급성기 뇌경색 환자에서 초기 경두개 자기자극 검사의 아급성기 운동기능 회복에 대한 예측
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Background : The prognostic application of transcranial magnetic stimulation (TMS) for assessing motor and functional recovery in stroke patients has yielded controversial results, largely because of heterogeneous inclusion criteria. Methods : Sixteen acute stroke patients (12 lacunar infarct, 4 cortical infarct) with motor deficit (Medical Research Council (MRC) Scale ≤3) were prospectively studied in the first week after stroke and evaluated by clinical scales (MRC Scale, modified Rankin Scale, NIH Stroke Scale), with 3-week follow-up. TMS was performed within 1 week after stroke, recording the motor evoked potential (MEP) in the first dorsal interossei (FDI) and abductor hallucis (AH). Results : Overall, the presence of MEP was associated with better motor recovery in both FDI and AH. This was consistent in the subgroup analysis with initially paralyzed limb. The patients with the presence of MEP in either FDI or AH had better functional recovery than those without. This was also significant in the subgroup analysis with lacunar infarct. Conclusions : MEP obtained by early TMS in acute stroke patients with motor deficit may be a useful prognostic indicator of motor and functional recovery, even after adjustment of initial weakness and lesion location. Korean Journal of Stroke 2000;2 (1): 57~61
Abstract
Background : The prognostic application of transcranial magnetic stimulation (TMS) for assessing motor and functional recovery in stroke patients has yielded controversial results, largely because of heterogeneous inclusion criteria. Methods : Sixteen acute stroke patients (12 lacunar infarct, 4 cortical infarct) with motor deficit (Medical Research Council (MRC) Scale ≤3) were prospectively studied in the first week after stroke and evaluated by clinical scales (MRC Scale, modified Rankin Scale, NIH Stroke Scale), with 3-week follow-up. TMS was performed within 1 week after stroke, recording the motor evoked potential (MEP) in the first dorsal interossei (FDI) and abductor hallucis (AH). Results : Overall, the presence of MEP was associated with better motor recovery in both FDI and AH. This was consistent in the subgroup analysis with initially paralyzed limb. The patients with the presence of MEP in either FDI or AH had better functional recovery than those without. This was also significant in the subgroup analysis with lacunar infarct. Conclusions : MEP obtained by early TMS in acute stroke patients with motor deficit may be a useful prognostic indicator of motor and functional recovery, even after adjustment of initial weakness and lesion location. Korean Journal of Stroke 2000;2 (1): 57~61