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Publication Detail
Changes in cortical excitability and interhemispheric interactions after stroke
  • Publication Type:
    Chapter
  • Authors:
    Talelli P, Swayne O, Rothwell JC
  • Publication date:
    01/01/2010
  • Pagination:
    103, 112
  • ISBN-13:
    9780521515337
  • Status:
    Published
  • Book title:
    Brain Repair After Stroke
Abstract
Animal models of stroke have provided essential insights into the neural mechanisms that contribute to recovery of function. These involve not only synaptic plasticity but also growth of new connections within and between cortical areas. Recent work in humans has been directed to developing non-invasive methods of testing whether similar changes occur in patients after stroke. If successful, they would give us methods of following changes in neural organization during recovery and of using this knowledge to guide treatment. Tools presently available for this include functional brain imaging, electroencephalography, magnetoencephalography, and transcranial magnetic stimulation (TMS). This chapter will focus on knowledge obtained from TMS measures of cortical excitability in the hemisphere damaged by stroke as well as in the non-stroke hemisphere. We concentrate on motor function, since this forms the basis of the majority of studies in this area, and since this is among the most commonly affected domains of behavior affected by stroke. Using TMS to quantify the damage resulting from a stroke Single pulses of TMS over the motor cortex evoke twitches in contralateral muscles of the body that can be recorded electrophysiologically by placing surface electrodes over the muscle of interest (motor-evoked potential, MEP). A series of basic physiological studies, including recordings of descending corticospinal activity from electrodes implanted into the spinal epidural space for treatment of chronic pain, have shown the following sequence of events.
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