Cutaneous reflexes in patients with acute lacunar infarctions

Area of Science:

• Neuroscience
• Neurology
• Clinical Electrophysiology

Background:

• Lacunar stroke can cause subtle neurological deficits.
• Assessing subclinical dysfunction is crucial for stroke management.
• Cutaneous reflex (CR) offers a potential window into neural pathway integrity.

Purpose of the Study:

• To investigate cutaneous reflex (CR) alterations in patients with acute lacunar stroke.
• To explore the diagnostic and prognostic value of CR in lacunar stroke.
• To identify potential central nervous system pathways involved in CR.

Main Methods:

• Measured CR using EMG in 15 acute lacunar stroke patients and 15 controls.
• Stimulated the index finger at four times sensory threshold.
• Analyzed early inhibitory (I1) and second excitatory (E2) components and their interpeak amplitude (A2).

Main Results:

• All patients exhibited CR abnormalities.
• Reduced I1 and E2 components and significantly reduced A2 were observed in most patients.
• Prolonged I1-E2 latency correlated with sensory symptoms.
• CR abnormalities showed partial reversal at 1-month follow-up, even in recovered patients.

Conclusions:

• Findings suggest a thalamic relay in the afferent limb of the CR.
• CR assessment is a valuable tool for detecting long tract dysfunction post-stroke.
• CR monitoring can aid in assessing functional recovery after lacunar stroke.