Training-induced brain plasticity in stroke survivors with severe and chronic upper limb paresis as revealed with TMS

Brauer, S. G., Barker, R. N. and Carson, R. G. (2006). Training-induced brain plasticity in stroke survivors with severe and chronic upper limb paresis as revealed with TMS. In: Society for Neuroscience Abstracts. Society for Neuroscience Annual Meeting, Atlanta, Georgia, USA, (). 14-18 October, 2006.


Author Brauer, S. G.
Barker, R. N.
Carson, R. G.
Title of paper Training-induced brain plasticity in stroke survivors with severe and chronic upper limb paresis as revealed with TMS
Conference name Society for Neuroscience Annual Meeting
Conference location Atlanta, Georgia, USA
Conference dates 14-18 October, 2006
Proceedings title Society for Neuroscience Abstracts
Place of Publication Online
Publisher Neuroscience Society
Publication Year 2006
Volume 32
Issue Program No. 559.6.
Language eng
Formatted Abstract/Summary
Background
Transcranial magnetic stimulation (TMS) was used to study training induced brain plasticity in stroke survivors with severe and chronic upper limb paresis. The first objective was to assess the integrity and utilization of contralateral and ipsilateral corticospinal pathways before and after training of reaching and the second objective was to determine the relationship between arm function and the utilization of contralateral and ipsilateral pathways.

Method
In a single blind randomized clinical trial, 33 stroke survivors were randomized to one of two groups who received training of reaching or to a control group. TMS was used to evoke a response in triceps brachii during an isometric reaching task prior to training, at completion and 2 months after training had been completed.

Results

Prior to training, participants either failed to exhibit a contralateral response or exhibited delayed contralateral motor evoked potentials (MEPs) of reduced amplitude. Greater frequency of ipsilateral MEPs compared with normal values was also observed. Those participants who exhibited contralateral MEPs prior to training exhibited responses following training that were more consistent with normal function in terms of timing and amplitude. There was no reliable change in ipsilateral responses as a consequence of training. Improvements in arm function occurred in parallel with increased reactivity of contralateral pathways.

Conclusion
It was concluded that increased reactivity of contralateral pathways was an expression of the operation of the most efficient mechanism associated with improvements in arm function. The clinical implication of these findings is that intensive and repetitive task related practice leads to changes in arm function that are associated with normalization of brain function, even in stroke survivors with severe paresis who are well beyond the acute stage of recovery after stroke. 
Subjects 110603 Motor Control
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown

 
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Created: Fri, 23 Jan 2009, 13:35:49 EST by Ms Lynette Adams on behalf of School of Human Movement and Nutrition Sciences