Deans' stroke musings: Search for approaches to the strategy of transcranial neuromodulation in patients with post-stroke hemiparesis in real clinical practice

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, June 14, 2024

Search for approaches to the strategy of transcranial neuromodulation in patients with post-stroke hemiparesis in real clinical practice

I couldn't make heads or tails if this provided any recovery at all. But since it talks about biomarkers it is completely useless research for survivors.

Search for approaches to the strategy of transcranial neuromodulation in patients with post-stroke hemiparesis in real clinical practice

Authors: Zakharov Y.Y.¹^,2, Belkin A.A.¹^,2, Shirokov V.A.², Pozdnyakov D.G.¹
Affiliations:
1. Clinic Institute of Brain
2. Ural State Medical University
Section: ORIGINAL STUDY ARTICLE
URL: https://journals.eco-vector.com/2658-6843/article/view/627445
DOI: https://doi.org/10.36425/rehab627445
ID: 627445

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Abstract

Background:

In order to increase the efficiency of motor recovery after a stroke in routine clinical practice, the search for selective biomarkers that determine the choice of the optimal strategy for non-invasive neuromodulation of the brain remains relevant. The study of patterns of interhemispheric interaction can hypothetically help in determining the correct conceptual model of neuromodulation.

Aims:

To determine variants of interhemispheric interaction based on a correlation analysis of motor cortex excitability in subgroups of patients with post-stroke hemiparesis stratified by the degree of motor deficit.

Materials and methods:

The retrospective observational study involved 185 people (men (56.2%) and women (43.8%) aged 19 to 88 years) with verified post-stroke hemiparesis and 40 healthy volunteers (men (55.0%) and women (45.0%) aged 20 to 85). The patients underwent diagnostic transcranial magnetic stimulation in the projection of the cortical representation of m. Abductor pollicis brevis and m. Tibialis anterior of both brain hemispheres. The level of excitability of the motor cortex and its interhemispheric asymmetry were recorded, followed by correlation analysis in subgroups stratified by the degree of paresis.

Results:

It was revealed that there was no interhemispheric correlation of rest motor thresholds (rMT) in patients with a level of muscle strength for the “hand” segment of 0-2 points (р>0,05). In the remaining compared subgroups, positive interhemispheric correlation of the rMT were noted (p<0.02). A positive correlation of the rMT of the damaged brain hemisphere and interhemispheric asymmetry of the motor cortex excitability for all degrees of paresis was observed when studying the cortical representation of the muscles of the upper limbs. A negative correlation between rMT of the unaffected brain hemisphere and interhemispheric asymmetry was detected for all degrees of motor deficit of the “foot” segment (p<0.02).

Conclusions:

The study did not confirm the concept of interhemispheric competition of the studied functional activity of the brain. Three authentic variants of interhemispheric interaction were identified: unidirectional hemispheric interaction with predominant reactivity of the affected hemisphere; unidirectional hemispheric interaction with predominant reactivity of the unaffected hemisphere; functional interhemispheric dissociation. The results obtained indicate the need to rethink some approaches to transcranial neuromodulation strategies.