Analisys of Cortical Excitability and Motor Function of Post Stroke Patients
Condition: Stroke; Motor Function; Cortical Excitability
MeSH terms: Stroke
Study type: Observational

Summary: 
      Healthy individuals, after reading and signing the free and informed consent will be
      submitted to a single session to obtain the normal neurophysiological measures and thus
      compare with those obtained in individuals with PD. Healthy and post stroke patients will be
      submitted to a neurophysiological evaluation through transcranial magnetic stimulation (TMS)
      and electroencephalography (EEG). The post stroke patients will also performed the evaluation
      trought the fugl meyer scale.
    

Detailed description: 
      Fugl Meyer assesment is used to measure motor control recovery. It is a 226 point scoring
      system that includes the following sessions: range of motion, pain, sensation,motor function
      of upper and lower limbs, balance, coordination and velocity. The investigators will aplly
      only two sessions: upper limb motor function and coordination/velocity, these sessions
      totalize 66 points.

      Cortical excitability level it will be evaluated through single pulse transcranial magnetic
      stimulation paradigms (Neurosoft, Russia). Initially, rest motor threshold (RMT) will be
      determined by finding the lowest stimulator output that elicit motor evoked potential (MEP)
      around 50 μV (TMS Motor Threshold Assessment Tool -MTAT 2.0 - USA). For RMT measure, a
      figure-eight coil connected to the magnetic stimulator held manually at 45 degrees from the
      midline, will be placed over the right primary motor cortex of lesioned and non lesioned
      hemisphere (C3 and/or C4 - 10/20 System). After, motor evoked potential will be evaluet by 20
      pulses firing with 120% of RMT.

      EEG Patients will perform an assessment of brain activity through the EEG. Initially,
      patients will be placed seated in a chair at 90cm in front of a computer. Then, the equipment
      will be assembled, the points according to the 10-20 marking system will be identified: Cz,
      C3, C4, F3, F4, P3, P4, Fz and Pz.

      The protocol will follow the sequence of six consecutive moments (1 minute each) to monitor
      the patient's brain activity through Neuro Spectrum software:

        1. 1st minute: REST: the patient will be relaxed, at rest, without any communication and
           with eyes open;

        2. 2nd minute: OBSERVE - the patient will observe the video of the movement hand to mouth;

        3. 3rd minute: EXECUTION - the patient will reproduce the movement of the video with
           healthy limb (post stroke patient)/ dominant hand (healthy);

        4. 4th minute: IMAGINATION - the patient will imagine the previous movement;

        5. 5th minute: EXECUTION - the patient will reproduce the movement of the video with a
           paretic limb (post stroke patient)/ non dominant hand (healthy);

        6. 6th minute: IMAGINATION - the patient will imagine the previous movement;
    

Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        The population study was composite for patients post-stroke with auditory major that 3
        months and found in the eligibility criteria. In addition, it will rely on babies with
        health or neurological disorders.