title: The Predictive Value of Motor-Evoked Potentials and the Silent Period on Patient Outcome after Acute Cerebral Infarction.
abstract: BACKGROUND
  The predictive value of neurophysiologic assessment on patients' outcome after acute cerebral infarction is poorly understood. The aim of this study was to investigate the prognostic value of motor-evoked potentials (MEPs) and the silent period (SP) on clinical outcome.
  
  
  METHODS
  A total of 202 patients with acute cerebral infarction were prospectively recruited. MEP and SP were recorded from the abductor pollicis brevis of the affected side within 10 days after stroke onset. Patient outcome was measured as the dependency rate.
  
  
  RESULTS
  Cortical MEP was induced in 78 patients whereas it was absent in 82 patients. The initial NIHSS (National Institutes of Health Stroke Scale) score was significantly lower in patients with MEP than in those without MEP (P < .001). Regression analysis demonstrated that a left-sided lesion (OR = .391, 95% CI .178-.858, P = .019), NIHSS at admission (OR = .826, 95% CI .744-.917, P < .001), and presence of MEP (OR = 3.918, 95% CI 1.770-8.672, P < .001) were independent predictors of outcome 3 months after stroke. Among patients with MEP, only the contralateral cortical SP value was significantly shorter in the good outcome subgroup (t = 2.541, P = .013). Receiver operating characteristic curve analysis demonstrated that SP was able to predict patients at higher risk of unfavorable outcome 3 months after stroke onset (area under the curve .721, 95% CI .58-.86, P = .008).
  
  
  CONCLUSIONS
  These data suggested that MEP and SP were useful tools to predict patients' acute outcomes following cerebral infarction.
authors.affiliation: Department of Electrophysiology, Tianjin Huanhu Hospital, Tianjin, China.
authors.forename: Xueqing
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Electrophysiology, Tianjin Huanhu Hospital, Tianjin, China.
authors.forename: Wenzhen
authors.initials: W
authors.lastname: Ji
authors.affiliation: Department of Medical Insurance, Tianjin Huanhu Hospital, Tianjin, China.
authors.forename: Lancui
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Changshen
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Wanjun
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Shoufeng
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Chunlin
authors.initials: C
authors.lastname: Gao
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Qiu
authors.affiliation: Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Tong
authors.affiliation: Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
authors.forename: Jinhuan
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China. Electronic address: wywjl2009@hotmail.com.
authors.forename: Jialing
authors.initials: J
authors.lastname: Wu
mesh_terms: D000208:Acute Disease; D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D004576:Electromyography; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009044:Motor Cortex / Q000503:physiopathology*; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000294:innervation*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome
keywords: Cerebral infarction; motor-evoked potentials; outcome; silent period; transcranial magnetic stimulation