title: Neurophysiological Characterization of Subacute Stroke Patients: A Longitudinal Study.
abstract: Various degrees of neural reorganization may occur in affected and unaffected hemispheres in the early phase after stroke and several months later. Recent literature suggests to apply a stratification based on lesion location and to consider patients with cortico-subcortical and subcortical strokes separately: different lesion location may also influence therapeutic response. In this study we used a longitudinal approach to perform TMS assessment (Motor Evoked Potentials, MEP, and Silent Period, SP) and clinical evaluations (Barthel Index, Fugl-Meyer Assessment for upper limb motor function and Wolf Motor Function Test) in 10 cortical-subcortical and 10 subcortical ischemic stroke patients. Evaluations were performed in a window between 10 and 45 days (t0) and at 3 months after the acute event (t1). Our main finding is that 3 months after the acute event patients affected by subcortical stroke presented a reduction in contralateral SP duration in the unaffected hemisphere; this trend is related to clinical improvement of upper limb motor function. In conclusion, SP proved to be a valid parameter to characterize cortical reorganization patterns in stroke survivors and provided useful information about motor recovery within 3 months in subcortical patients.
authors.affiliation: Unit of Neurorehabilitation, Department of Neuroscience, University of Pisa Pisa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lamola
authors.affiliation: Unit of Neurorehabilitation, Department of Neuroscience, University of PisaPisa, Italy; The BioRobotics Institute, Scuola Superiore Sant'AnnaPisa, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fanciullacci
authors.affiliation: Unit of Neurorehabilitation, Department of Neuroscience, University of Pisa Pisa, Italy.
authors.forename: Giada
authors.initials: G
authors.lastname: Sgherri
authors.affiliation: Unit of Neurorehabilitation, Department of Neuroscience, University of Pisa Pisa, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Bertolucci
authors.affiliation: The BioRobotics Institute, Scuola Superiore Sant'Anna Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Panarese
authors.affiliation: The BioRobotics Institute, Scuola Superiore Sant'AnnaPisa, Italy; Translational Neural Engineering Lab, Center for NeuroprostheticsLausanne, Switzerland.
authors.forename: Silvestro
authors.initials: S
authors.lastname: Micera
authors.affiliation: Unit of Neurorehabilitation, Department of Neuroscience, University of Pisa Pisa, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Rossi
authors.affiliation: Unit of Neurorehabilitation, Department of Neuroscience, University of Pisa Pisa, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Chisari
keywords: clinical neurophysiology; cortical excitability; functional recovery; intracortical inhibition; motor evoked potentials; silent period; stroke; unaffected hemisphere