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Related Experiment Video

Updated: Mar 19, 2026

Electroencephalography Network Indices as Biomarkers of Upper Limb Impairment in Chronic Stroke
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Interhemispheric Inhibition Measurement Reliability in Stroke: A Pilot Study.

Jessica M Cassidy1, Haitao Chu2, Mo Chen3

  • 1Department of Physical Medicine and Rehabilitation, Programs in Physical Therapy and Rehabilitation Science, University of Minnesota, Minneapolis, MN, USA.

Neuromodulation : Journal of the International Neuromodulation Society
|June 23, 2016
PubMed
Summary

Interhemispheric inhibition (IHI) indices reliably measure corticomotor excitability in stroke patients when assessed from the affected to unaffected hemisphere. Reliability was poor in the opposite direction, regardless of motor-evoked potential quantification.

Keywords:
Interhemispheric inhibitionmotor-evoked potentialreliabilitystrokestudy protocoltranscranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Transcranial magnetic stimulation (TMS) is crucial for assessing brain stimulation effects.
  • Reliable measures of corticomotor excitability are vital for evaluating noninvasive brain stimulation therapies.
  • Interhemispheric inhibition (IHI) is a key neurophysiological marker.

Purpose of the Study:

  • To evaluate the test-retest reliability of interhemispheric inhibition (IHI) index measurements in individuals with chronic stroke.
  • To compare the reliability of IHI indices derived from motor-evoked potential (MEP) amplitude versus area.

Main Methods:

  • Ten chronic stroke participants underwent six bilateral paired-pulse TMS sessions over three weeks.
  • IHI was measured in both contra-to-ipsilesional and ipsi-to-contralesional primary motor cortex directions.
  • Intraclass correlation coefficients (ICC) assessed reliability; MEP amplitude and area were used for index computation.

Main Results:

  • Contra-to-ipsilesional IHI indices showed moderate to excellent reliability (ICC = 0.725-0.913) after the first week.
  • Ipsi-to-contralesional IHI indices exhibited poor or invalid reliability (ICC = -1.153-0.105).
  • MEP amplitude and area quantification methods yielded similar reliability for IHI indices.

Conclusions:

  • IHI index reliability varies significantly depending on the direction of measurement in stroke patients.
  • Contra-to-ipsilesional IHI measurements offer a more reliable index of corticomotor excitability.
  • Strategies to enhance IHI measurement reliability are discussed.