Tuesday, July 24, 2007

Motor Cortex Stimulation and Motor Recovery

A recent paper published in Neurosurgery looked at motor recovery in patients with ischemic stroke at least four months out from the start of the study. All had moderate motor weakness. A treatment group had electrode implantation and the control group received the same three weeks of rehabilitation that the study patients received after their implants. Implanted patients were stimulated only during therapy.
All of the patients were followed for 12 weeks after their rehabilitation. And the results were pretty good: the implant group had significantly better scores on the Fugl-Meyer and hand function portion of the Stroke Impact Scale.
My conclusion was that motor cortex stimulation can improve motor recovery after a stroke, particularly in a patient without a dense hemiplegia and that motor cortex stimulation provides additional benefit to patients compared to rehabilitation, alone.
This is a nice example of improved motor recovery as a result of neuromodulation. I am going to have to go dig into my files to find a paper I read and tucked away that commented on the positive predictive value of TMS in anticipating a positive response to implanted motor cortex stimulators. Is anyone aware of any studies that compare motor recovery ( would that be a head to head study......anyone, Bueller????) with TMS vs implanted stimulation??