title: Navigated Transcranial Magnetic Stimulation: A Biologically Based Assay of Lower Extremity Impairment and Gait Velocity.
abstract: Objectives. (a) To determine associations among motor evoked potential (MEP) amplitude, MEP latency, lower extremity (LE) impairment, and gait velocity and (b) determine the association between the presence of a detectable MEP signal with LE impairment and with gait velocity.Method. 35 subjects with chronic, stable LE hemiparesis were undergone TMS, the LE section of the Fugl-Meyer Impairment Scale (LE FM), and 10-meter walk test. We recorded presence, amplitude, and latency of MEPs in the affected tibialis anterior (TA) and soleus (SO).Results. MEP presence was associated with higher LEFM scores in both the TA and SO. MEP latency was larger in subjects with lower LEFM and difficulty walking.Conclusion. MEP latency appears to be an indicator of LE impairment and gait.Significance. Our results support the precept of using TMS, particularly MEP latency, as an adjunctive LE outcome measurement and prognostic technique.
authors.affiliation: Division of Occupational Therapy, The Ohio State University, Columbus, OH, USA; B.R.A.I.N. (Better Rehabilitation and Assessment for Improved Neuro-recovery) Laboratory, Ohio State University, Columbus, OH, USA.
authors.forename: Heather T
authors.identifier: 0000-0002-9059-1056
authors.initials: HT
authors.lastname: Peters
authors.affiliation: The University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Kari
authors.initials: K
authors.lastname: Dunning
authors.affiliation: Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Samir
authors.identifier: 0000-0003-0463-1507
authors.initials: S
authors.lastname: Belagaje
authors.affiliation: The University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Brett M
authors.identifier: 0000-0002-9773-4013
authors.initials: BM
authors.lastname: Kissela
authors.affiliation: The University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
authors.affiliation: Nexstim, Ltd., Helsinki, Finland.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Laine
authors.affiliation: Division of Occupational Therapy, The Ohio State University, Columbus, OH, USA; B.R.A.I.N. (Better Rehabilitation and Assessment for Improved Neuro-recovery) Laboratory, Ohio State University, Columbus, OH, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
mesh_terms: D000368:Aged; D019054:Evoked Potentials, Motor; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D038361:Neuronavigation / Q000379:methods*; D010291:Paresis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*