Assessing the Relationship Between Motor Anticipation and Cortical Excitability in Subacute Stroke Patients With Movement-Related Potentials

What the fuck is the possible use of this research in getting survivors 100% recovered? Describes a problem, but too fucking lazy to even suggest a solution. 

Assessing the Relationship Between Motor Anticipation and Cortical Excitability in Subacute Stroke Patients With Movement-Related Potentials

Ling Chen^1,2, Yurong Mao¹, Minghui Ding¹, Le Li¹, Yan Leng¹, Jiangli Zhao¹, Zhiqin Xu¹, Dong Feng Huang^1,3* and Wai Leung Ambrose Lo^1*

• ¹Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
• ²Department of Acupuncture and Moxibustion, The Secondary Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
• ³Xinhua College of Sun Yat-sen University, Guangzhou, China

Background: Stroke survivors may lack the cognitive ability to anticipate the required control for palmar grasp execution. The cortical mechanisms involved in motor anticipation of palmar grasp movement and its association with post-stroke hand function remains unknown.

Aims: To investigate (Not come up with a solution to the problem)the cognitive anticipation process during a palmar grasp task in subacute stroke survivors and to compare with healthy individuals. The association between cortical excitability and hand function was also explored.

Methods: Twenty-five participants with hemiparesis within 1–6 months after first unilateral stroke were recruited. Twenty-five matched healthy individuals were recruited as control. Contingent negative variation (CNV) was measured using electroencephalography recordings (EEG). Event related potentials were elicited by cue triggered hand movement paradigm. CNV onset time and amplitude between pre-cue and before movement execution were recorded.

Results: The differences in CNV onset time and peak amplitude were statistically significant between the subacute stroke and control groups, with patients showing earlier onset time with increased amplitudes. However, there was no statistically significant difference in CNV onset time and peak amplitude between lesioned and non-lesioned hemisphere in the subacute stroke group. Low to moderate linear associations were observed between cortical excitability and hand function.

Conclusions: The earlier CNV onset time and higher peak amplitude observed in the subacute stroke group suggest increased brain computational demand during palmar grasp task. The lack of difference in CNV amplitude between the lesioned and non-lesioned hemisphere within the subacute stroke group may suggest that the non-lesioned hemisphere plays a role in the motor anticipatory process. The moderate correlations suggested that hand function may be associated with cortical processing of motor anticipation.

Introduction

Cognitive Process of Movement Anticipation in Stroke Patients

Stroke is among the leading causes of long-term disability worldwide (1). It is one of the most severe issues encountered by the aging population (2). Seventy-five percent of stroke survivors have motor dysfunction that affects body coordination and motor skill (3). Motion prediction is a key component of cognitive function and is a high-level function that affects motor control (4). Motor function recovery is often measured in terms of motor execution, with little consideration given to the high level cognitive processes that feeds into the actual motor response (5). To execute activities of daily living such as reach and grasp, the upper extremity must apply the correct force, move the precise range and accurately coordinate multiple limb segments (6–10). The cognitive ability to anticipate the required movement control is therefore fundamental to hand motor performance. Published literature indicates that stroke patients lack the anticipatory ability of upper limb movement that is associated with palmar grasp (11–13). The lack of ability to anticipate was evidenced in the suboptimal application of force by producing markedly increased grip forces during lifting, holding and moving a hand-held object in patients with acute stroke (14). Patients with chronic stroke demonstrated a slower response to adapt to the perturbing force and exhibited smaller aftereffects when the perturbing force was unexpectedly removed than healthy controls (11).

Discussion

The primary aim of this study was to investigate the difference in the cognitive anticipation process between the lesioned and non-lesioned hemisphere in subacute stroke survivors and to compared those with healthy individuals.(Useless for recovery) The association between the electrophysiological process and the functional level as measured by the ARAT in the stroke group was also investigated.

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