MEG response to median nerve stimulation correlates with recovery of sensory and motor function after stroke

• Published in: Clinical neurophysiology Vol. 115; no. 4; pp. 820 - 833
• Main Authors: Huang, M, Davis, L.E, Aine, C, Weisend, M, Harrington, D, Christner, R, Stephen, J, Edgar, J.C, Herman, M, Meyer, J, Paulson, K, Martin, K, Lee, R.R
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-04-2004; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Fingers - innervation; Fingers - physiology; Humans; Magnetoencephalography; Male; Median nerve; Median Nerve - cytology; Median Nerve - physiology; Medical sciences; Middle Aged; Motor; Motor Neurons - physiology; Neurology; Neurons, Afferent - physiology; Reaction Time - physiology; Somatosensory; Stroke; Stroke - physiopathology; Vascular diseases and vascular malformations of the nervous system; Somatosensory; Stroke; Motor; Magnetoencephalography; Median nerve; Motor pathway; Motor system disorder; Cardiovascular disease; Recovery; Vascular disease; Restoration; Somesthetic pathway; Motor cortex; Neurological disorder; Motricity; Cerebrovascular disease; Human; Hemiparesis; Nervous system diseases; Somesthesia; Electrical stimulus; Motor control; Cerebral disorder; Central nervous system disease; Technique; Functional imaging
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2003.11.022

Objective: Hemiparesis due to damage by stroke in primary motor cortex (MI) or its underlying projections presents a problem for functional neuroimaging technologies that attempt to evaluate the neurophysiological basis for restoration of motor function. Traditional assessments of MI function require patients to move their fingers, hands, or limbs, which can be either impossible or markedly compromised after stroke. We recently demonstrated in normal subjects that magnetoencephalography (MEG), a non-invasive neuromagnetic functional imaging technique, detects neuronal response elicited by electrical median nerve stimulation in MI, as well as primary somatosensory cortex (SI). In the present study, we used the MEG response from median nerve stimulation to investigate the recovery of primary motor and somatosensory in acute ischemic stroke patients.
Methods: Twelve patients with unilateral ischemic strokes that affected sensorimotor functions of their hand were studied in the acute stage (4.4±1.2 days, mean±SD) and during a 1-month follow-up (38.6±5.6 days, except for one patient's follow-up done 6 month after stroke).
Results: Among the multiple cortical sources localized after median nerve stimulation, one source localized to SI and another localized to the vicinity of MI. Changes in the source strengths of the first component post-stimulus of MI and SI correlated with the extent of recovery of sensorimotor functions as determined by neurological exams.
Conclusions: This study provides a novel way of indirectly assessing MI function using MEG during the acute stroke phase, when many patients often cannot perform motor tasks due to paralysis.