Relationship between spinal reflexes and leg motor function in sub-acute and chronic stroke patients. (June 2022)

• Record Type: Journal Article
• Authors: Takahashi, Yoko; Kawakami, Michiyuki; Mikami, Rena; Nakajima, Toshiya; Nagumo, Towa; Yamaguchi, Tomofumi; Honaga, Kaoru; Kondo, Kunitsugu; Ishii, Ryota; Fujiwara, Toshiyuki; Liu, Meigen
• Is Part Of: Clinical neurophysiology. Volume 138(2022)
• Page Start: 74
• Page End: 83
• Publication Date: 2022-06
• Subjects: Reciprocal inhibition -- Heteronymous facilitation -- Heteronymous inhibition -- D1 inhibition -- Presynaptic inhibition -- Spasticity; SAS sub-acute stroke -- CS chronic stroke -- HF heteronymous facilitation -- HI heteronymous inhibition -- DRI disynaptic reciprocal inhibition -- D1 D1 inhibition -- FMA-LE Fugl-Meyer Assessment Lower Extremity -- MAS modified Ashworth scale -- TA tibialis anterior -- SOL soleus -- QUAD quadriceps -- ISI inter-stimulus interval; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2022.02.025
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: The relation of spinal reflexes with leg motor function was tested in sub-acute and chronic stroke. Severe spasticity is linked to heteronymous facilitation and disynaptic reciprocal inhibition in sub-acute stroke patients. Spinal reflexes are potential biomarkers for spasticity and motor function. Abstract: Objective: To assess the relationship between spinal reflexes and motor function in sub-acute (SAS) and chronic stroke (CS) patients. Methods: Twelve SAS and 16 CS patients underwent electrophysiological assessment of heteronymous facilitation (HF), heteronymous inhibition (HI), disynaptic reciprocal inhibition (DRI), and D1 inhibition (D1). The Fugl-Meyer Assessment Lower Extremity (FMA-LE) and modified Ashworth scale (MAS) were assessed. The relationship between spinal reflexes and motor function was examined in a cross-sectional manner. SAS patients were also longitudinally evaluated before and after intensive rehabilitation for approximately 2 months. Results: SAS patients with triceps surae muscle spasticity (MAS ≥ 1) showed higher HF values (p = 0.03) than those without spasticity. SAS patients with quadriceps muscle spasticity showed higher HF values (p < 0.01); patients with hamstring muscle spasticity showed higher DRI value (disinhibition) (p < 0.01) than those without spasticity. CS patients showed no significant correlation between spinal reflexes and motor function. The longitudinal study revealed a significant correlation between increase in D1 inhibition and FMA-LE improvement in SAS patients (r = 0.69). Conclusions: The association between impaired spinal reflexes varies with the stage of stroke; HF and DRI may be spasticity indicators in SAS patients. Significance: Spinal reflexes as potential biomarkers may facilitate tailor-made rehabilitation of stroke patients.