Introduction and Objectives

Motor evoked potentials (MEPs) have been postulated to be useful in predicting recovery in patients with motor impairment. We aimed to investigate whether MEPs elicited by transcranial magnetic stimulation (TMS), serum brain derived neurotrophic factor (BDNF) and its genotype have prognostic value on stroke recovery in patients with hand paresis due to stroke.

Methods

This was an observational cohort study. Patients underwent TMS with MEPs from abductor digiti minimi evaluation between 2–14 (D0) and 30 days (D30) after stroke and their impact on motor function of the upper limb and general outcome was assessed after 3 months (D90). The presence of a BDNF gene polymorphism was determined and serum BDNF concentrations were measured at D0, D30 and D90.

Results

The presence of MEPs and their amplitude at rest and in effort significantly correlated with improvement of upper-limb paresis and general outcome after 3 months. Resting motor threshold did not have prognostic value. Central motor conduction time and MEP latency less consistently predicted stroke outcome or motor deficit improvement. Neither BDNF polymorphisms nor BDNF concentration at D0, D30 and D90 corresponded with the degree of paresis or the independence of patients 3 months after stroke.

Conclusions

The presence of MEPs and their amplitude are useful predictors of upper-limb motor function recovery and general outcome after stroke. BDNF concentration and its genotype had no prognostic value. Further studies conducted on large cohorts are necessary to determine the usefulness of these methods in motor recovery and stroke outcome prediction.

中文翻译：

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利用运动诱发电位和脑源性神经营养因子预测亚急性卒中的恢复和结果

介绍和目标

假设运动诱发电位（MEP）可用于预测运动障碍患者的康复情况。我们旨在调查经颅磁刺激（TMS），血清脑源性神经营养因子（BDNF）及其基因型引起的MEP对卒中后手部轻瘫患者的卒中恢复有预后价值。

方法

这是一项观察性队列研究。在卒中后2–14（D0）至30天（D30）之间，对接受过数字指外展评估的MEP患者进行TMS治疗，并在3个月后（D90）评估其对上肢运动功能和总体预后的影响。确定存在BDNF基因多态性，并在D0，D30和D90测量血清BDNF浓度。

结果

MEP的存在及其在静止和努力状态下的振幅与3个月后上肢轻瘫的改善和总体预后显着相关。静息运动阈值没有预后价值。中枢运动传导时间和MEP潜伏期不太一致地预测卒中结局或运动不足。脑卒中后3个月，D0，D30和D90的BDNF多态性和BDNF浓度均与麻痹程度或患者的独立性无关。

结论

MEP的存在及其幅度是卒中后上肢运动功能恢复和总体预后的有用预测指标。BDNF浓度及其基因型没有预后价值。为了确定这些方法在运动恢复和中风结果预测中的有用性，有必要对大型队列进行进一步研究。