title: Modulation of cortical and spinal   inhibition with functional recovery   of upper extremity motor function   among patients with chronic stroke.
abstract: OBJECTIVE
  We hypothesized that recovery of upper extremity motor function is associated with reduction of intracortical inhibition and improved reciprocal inhibition. This study examines the relationships of functional recovery in chronic stroke with the intracortical inhibition and spinal reciprocal inhibition.
  
  
  METHODS
  Participants were 61 patients with chronic hemiparetic stroke. The participants were applied hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for 3 weeks. The Fugl-Meyer test upper extremity motor score (FM) and modified Ashworth scale (MAS) were assessed before (T0), immediately after (T1) and 3 months after (T2) the end of HANDS therapy. A paired pulse TMS paradigm was applied to assess short intracortical inhibition (SICI). Reciprocal inhibition (RI) was assessed with H reflex conditioning-test paradigm.
  
  
  RESULTS
  FM and MAS were improved until T2. The change of FM from T0 to T2 was positively correlated with the change in affected SICI from T0 toT1. The change of wrist MAS from T0 to T1 was positively correlated with the change of RI.
  
  
  CONCLUSIONS
  In chronic stroke patients with moderate or severe hemiparesis, well-recovered patients showed disinhibition of ipsilesional hemisphere and increased resiprocal inhibition of forearm.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Honaga
authors.forename: Michiyuki
authors.initials: M
authors.lastname: Kawakami
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nishimoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Abe
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Kodama
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Masakado
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsuji
authors.forename: Meigen
authors.initials: M
authors.lastname: Liu
mesh_terms: D001921:Brain / Q000503:physiopathology*; D002908:Chronic Disease; D015331:Cohort Studies; D004599:Electric Stimulation Therapy / Q000379:methods; D004576:Electromyography / Q000379:methods; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009433:Neural Inhibition / Q000502:physiology; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000503:physiopathology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*