS-Induced Central Motor Conduction Time at the Non-Infarcted Hemisphere Is Associated with Spontaneous Motor Recovery of the Paretic Upper Limb after Severe Stroke

Maurits H J Hoonhorst  1 , Rinske H M Nijland  2 , Cornelis H Emmelot  3 , Boudewijn J Kollen  4 , Gert Kwakkel  2   5   6   7
Affiliations

TMS-Induced Central Motor Conduction Time at the Non-Infarcted Hemisphere Is Associated with Spontaneous Motor Recovery of the Paretic Upper Limb after Severe Stroke

Maurits H J Hoonhorst et al. Brain Sci. .

Abstract

Background: Stroke affects the neuronal networks of the non-infarcted hemisphere. The central motor conduction time (CMCT) induced by transcranial magnetic stimulation (TMS) could be used to determine the conduction time of the corticospinal tract of the non-infarcted hemisphere after a stroke.

Objectives: Our primary aim was to demonstrate the existence of prolonged CMCT in the non-infarcted hemisphere, measured within the first 48 h when compared to normative data, and secondly, if the severity of motor impairment of the affected upper limb was significantly associated with prolonged CMCTs in the non-infarcted hemisphere when measured within the first 2 weeks post stroke.

Methods: CMCT in the non-infarcted hemisphere was measured in 50 patients within 48 h and at 11 days after a first-ever ischemic stroke. Patients lacking significant spontaneous motor recovery, so-called non-recoverers, were defined as those who started below 18 points on the FM-UE and showed less than 6 points (10%) improvement within 6 months.

Results: CMCT in the non-infarcted hemisphere was prolonged in 30/50 (60%) patients within 48 h and still in 24/49 (49%) patients at 11 days. Sustained prolonged CMCT in the non-infarcted hemisphere was significantly more frequent in non-recoverers following FM-UE.

Conclusions: The current study suggests that CMCT in the non-infarcted hemisphere is significantly prolonged in 60% of severely affected, ischemic stroke patients when measured within the first 48 h post stroke. The likelihood of CMCT is significantly higher in non-recoverers when compared to those that show spontaneous motor recovery early post stroke.

Keywords: prognosis; recovery; stroke; transcranial magnetic stimulation; upper limb.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient exclusion flowchart.
Figure 2
Figure 2
Time course of individual FM-UE scores for the affected upper limb of all patients (N = 50), between baseline (i.e., within 48 h after stroke) and 6 months post stroke. Blue lines represent the non-recoverers (N = 17) and black lines those who showed spontaneous neurological recovery (N = 33).
See this image and copyright information in PMC

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