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Updated: May 30, 2025
Electroencephalography Network Indices as Biomarkers of Upper Limb Impairment in Chronic Stroke
Published on: July 14, 2023
Association of TMS-EEG interhemispheric imbalance with upper limb motor impairment in chronic stroke patients: An
Alex Martino Cinnera1, Elias Paolo Casula2, Valentina Pezzopane3
1Scientific Institute for Research, Hospitalization and Health Care IRCCS Santa Lucia Foundation, Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy.
Objective:
We aimed to investigate the involvement of interhemispheric cortical dynamics as measured by combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) in recovery of upper limb (UL) motor functions in chronic stroke patients.
Methods:
Ten patients with a history of single ischemic chronic stroke were enrolled (4F, 63.8 ± 9.9 years). Each patient underwent TMS-EEG recordings to evaluate interhemispheric cortical dynamics as well as a reaching task recorded with inertial measurement units, and a series of clinical assessments. TMS-EEG neurophysiological data were analysed considering spatiotemporal, power response, and interhemispheric balance (IHB) dynamics.
Results:
We found that IHB index (IHBi) and low-frequency power (LFP) (4-13 Hz) in the affected hemisphere were associated with the degree of UL impairment.
Conclusion:
Increased IHBi due to stroke is an unfavourable factor of UL' functions. Similarly, LFP of both hemispheres is strongly correlated with clinical and kinematic outcomes.
Significance:
TMS-EEG biomarkers of interhemispheric unbalance could be used to estimate functional recovery and drive tailored neuromodulation and neurorehabilitation approaches.
