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Position-Cortical Coherence as a Marker of Afferent Pathway Integrity Early Poststroke: A Prospective Cohort Study
Neurorehabilitation and Neural Repair ( IF 3.7 ) Pub Date : 2020-03-04 , DOI: 10.1177/1545968319893289
Sarah B Zandvliet 1 , Erwin E H van Wegen 1 , S Floor Campfens 2 , Herman van der Kooij 2 , Gert Kwakkel 1, 3, 4 , Carel G M Meskers 1, 3
Affiliation  

Background. Addressing the role of somatosensory impairment, that is, afferent pathway integrity, in poststroke motor recovery may require neurophysiological assessment. Objective. We investigated the longitudinal construct validity of position-cortical coherence (PCC), that is, the agreement between mechanically evoked wrist perturbations and electroencephalography (EEG), as a measure of afferent pathway integrity. Methods. PCC was measured serially in 48 patients after a first-ever ischemic stroke in addition to Fugl-Meyer motor assessment of the upper extremity (FM-UE) and Nottingham Sensory Assessment hand-finger subscores (EmNSA-HF, within 3 and at 5, 12, and 26 weeks poststroke. Changes in PCC over time, represented by percentage presence of PCC (%PCC), mean amplitude of PCC over the affected (Amp-A) and nonaffected hemisphere (Amp-N) and a lateralization index (L-index), were analyzed, as well as their association with FM-UE and EmNSA-HF. Patients were retrospectively categorized based on FM-UE score at baseline and 26 weeks poststroke into high- and low-baseline recoverers and non-recoverers. Results. %PCC increased from baseline to 12 weeks poststroke (β = 1.6%, CI = 0.32% to 2.86%, P = .01), which was no longer significant after adjusting for EmNSA-HF and FM-UE. A significant positive association was found between %PCC, Amp-A, and EmNSA-HF. Low-baseline recoverers (n = 8) showed longitudinally significantly higher %PCC than high-baseline recoverers (n = 23). Conclusions. We demonstrated the longitudinal construct validity of %PCC and Amp-A as a measure of afferent pathway integrity. A high %PCC in low-baseline recoverers suggests that this measure also contains information on cortical excitability. Use of PCC as an EEG-based measure to address the role of somatosensory integrity to motor recovery poststroke requires further attention.

中文翻译:

位置皮质一致性作为脑卒中后早期传入通路完整性的标志:一项前瞻性队列研究

背景。解决躯体感觉障碍(即传入通路完整性)在卒中后运动恢复中的作用可能需要神经生理学评估。客观的。我们调查了位置皮质相干 (PCC) 的纵向结构有效性,即机械诱发腕部扰动和脑电图 (EEG) 之间的一致性,作为传入通路完整性的衡量标准。方法。除了上肢的 Fugl-Meyer 运动评估 (FM-UE) 和诺丁汉感官评估手手指子评分 (EmNSA-HF,3 内和 5 时,在首次缺血性中风后连续测量 48 名患者的 PCC,中风后 12 周和 26 周 PCC 随时间的变化,以 PCC 存在百分比 (%PCC) 表示,分析了受影响半球 (Amp-A) 和未受影响半球 (Amp-N) 的 PCC 平均振幅和侧化指数 (L-index),以及它们与 FM-UE 和 EmNSA-HF 的关联。根据基线和卒中后 26 周的 FM-UE 评分将患者回顾性分类为高基线和低基线恢复者和非恢复者。结果。%PCC 从基线增加到卒中后 12 周(β = 1.6%,CI = 0.32% 至 2.86%,P = .01),在针对 EmNSA-HF 和 FM-UE 进行调整后不再显着。在 %PCC、Amp-A 和 EmNSA-HF 之间发现了显着的正相关。低基线回收率 (n = 8) 的纵向百分比 PCC 显着高于高基线回收率 (n = 23)。结论。我们证明了 %PCC 和 Amp-A 的纵向结构有效性作为传入通路完整性的衡量标准。低基线恢复者的高 %PCC 表明该测量还包含有关皮质兴奋性的信息。使用 PCC 作为基于 EEG 的措施来解决体感完整性对卒中后运动恢复的作用需要进一步关注。
更新日期:2020-03-04
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