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The Effect of Diabetes on Cortical Function in Stroke: Implications for Poststroke Plasticity
William Huynh1,2, Natalie Kwai3, Ria Arnold3
1Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia w.huynh@neura.edu.au.
Diabetes
|March 23, 2017
Summary
Diabetes impairs neuroplasticity after stroke, leading to poorer recovery. Patients with diabetes showed reduced cortical inhibition only in one hemisphere, unlike those without diabetes, indicating a "double-hit" effect.
Area of Science:
- Neuroscience
- Neurology
- Endocrinology
Background:
- Diabetes mellitus is a prevalent comorbidity associated with impaired functional recovery after stroke.
- The underlying mechanisms by which diabetes affects post-stroke neuroplasticity remain incompletely understood.
Purpose of the Study:
- To investigate the impact of diabetes on cortical plasticity and functional recovery in acute stroke patients.
- To determine if diabetes exacerbates stroke-related alterations in cortical function.
Main Methods:
- Utilized threshold-tracking transcranial magnetic stimulation (TMS) to assess cortical excitability.
- Compared short-interval intracortical inhibition (SICI) in stroke patients with and without diabetes, alongside diabetic and non-diabetic control groups.
Main Results:
- Stroke patients without diabetes exhibited reduced SICI in both ipsilesional and contralesional motor cortices compared to controls.
- Stroke patients with diabetes showed reduced SICI only in the contralesional cortex, with no significant change in the ipsilesional cortex.
- Diabetic individuals without stroke demonstrated reduced SICI compared to non-diabetic controls, suggesting pre-existing cortical alterations.
Conclusions:
- Diabetes appears to impair ipsilesional cortical plasticity following stroke, potentially due to a
- double-hit
- phenomenon combining pre-existing diabetic cortical changes with stroke-induced effects.
- Altered cortical reorganization, particularly reliance on the contralesional hemisphere, may significantly influence functional recovery in diabetic stroke survivors.
