The predictive value of transcranial magnetic stimulation combined with clinical assessment in motor recovery of hemiplegic upper limbs
PAN Lulu, ZHENG Hebin, ZHANG Yanyan, CHENG Zhiqing, PAN Rongrong, ZHANG Guowei, ZHI Yinghao
Department of Rehabilitation 3, Wenzhou Hospital of Traditional Chinese Medicine, Zhejiang University of Traditional Chinese Medicine, Wenzhou 325015, China
PAN Lulu,ZHENG Hebin,ZHANG Yanyan, et al. The predictive value of transcranial magnetic stimulation combined with clinical assessment in motor recovery of hemiplegic upper limbs[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(2): 139-143.
Abstract：Objective: To investigate the predictive value of transcranial magnetic stimulation (TMS)-induced motor evoked potentials (EDC-MEPs) of extensor muscles combined with clinical evaluation (SAFE) in the recovery of upper limb motor function 3 months after cerebral infarction. Methods: Totally 76 patients with cerebral infarction hospitalized in the Rehabilitation Department of Wenzhou Hospital of Traditional Chinese Medicine from January 2020 to June 2021 were enrolled in this study. All patients received Fugl-Meyer upper limb motor function assessment, SAFE assessment and TMS assessment upon admission, and again 3 months after cerebral infarction. Three prediction methods (SAFE, EDC-MEPs and SAFE combined with EDC-MEPs) were established according to the assessment content. Multi-factor logistic regression analysis was used to determine the predictors of upper limb functional recovery, and the efficacy of prediction methods was evaluated by ROC curves. Results: Multi-factorial analysis showed statistical difference among SAFE, EDC-MEPs and SAFE combined with EDC-MEPsin the effect on functional recovery of the upper limb (P<0.05). The area under the ROC curve (AUC) for SAFE was 0.795 (SE=0.059, 95%CI=0.680-0.910) and for EDC-MEPs it was 0.729 (SE=0.067, 95%CI=0.599-0.860), but SAFE combined with EDC-MEPs it was increased to 0.824 (SE=0.056, 95%CI=0.715-0.934), showing significant difference compared with EDC-MEPs (Z=2.398, P<0.05). Conclusion: Transcranial magnetic stimulation combined with clinical assessment is of higher value in predicting functional recovery of hemiplegic upper limbs after cerebral infarction.
