Article
The relationship between TMS measures of functional properties and DTI measures of microstructure of the corticospinal tract.
Department of Neurology, Goethe-University Frankfurt, Frankfurt, Germany.
Brain Stimulation (impact factor:
3.76).
04/2011;
5(3):297-304.
DOI:10.1016/j.brs.2011.03.008
pp.297-304
Source: PubMed
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Citations (0)
- Cited In (1)
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Article: Prognostic value of cortically induced motor evoked activity by TMS in chronic stroke: caveats from a revealing single clinical case.
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ABSTRACT: We report the case of a chronic stroke patient (62 months after injury) showing total absence of motor activity evoked by transcranial magnetic stimulation (TMS) of spared regions of the left motor cortex, but near-to-complete recovery of motor abilities in the affected hand. Multimodal investigations included detailed TMS based motor mapping, motor evoked potentials (MEP), and Cortical Silent period (CSP) as well as functional magnetic resonance imaging (fMRI) of motor activity, MRI based lesion analysis and Diffusion Tensor Imaging (DTI) Tractography of corticospinal tract (CST). Anatomical analysis revealed a left hemisphere subinsular lesion interrupting the descending left CST at the level of the internal capsule. The absence of MEPs after intense TMS pulses to the ipsilesional M1, and the reversible suppression of ongoing electromyographic (EMG) activity (indexed by CSP) demonstrate a weak modulation of subcortical systems by the ipsilesional left frontal cortex, but an inability to induce efficient descending volleys from those cortical locations to right hand and forearm muscles. Functional MRI recordings under grasping and finger tapping patterns involving the affected hand showed slight signs of subcortical recruitment, as compared to the unaffected hand and hemisphere, as well as the expected cortical activations. The potential sources of motor voluntary activity for the affected hand in absence of MEPs are discussed. We conclude that multimodal analysis may contribute to a more accurate prognosis of stroke patients.BMC Neurology 06/2012; 12:35. · 2.17 Impact Factor
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Keywords
active motor threshold
central motor conduction time
correlations
diffusion tensor magnetic resonance imaging
electrophysiologic measurements
electrophysiologic parameter
fractional anisotropy
IO curve slope
IO-curve
left-hemispheric S1mV
local tissue microstructure
MEP input-output curve
microstructural properties
regional FA
resting motor threshold
significant correlation
significant correlations
TBSS correlation analysis
transcranial magnetic stimulation
white matter