The most important predictive factors for upper limb recovery following stroke appears to the initial severity of motor impairment or function
Objective : To systematic ally review and summarize the current available literature on prognostic variables relating to upper limb recovery following stroke .
To identify which , if any variables predict upper limb recovery following stroke .
Post-stroke reorganization of hand motor area: a 1-year prospective follow-up with focal transcranial magnetic stimulation
OBJECTIVE Focal transcranial magnetic stimulation was used to test prospect ively corticospinal excitability changes and reorganization of first dorsal interosseous ( FDI ) motor cortical representation in 31 patients who experienced a first ischemic stroke in the middle cerebral artery territory . All had severe h and palsy at onset . METHODS Patients were assessed clinical ly with the Medical Research Council , Rankin , the National Institutes of Health stroke scales and Barthel Index at days 1 , 8 , 30 , 90 , 180 and 360 after stroke . The following parameters of FDI  motor evoked potential ( MEPS ) to focal transcranial magnetic stimulation were measured at the same delays : motor threshold , MEP amplitude , excitable cortical area , hot spot and center of gravity of FDI motor maps on affected and unaffected hemispheres . Correlations were sought between clinical and electrophysiological parameters . RESULTS In patients whose affected motor cortex remained excitable at day 1 , motor thresholds were not significantly different between sides and were similar to those of controls . Persistence of MEP on the affected side at day 1 was a strong predictor of good recovery . If present at day 1 , MEPs recorded in affected FDI were significantly smaller than of the opposite side or in normals and progressively recovered up to day 360 . In these patients , area of excitable cortex remained stable throughout the entire study . At day 1 , amplitudes of MEPs obtained in unaffected FDI were significantly larger than later . Between days 1 and 360 , we observed a significant displacement of center of gravity of motor maps towards more frontal regions on the affected side while no change was noted on the unaffected side . CONCLUSIONS Our data confirm the early prognosis value of transcranial magnetic stimulation in stroke . They indicate that the brain insult induces a transient hyperexcitability of the unaffected motor cortex . The evolution of FDI motor maps along the course of recovery mostly reflect corticospinal excitability changes but might also reveal some degree of brain plasticity . Most modifications observed occurred within 3 months of stroke onset
The most important predictive factors for upper limb recovery following stroke appears to the initial severity of motor impairment or function
Objective : To systematic ally review and summarize the current available literature on prognostic variables relating to upper limb recovery following stroke .
To identify which , if any variables predict upper limb recovery following stroke .