Motor evoked 'potentials' don't deliver recovery! You're fired for incompetence! With no motor evoked potentials you're referring to dead brain. Where are you in creating dead brain rehab?
Cervicomedullary motor evoked responses in individuals with severe chronic hemiparesis post-stroke: a feasibility study
Abstract
Understanding the neural mechanisms underlying upper limb motor recovery after stroke remains a significant challenge in rehabilitation research. It has been proposed that individuals who show no motor-evoked potential (MEP) response to transcranial magnetic stimulation (TMS) and are thus classified as MEP negative (MEP−) have limited potential for recovery(Your job is to change that to: 'You will recover using these EXACT PROTOCOLS!') in part due to damage of the corticospinal pathway. In this study, we investigate how individuals categorized as MEP− with TMS respond to stimulation of the corticospinal pathway at a subcortical level. We describe the methodology for eliciting MEPs by using cervicomedullary electrical stimulation (CMEP) in post-stroke individuals with severe upper limb hemiparesis. MEP status (+/−) of the more affected arm was assessed using TMS and cervicomedullary electrical stimulation in stroke survivors with severe upper extremity hemiparesis. While most of the participants were classified as MEP−, all individuals were categorized as CMEP+ in the biceps brachii, extensor carpi radialis, and first dorsal interosseous muscles. Importantly, we report the first testing of CMEPs in a small cohort of individuals with stroke. This technique is feasible in this population and has potential for application in clinical translation settings. Our findings provide a foundation for future studies to replicate and expand upon this approach, enabling the exploration of new hypotheses related to post-stroke rehabilitation and recovery.
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