From the Department of Neurology, Castellón General Hospital
(J.V.E.); Department of Neurology, Valencia University School of Medicine,
Valencia University General Hospital (J.S.); Department of Public Health,
Research Service, Valencia University Clinic Hospital (D.B.); Department of
Neurophysiology, University Peset Hospital, Valencia (M.E.); and Laboratory of
Neurophysiology, Department of Neurology, Valencia University General Hospital
(J.L.-T.) (Spain).
Background and Purpose—The early
prognostic application of transcranial magnetic brain
stimulation (TMS) for assessing motor and functional recovery in
ischemic stroke patients has yielded contradictory results. We
performed a prospective study of patients with acute ischemic
stroke and motor deficit to evaluate the early prognostic value of TMS
in motor and functional recovery.
Methods—Fifty patients with different degrees of hemiparesis were
studied in the first week after ischemic stroke and evaluated
by clinical scales (Medical Research Council Scale, Canadian
Neurological Scale, Barthel Index), with clinical follow-up over 6
months. TMS (Magstim 200) was performed at the same time,
recording the motor evoked potential (MEP) in the thenar
eminence muscles, with facilitation by voluntary contraction.
Results—Of the total group of 50 patients, MEP was absent in 20
and present in 30 (17 with normal and 13 with delayed central
conduction time [CCT]). The patients with MEP showed better motor and
functional recovery than those without. The MEP provided information on
patient recovery, regardless of the initial strength and/or Barthel
values. The degree of recovery was better in those patients with normal
CCT than in those with delayed CCT.
Conclusions—MEP obtained by TMS in patients with hemiparesis
after acute ischemic stroke is useful as an early prognostic
indicator of motor and functional recovery. This technique would allow
the early identification of those patients who will have a good
recovery, particularly among those with severe initial paresis.
© 1998 American Heart Association, Inc.
Original Contributions
Prognostic Value of Motor Evoked Potential Obtained by Transcranial Magnetic Brain Stimulation in Motor Function Recovery in Patients With Acute Ischemic Stroke
Key Words: evoked potentials, motor • prognosis • stimulation, transcranial magnetic • stroke, acute • stroke, ischemic
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