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Related Experiment Video

Updated: Oct 22, 2025

Author Spotlight: Using Motor Imagery Brain-Computer Interface to Improve Motor and Cognitive Function in Stroke Patients
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Including Distal Motor Function within the NIHSS: Correlation with Motor Arm Function and IV rt-PA Treatment

Aron Egelko1, Kathryn F Kirchoff-Torres2, Srinath Ramaswamy3

  • 1Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|August 28, 2021
PubMed
Summary
This summary is machine-generated.

Distal Motor Function (DMF) strongly correlates with NIH Stroke Scale (NIHSS) Motor Arm Function (MAF) after IV tPA treatment. Adding DMF to NIHSS does not appear to increase its clinical utility for stroke patients.

Keywords:
National institute of health stroke scaleNational institute of neurological disorders and strokeRecovery of functionStrokeThrombolytic therapyTreatment outcome

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Area of Science:

  • Neurology
  • Stroke Rehabilitation
  • Clinical Assessment

Background:

  • The NIH Stroke Scale (NIHSS) is a crucial tool for assessing stroke severity.
  • The Distal Motor Function (DMF) sub-score, though not currently part of the NIHSS, has been measured in stroke trials.
  • The clinical utility of incorporating DMF into the NIHSS remains unexamined.

Purpose of the Study:

  • To analyze the correlation between DMF and the NIHSS Motor Arm Function (MAF) sub-score.
  • To evaluate the impact of IV tPA treatment on DMF.
  • To determine if adding DMF enhances the overall utility of the NIHSS.

Main Methods:

  • Retrieved MAF and DMF sub-scores from the NINDS rt-PA Stroke Trials.
  • Correlated MAF and DMF using Spearman correlation across multiple time points.
  • Assessed the effect of IV tPA on DMF and MAF using linear models and analyzed NIHSS utility with DMF inclusion via CFI.

Main Results:

  • Highly significant correlation (p < 0.0001) was found between MAF and DMF.
  • IV tPA accounted for 21% of the change in DMF and 39% of the change in MAF from baseline to 3 months.
  • Adding DMF to the NIHSS did not improve its utility, as indicated by a decrease in CFI and clustering of DMF with MAF.

Conclusions:

  • The inclusion of DMF to the NIHSS does not offer additional clinical value.
  • Proximal and distal upper extremity motor function are strongly correlated post-IV tPA, with MAF showing greater improvement.
  • Further investigation is warranted regarding IV tPA's role in minor strokes affecting DMF.