title: Effect of thermal stimulation on corticomotor excitability in patients with stroke.
abstract: OBJECTIVE
  This study examined the immediate effects of noxious and innocuous thermal stimulation intervention on corticomotor excitability for the paretic arm in patients with stroke.
  
  
  METHODS
  Sixteen patients with stroke for more than 3 mos were randomly assigned into the experimental and control groups. All participants received the thermal stimulation protocol on the affected arm for 30 mins. The experimental group received noxious heat (46°C-47°C) and cold (7°C-8°C) stimuli, and the control group received innocuous heat (40°C-41°C) and cold (20°C-21°C) stimuli. Corticomotor excitability was assessed to measure the motor threshold, size of cortical motor output map, and mean motor evoked potentials for the abductor pollicis brevis by focal transcranial magnetic stimulation before and after 30 mins of thermal stimulation intervention program.
  
  
  RESULTS
  The findings of transcranial magnetic stimulation revealed a significant increase in map size of the affected hemisphere and mean motor evoked potentials in the experimental group. Moreover, significant differences in the change values of map size (7.0 [7.9] for the experimental group vs. -1.7 [2.9] for the control group, P = 0.03) and mean (SD) motor evoked potentials (0.4 [8.9] mV for the experimental group vs. -0.1 [0.1] mV for the control group, P = 0.03) were found.
  
  
  CONCLUSIONS
  The preliminary results suggest that the noxious 30 mins of thermal stimulation intervention induced neurophysiologic changes in the motor cortex of the lesioned hemisphere.
authors.affiliation: From the Department and Graduate Institute of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (IT, C-LL, M-JH, R-TL, J-HL); Department of Neurology, Kaohsiung Medical University Chung-Ho Hospital, Kaohsiung, Taiwan (C-LL, R-TL); Department of Physical Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan (M-JH, C-LL, J-HL); Department of Physical Medicine and Rehabilitation, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (M-HH); Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Chung-Ho Hospital, Kaohsiung, Taiwan (M-HH); School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan (C-LH); and Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan (C-LH).
authors.forename: I
authors.initials: I
authors.lastname: Tai
authors.forename: Chiou-Lian
authors.initials: CL
authors.lastname: Lai
authors.forename: Miao-Ju
authors.initials: MJ
authors.lastname: Hsu
authors.forename: Ruey-Tay
authors.initials: RT
authors.lastname: Lin
authors.forename: Mao-Hsiung
authors.initials: MH
authors.lastname: Huang
authors.forename: Chuan-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Hsieh
authors.forename: Jau-Hong
authors.initials: JH
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009473:Neuronal Plasticity / Q000502:physiology; D026741:Physical Therapy Modalities; D011712:Pyramidal Tracts / Q000503:physiopathology; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation