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Journal of Neurology
Published in: Journal of Neurology 3/2007

01-03-2007 | ORIGINAL COMMUNICATION

Outcome prediction in acute monohemispheric stroke via magnetoencephalography

Authors: Franca Tecchio, Patrizio Pasqualetti, Filippo Zappasodi, Mario Tombini, Domenico Lupoi, Fabrizio Vernieri, Paolo Maria Rossini

Published in: Journal of Neurology | Issue 3/2007

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Abstract

Background

Following an ischemic stroke a highly variable clinical outcome is commonly evident despite similar onset symptoms as well as lesion characteristics. The aim of this study was to identify indexes providing early prediction of functional recovery, in addition to clinical severity and lesion dimension at onset of stroke.

Methods

In 32 patients, magnetoencephalographic (MEG) parameters collected in the acute phase (< 10 days from symptoms onset, T0) from affected (AH) and unaffected (UH) hemispheres at rest and evoked by sensory stimuli were evaluated in association with the clinical outcome in a stabilized phase (T1, median 7.8 months) classified with three levels: worsening, partial and full recovery.

Results

Multiple multinomial logistic regression indicated AH gamma and UH delta band powers able to prognosticate clinical outcome at T1. After inclusion in this analysis, lesion volume had the strongest predictive ability, and UH delta band power remained as a predictive factor with a measurable cut-off, maximizing both sensitivity and specificity of the prediction: a patient with UH delta below cut-off would recover to some extent; a patient with UH delta above cut-off would have a probability of about 70% to worsen.

Conclusions

MEG UH delta and AH gamma band powers were found to provide useful information about long-term outcome prognosis. Only the increase of delta band activity in the unaffected hemisphere contains information about the outcome in addition to the lesion volume.
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Literature
1.
Adams HP Jr, Adams JR, Brott T, del Zoppo GJ, Furlan A, Goldstein LB, et al. (2003) Guidelines for the early management of patients with ischemic stroke. A Scientific Statement from the Stroke Council of the American Stroke Association. Stroke 34:1056 –1083PubMedCrossRef
2.
Ahmed I (1988) Predictive value of the electroencephalogram in acute hemispheric lesions. Clin Electroencephalogr 19:205–9PubMed
3.
Andrews RJ (1991) Transhemispheric diaschisis. A review and comment. [Review] Stroke 22:943–9PubMed
4.
Baird AE, Dambrosia J, Janket S-J, Eichbaum Q, Chaves C, Silver B et al. (2001) A three-item scale for the early prediction of stroke recovery. Lancet 357:2095–99PubMedCrossRef
5.
Barbati G, Porcaro C, Zappasodi F, Rossini PM, Tecchio F (2004) Optimization of an independent component analysis approach for artifact identification and removal in magnetoencephalographic signals. Clin Neurophysiol 115:1220–32PubMedCrossRef
6.
Barber PA, Darby DG, Desmond PM, Yang Q, Gerraty RP, Jolley D (1998) Prediction of stroke outcome with echoplanar perfusionand diffusion-weighted MRI. Neurology 51:418–26PubMed
7.
Beaulieu C, de Crespigny A, Tong DC, Moseley ME, Albers GW, Marks MP (1999) Longitudinal magnetic resonance imaging study of perfusion and diffusion in stroke: evolution of lesion volume and correlation with clinical outcome. Ann Neurol 46:568–78PubMedCrossRef
8.
Benzel EC, Lewine JD, Bucholz RD, Orrison WW (1993) Magnetic source imaging: a review of the Magnes system of biomagnetic technologies incorporated. Neurosurgery 33:252–9PubMedCrossRef
9.
Bruehl C, Neumann-Haefelin T, Witte OW (2000) Enhancement of whole cell calcium currents following transient MCAO. Brain Res 884:129–38PubMedCrossRef
10.
Buchkremer-Ratzmann I, August M, Hagemann G, Witte OW (1996) Electrophysiological transcortical diaschisis after cortical photothrombosis in rat brain. Stroke 27:1105–11PubMed
11.
Butefisch CM, Netz J, Wessling M, Seitz RJ, Homberg V (2003) Remote changes in cortical excitability after stroke. Brain 126:470–81PubMedCrossRef
12.
Butz M, Gross J, Timmermann L, Moll M, Freund H-J, Witte OW, et al. (2004) Perilesional pathological oscillatory activity in the magnetoencephalogram of patients with cortical brain lesions. Neurosci Letters 355:93–96CrossRef
13.
Calabresi P, Cupini LM, Centonze D, Pisani F, Bernardi G (2003) Antiepileptic drugs as a possible neuroprotective strategy in brain ischemia. Ann Neurol 53:693–702PubMedCrossRef
14.
Calautti C, Leroy F, Guincestre JY, Marie RM, Baron JC (2001) Sequential activation brain mapping after subcortical stroke: changes in hemispheric balance and recovery. Neuroreport 12:3883–6PubMedCrossRef
15.
Carmichael ST, Chesselet MF (2002) Synchronous neuronal activity is a signal for axonal sprouting after cortical lesions in the adult. J Neurosci 22:6062–70PubMed
16.
Chu WJ, Mason GF, Pan JW, Hetherington HP, Liu HG, San Pedro EC, et al. (2002) Regional cerebral blood flow and magnetic resonance spectroscopic imaging findings in diaschisis from stroke. Stroke 33:1243–8PubMedCrossRef
17.
Cicinelli P, Pasqualetti P, Zaccagnini M, Traversa R, Oliveri M, Rossini PM (2003) Interhemispheric asymmetries of motor cortex excitability in the postacute stroke stage: a paired-pulse transcranial magnetic stimulation study. Stroke 34:2653–8PubMedCrossRef
18.
Counsell C, Dennis M (2001) Systematic Review of Prognostic Models in Patients with Acute Stroke. Cerebrovasc Dis 12:159–70PubMedCrossRef
19.
Cuspineda E, Machado C, Aubert E, Galan L, Llopis F, Avila Y (2003) Predicting outcome in acute stroke: a comparison between QEEG and the Canadian Neurological Scale. Clin Electroencephalogr 34:1–4PubMed
20.
Dachy B, Biltiau E, Bouillot E, Dan B, Deltenre P (2003) Facilitation of motor evoked potentials in ischemic stroke patients: prognostic value and neurophysiologic correlations. Clin Neurophysiol 114:2370–2375PubMedCrossRef
21.
De Reuck J, Paemeleire K, Van Maele G, Goethals M (2004) The prognostic significance of changes in lesion size of established cerebral infarcts on computed tomography of the brain. Cerebrovasc Dis 17:320–5PubMedCrossRef
22.
Del Gratta C, Pizzella V, Tecchio F, Romani G-L (1986) Magnetoencephalography - a non invasive brain imaging method with 1 ms time resolution. Rep Prog Phys 2001 64:1759–1814CrossRef
23.
Escudero JV, Sancho J, Bautista D, Escudero M, Lopez-Trigo J (1998) Prognostic value of motor evoked potential obtained by transcranial magnetic brain stimulation in motor function recovery in patients with acute ischemic stroke. Stroke 29:1854–1859PubMed
24.
Feeney DM, Baron JC. Diaschisis. [Review]. Stroke 17:817–30
25.
Feeney DM (1997) From laboratory to clinic: noradrenergic enhancement of physical therapy for stroke or trauma patients. Adv Neurol 73:383–94PubMed
26.
Fierro B, La Bua V, Oliveri M, Daniele O, Brighina F (1999) Prognostic value of somatosensory evoked potentials in stroke. Electromyograph Clin Neurophysiol 39:155–60
27.
Finnigan SP, Rose SE, Walsh M, Griffin M, Janke AL, McMahon KL, et al. (2004) Correlation of quantitative EEG in acute ischemic stroke with 30-day NIHSS score: comparison with diffusion and perfusion MRI. Stroke 35:899–903PubMedCrossRef
28.
Forss N, Hietanen M, Salonen O, Hari R (1999) Modified activation of somatosensory cortical network in patients with right-hemisphere stroke. Brain 122:1889–99PubMedCrossRef
29.
Friel KM, Nudo RJ (1998) Recovery of motor functions after focal cortical injury in primates: compensatory movement patterns used during rehabilitative training. Somatosens Mot Res 15:173–89PubMedCrossRef
30.
Giaquinto S, Cobianchi A, Macera F, Nolfe G (1994) EEG recordings in the course of recovery from stroke. Stroke 25:2204–9PubMed
31.
Gross DW, Gotman J (1999) Correlation of high-frequency oscillations with the sleep–wake cycle and cognitive activity in humans. Neuroscience 94:1005–18PubMedCrossRef
32.
Huang JC, Nicholson C, OkadaYC (1990) Distortion of magnetic evoked fields and surface potentials by conductivity differences and boundaries in brain tissue. Biophysical J 57:1155–667CrossRef
33.
Klimesch W (1999) EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. [Review]. Brain Res Rev 29:169–195PubMedCrossRef
34.
Kluytmans M, Van Everdingen KJ, Kappelle LJ, Ramos LM, Viergever MA, van der Grond J (2000) Prognostic value of perfusion- and diffusion-weighted MR imaging in first 3 days of stroke. Eur Radiol 10:1434–41PubMedCrossRef
35.
Komatsumoto S, Greenberg JH, Hickey WF, Reivich M (1995) Clinicopathological observations in middle cerebral artery occlusion in the cat. Neurol Res 17:120–8PubMed
36.
IFSECN (1974) A glossary of terms commonly used by clinical electroencephalographers. Electroencephalogr Clin Neurophysiol 37:538–548CrossRef
37.
Lagreze HL, Levine RL, Pedula KL, Nickles RJ, Sunderland JS, Rowe BR (1987) Contralateral flow reduction in unilateral stroke: evidence for transhemispheric diaschisis. Stroke 18:882–6PubMed
38.
Lovblad KO, Baird AE, Schlaug G, Benfield A, Siewert B, Voetsch B et al. (1997) Ischemic lesion volumes in acute stroke by diffusion-weighted magnetic resonance imaging correlate with clinical outcome. Ann Neurol 42:164–170PubMedCrossRef
39.
Lu XC, Williams AJ, Tortella FC (2001) Quantitative electroencephalography spectral analysis and topographic mapping in a rat model of middle cerebral artery occlusion. Neuropathol Appl Neurobiol 27:481–95PubMedCrossRef
40.
Massimini M, Amzica F (2001) Extracellular calcium fluctuations and intracellular potentials in the cortex during the slow sleep oscillation. J Neurophysiol 85:1346–50PubMed
41.
Matteis M, Vernieri F, Troisi E, Pasqualetti P, Tibuzzi F, Caltagirone C, et al. (2003) Early cerebral hemodynamic changes during passive movements and motor recovery after stroke. J Neurol 250:810–7PubMedCrossRef
42.
Meador KJ, Ray PG, Echauz JR, Loring DW, Vachtsevanos GJ (2002) Gamma coherence and conscious perception. Neurology 59:847–54PubMed
43.
Melamed E, Lavy S, Portnoy Z, Sadan S, Carmon A (1975) Correlation between regional cerebral blood flow and EEG frequency of the contralateral hemisphere in acute cerebral infarction. J Neurol Sci 26:21–27PubMedCrossRef
44.
Menon V, Freeman WJ, Cutillo BA, Desmond JE, Ward MF, Bressler SL, et al. (1996) Spatio-temporal correlations in human gamma band electrocorticograms. Electroencephalogr Clin Neurophysiol 98:89–102PubMedCrossRef
45.
Meyer JS, Obara K, Muramatsu K (1993) Diaschisis [Review]. Neurol Res 15:362–6PubMed
46.
von Monakow C (1895) Experimentelle und pathologisch-anatomische Untersuchungen uber die Haubenregion, Sehhugel und die Regio subthalamica, nebst Beitragen zur Kenntnis fruh erworbener Grob- und Kleihirndefekten. Arch Psychtrie Nervenkrankheiten 27:1–128CrossRef
47.
von Monakow C (1914 ) Die Lokalisation im Großhirn und der Abbau der Funktion durch Kortikale Herde. Bergmann JF, Wiesbaden
48.
Nakase T, Fushiki S, Naus CC (2003) Astrocytic gap junctions composed of connexin 43 reduce apoptotic neuronal damage in cerebral ischemia. Stroke 34:1987–93PubMedCrossRef
49.
Neumann-Haefelin T, Wittsack HJ, Wenserski F, Siebler M, Seitz RJ, Modder U et al. (1999) Diffusion- and perfusion-weighted MRI. The DWI/PWI mismatch region in acute stroke. Stroke 30:1591–97PubMed
50.
Nighoghossian N, Hermier M, Adeleine P, Derex L, Dugor JF, Philippeau F, et al. (2003) Baseline magnetic resonance imaging arameters and stroke outcome in patients treated by intravenous tissue plasminogen activator. Stroke 34:458–63PubMedCrossRef
51.
Nudo RJ, Wise BM, SiFuentes F, Milliken GW (1996) Neural substrates for the effects of rehabilitative training on motor recovery after ischemic infarct. Science 272:1791–94PubMedCrossRef
52.
Oliviero A, Tecchio F, Zappasodi F, Pasqualetti P, Salustri C, Lupoi D, et al. (2004) Brain sensorimotor hand area functionality in acute stroke: insights from magnetoencephalography. Neuroimage 23:542–550PubMedCrossRef
53.
Orrison WW, Lewine JD (1993) Magnetic source imaging in neurosurgical practice. Perspect Neurol Surg 4:141–8
54.
Péréon Y, Aubertin P, Guihéneuc P (1995) Prognostic significance of electrophysiological investigations in stroke patients: somatosensory and motor evoked potentials and sympathetic skin response. Neurophysiol Clin 25:146–57PubMedCrossRef
55.
Pizzella V, Tecchio F, Romani G-L, Rossini PM (1999) Functional localization of the sensory hand area with respect to the motor central gyrus knob. Neuroreport 10:1–6CrossRef
56.
Rawanduzy A, Hansen A, Hansen TW, Nedergaard M (1997) Effective reduction of infarct volume by gap junction blockade in a rodent model of stroke. J Neurosurg 87:916–20PubMedCrossRef
57.
Robbins J, Levine RL, Maser A, Rosenbek JC, Kempster GB (1993) Swallowing after unilateral stroke of the cerebral cortex. Arch Phys Med Rehabil 74:1295–300PubMedCrossRef
58.
Rossini PM, Tecchio F, Pizzella V, Lupoi D, Cassetta E, Pasqualetti P, et al. (1998) On the reorganization of sensory hand areas after mono-hemispheric lesion: a functional (MEG)/ anatomical (MRI) integrative study. Brain Res 782:153–166PubMedCrossRef
59.
Rossini PM, Tecchio F, Pizzella V, Lupoi D, Cassetta E., Pasqualetti P (2001) Interhemispheric differences of sensory hand areas after monohemispheric stroke: MEG/MRI integrative study. Neuroimage 14:474–485PubMedCrossRef
60.
Rossini PM, Calautti C, Pauri F, Baron JC (2003) Post-stroke plastic reorganisation in the adult brain. [Review]. Lancet Neurol 2:493–502PubMedCrossRef
61.
Rossini PM, Altamura C, Ferretti A, Vernieri F, Zappasodi F, Caulo M, et al. (2004) Does cerebrovascular disease affect the coupling between neuronal activity and local hemodinamics? Brain 127:99–110PubMedCrossRef
62.
Saunders DE, Clifton AG, Brown MM (1996) Measurement of infarct size using MRI predicts prognosis in middle cerebral artery infarction. Stroke 26:2272–6
63.
Scavini C, Rozza A, Bo P, Lanza E, Favalli L, Savoldi F et al. (1990) Kappa-opioid receptor changes and neurophysiological alterations during cerebral ischemia in rabbits. Stroke 21:943–7PubMed
64.
Schiene K, Bruehl C, Zilles K, Qu M, Hagemann G, Kraemer M et al. (1996) Neuronal hyperexcitability and reduction of GABAAreceptor expression in the surround of cerebral photothrombosis. J Cereb Blood Flow Metab 16:906–14PubMedCrossRef
65.
Shimizu T, Hosaki A, Hino T, Sato M, Komori T, Hirai S et al. (2002) Motor cortical disinhibition in the unaffected hemisphere after unilateral cortical stroke. Brain 125:1896–1907PubMedCrossRef
66.
67.
Tecchio F, Rossini PM, Pizzella V, Cassetta E, Romani GL (1997) Spatial properties and interhemispheric differences of the sensory hand cortical representation: a neuromagnetic study. Brain Res 767:100–8PubMedCrossRef
68.
Tecchio F, Pasqualetti P, Pizzella V, Romani GL, Rossini PM (2000) Morphology of somatosensory evoked fields: inter-hemispheric similarity as a index for physiological and pathological neural connectivity. Neurosci Lett 287:203–6PubMedCrossRef
69.
Tecchio F, Padua L, Aprile I, Rossini PM (2002) Carpal Tunnel Syndrome modifies sensory hand cortical somatotopy: a MEG study. Hum Brain Mapping 17:28–36CrossRef
70.
Tecchio F, Babiloni C, Zappasodi F, Vecchio F, Pizzella V, Romani G-L, et al. (2003) Gamma synchronization in human primary somatosensory cortex as revealed by somatosensory evoked neuromagnetic fields. Brain Res 986:63–70PubMedCrossRef
71.
Tecchio F, De Lucia M, Salustri C, Montuori M, Bottaccio M, Babiloni C, et al. (2004) District-related frequency specificity in hand cortical representation: dynamics of regional activation and intra-regional functional connectivity. Brain Res 1014:80–86PubMedCrossRef
72.
Tecchio F, Zappasodi F, Pasqualetti P, Rossini PM (2005) Neural connectivity in hand sensorimotorbrain areas: an evaluation by evoked fields morphology. Hum Brain Mapp 24:99–108PubMedCrossRef
73.
Tecchio F, Zappasodi F, Pasqualetti P, Tombini M, Salustri C, Oliviero A, et al. (2005) Rhythmic brain activity at rest from rolandic areas in acute mono-hemispheric stroke: a magnetoencephalographic study. Neuroimage 28:72–78PubMedCrossRef
74.
Timmerhuis TPJ, Hageman G, Oosterloo SJ, Rozeboom AR (1996) The prognostic value of cortical magnetic stimulation in acute middle cerebral artery infarction compared to other parameters. Clin Neurol Neurosurg 98:231–6PubMedCrossRef
75.
Tong DC, Yenari MA, Albers GW, O’Brien M, Marks MP, Moseley ME (1998) Correlation of perfusion- and diffusion weighted MRI with NIHSS score in acute (6.5 hour) ischemic stroke. Neurology 50:864–870PubMed
76.
Traub RD, Kopell N, Bibbig A, Buhl EH, LeBeau FE, Whittington MA (2001) Gap junctions between interneuron dendrites can enhance synchrony of gamma oscillations in distributed networks. J Neurosci 21:9478–86PubMed
77.
Vieth JB (1990) Magnetoencephalography in the study of stroke cerebrovascular accident. Adv Neurol 54:261–269PubMed
78.
Warach S, Dashe JF, Edelman RR (1996) Clinical outcome in ischemic stroke predicted by early diffusion-weighted and perfusion magnetic resonance imaging: a preliminary analysis. J Cereb Blood Flow Metab 16:53–59PubMedCrossRef
79.
Ween JE, Alexander MP, D’Esposito M, Roberts M (1996) Factors predictive of stroke outcome in a rehabilitation setting. Neurology 47:388–92PubMed
80.
Wise R, Gibbs J, Frackowiak R, Marshall J, Jones T (1986 ) No evidence for transhemispheric diaschisis after human cerebral infarction. Stroke 17:853–61PubMed
81.
Wikstrom H, Roine RO, Salonen O, Lund KB, Salli E, Ilmoniemi RJ, et al. (1999) Somatosensory evoked magnetic fields from the primary somatosensory cortex (SI) in acute stroke. Clin Neurophysiol 110:916–23PubMedCrossRef
82.
Wikstrom H, Roine RO, Aronen HJ, Salonen O, Sinkkonen J, Ilmoniemi RJ, et al. (2000) Specific changes in somatosensory evoked magnetic fields during recovery from sensorimotor stroke. Ann Neurol 47:353–60PubMedCrossRef
Metadata
Title
Outcome prediction in acute monohemispheric stroke via magnetoencephalography
Authors
Franca Tecchio
Patrizio Pasqualetti
Filippo Zappasodi
Mario Tombini
Domenico Lupoi
Fabrizio Vernieri
Paolo Maria Rossini
Publication date
01-03-2007
Publisher
Steinkopff-Verlag
Published in
Journal of Neurology / Issue 3/2007
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-006-0355-0

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