[Prognostic value of transcranial magnetic brain stimulation in motor function recovery in patient with acute ischemic stroke]

ABSTRACT

Application of transcranial magnetic stimulation as a prognostic tool in stroke patients is a new method. in the present study, we used transcranial magnetic stimulation of the motor cortex to evaluate the functional state of corticospinal pathway innervated the first dorsal interosseous muscle and we have assessed the prognostic value of this study on prediction of motor function recovery. We have assessed 34 patients that experience first ever acute ischemic stroke in the middle cerebral artery territory and had complete hand palsy. All patients were clinically evaluated and tested with transcranial magnetic stimulation within the first 24 hours after onset of stroke. Patients were divided into three group, according to the amplitude of the motor evoked potential [MEP] at day1. These testes were repeated at day 14. Then, Correlation between clinical evaluation at day 14 and eleotrophysiologic results at day1 was investigated. After 2 weeks, all patients that their MEP were at the normal range, showed some hand muscle motor function recovery, whereas 25 of 27 patients with initially absent or small MEP were left with complete hand palsy. There was strong positive correlation between MEP amplitude at day1 and improvement of muscle strength at day 14 [P<0.001]. Also, measurement of central motor conduction time showed the same results [P=0.0001]. This study showed that transcranial magnetic stimulation of the motor cortex is a useful device for prediction of motor function recovery in patients with ischemic stroke