Global Summit on Stroke
Paracelsus Medical University Salzburg, Austria
Title: Functional improvement in stroke patients in the subacute stage after treatment with whole-hand electrical stimulation
Biography: Stefan Golaszewski
Introduction: Th e present study examines the eff ect of whole-hand electrical stimulation on motor recovery in stroke patients at the subacute stage. Peripheral electrical stimulation has been proved to modulate cortical plasticity in healthy and in patients. Such neuromodulatory eff ects have been also found aft er application of electrical hand mesh-glove stimulation (MGS) in our previous studies on healthy subjects. Materials & Methods: Patients with cortico-subcortical ischemic stroke and predominantly motor hemiparesis of the upper extremity were recruited for the study. MGS was applied on the paretic hand daily for 60 min before the standard rehabilitation training over three weeks. Th e hand motor and sensory functions were evaluated with Wolf Motor Function Test, Fugl-Meyer Assessment score, Nine Hole Peg Test and Semmes-Weinstein monofi laments. Single and paired-pulse transcranial magnetic stimulation (TMS) was applied to follow the corticospinal excitability changes over the treatment period. Further, functional magnetic resonance imaging (fMRI) was conducted to assess the cortical brain reorganization changes aft er the treatment. Eff ects of MGS were compared to control group receiving sham stimulation. Results: Patients form both groups showed signifi cant functional improvement as assessed with the motor functional tests. However the improvement degree for the MGS group was increased compared to the control group. Th ese functional eff ects correlated with neuroplastic changes within the sensorimotor area as revealed by TMS and fMRI. Discussion: Electrical stimulation applied before a physiotherapeutic training raise the motor cortical excitability in the lessoned cortex so that the subsequent training becomes more eff ective. Th e obtained results provide better understanding how modulation of central motor controlling structures by somatosensory stimulation correlates with the functional motor recovery.