A.S. Limonova - Faculty of Fundamental Medicine, Lomonosov Moscow State University; Research Centre of Neurology, Moscow E-mail: limonova-alena@yandex.ru M.A. Nazarova - Ph.D.(Med.), Research Scientist, National Research University, Higher School of Economics, Centre for Cognition and Decision Making, Moscow; Junior Research Scientist, Research Center of Neurology, Moscow E-mail: mnazarova@hse.ru S.P. Kulikova - Ph.D., Senior Research Scientist, Laboratory of Interdisciplinary Empirical Studies National research University Higher School of Ecnomics E-mail: SPKulikova@hse.ru L.A. Dobrynina - Dr.Sc. (Med.), Research Centre of Neurology, Moscow E-mail: dobrla@mail.ru M.A. Piradov - Academician RAS, Professor, Director, Research Centre of Neurology, Moscow E-mail: piradov@yandex.ru R.N. Konovalov - Ph. D. (Med.), Senior Research Scientist, Research Centre of Neurology, Moscow E-mail: krn_74@mail.ru

A research of predictors of motor outcome after stroke is one of the crucial problems of neurorehabilitation. Structural in-tegrity and functional state of the hemispheres are among the most important factors of motor outcome. We assessed them in chronic ischemic stroke patients of the combination of navigated transcranial magnetic stimulation (nTMS) and diffusion tensor imaging (DTI). 36 patients with the only chronic ischemic stroke were enrolled in the study and divided into 3 groups of motor outcome based on Fugl­Mеyer upper extremity scale. 9 healthy volunteers completed nTMS study and 30 - DTI study. DTI investigation revealed, that structural integrity was decreased over the corpus callosum, the corticospinal tract in the ipsilesional side and cerebellum in patients compared to healthy volunteers. Not the motor thresholds but the absence of the motor evoked potentials from the affected hemisphere was a good predictor of the unfavorable outcome (96 % success).

 

1. Auriat A.M., Neva J.L., Peters S., Ferris J.K., Boyd L. A review of transcranial magnetic stimulation and multimodal neuroimaging to characterize post-stroke neuroplasticity // Front. Neurol. 2015. V. 6. № 226. P. 1-20.
2. Koch P., Schulz R., Hummel F. Structural connectivity analyses in motor recovery research after stroke // Ann. Clin. Transl. Neurol. 2016. V. 3. № 3. P. 233-244.
3. Borich M.R,. Mang C., Boyd L. Both projection and commissural pathways are disrupted in individuals with chronic stroke: investigating microstructural white matter correlates of motor recovery // BMC Neurosci. 2012. V. 13. № 1. P. 107.
4. Jung S.H., Kim Y.K., Kim S.E., Paik N.J. Prediction of motor function recovery after subcortical stroke: Case series of activation PET and TMS studies // Ann. Rehabil. Med. 2012. V. 36. № 4. P. 501-511.
5. Di Pino G., Pellegrino G., Assenza G., Capone F., Ferreri F., Formica D., Ranieri F., Tombini M., Ziemann U., Rothwell J.C. Modulation of brain plasticity in stroke: a novel model for neurorehabilitation // Nat. Publ. Gr. 2014. V. 10. № 10. P. 597-608.
6. Cortes M., Black-Schaffer R.M., Edwards D.J. Transcranial magnetic stimulation as an investigative tool for motor dysfunction and recovery in stroke: an overview for neurorehabilitation clinicians // Neuromodu­lation. 2012. V. 15. № 4. P. 316-325.
7. Li Y. Wu P., Liang F., Huang W. The microstructural status of the corpus callosum is associated with the degree of motor function and  neurological deficit in stroke patients // PLoS One. 2015. V. 10. № 4. P. 1-17.
8. Wang L.E., Tittgemeyer M., Imperati D., Diekhoff S., Ameli M., Fink G.R., Grefkes C. Degeneration of corpus callosum and recovery of motor function after stroke: A multimodal magnetic resonance imaging study // Hum. Brain Mapp. 2012. V. 33. № 12. P. 2941-2956.
9. Fling B., Benson B. Transcallosal sensorimotor fiber tract structure-function relationships // Hum. Brain Mapp. 2013. V. 34. № 2. P. 384-395.
10. Kloppel S., Bäumer T., Kroeger J., Koch M.A., Büchel C., Münchau A., Siebner H.R. The cortical motor threshold reflects microstructural properties of cerebral white matter // Neuroimage. 2008. V. 40. № 4. P. 1782-1791.