Prognostic value of motor evoked potentials in motor function recovery of upper limb after stroke
Pizzi A et al. – Motor evoked potentials may be a supportive tool to increase the prognostic accuracy of upper limb motor and functional outcome in hemiparetic pts, especially pts with severe initial paresis (MRC <2) and/or with motor evoked potentials absent in post-stroke acute phase. Methods- Study of prognostic value of clinical assessment and motor evoked potentials for upper limb strength and functional recovery after acute stroke
- Evaluation of possible use of motor evoked potentials in rehabilitation
- Prospective assessment of 52 pts with hemiparesis 1 mo post-stroke; study conclusion at 120 mo by 38 pts
- Recording of motor evoked potentials at baseline and after 1 mo
- Dependent outcome variables 12 mo later: upper limb muscular strength (Medical Research Council Scale, MRC) and functional tests (Frenchay Arm Test, Barthel Index)
- Classification of motor evoked potentials as present or absent
- Assessment of predictive values of motor evoked potentials and MRC
Results- At 12 mo, pts with baseline recordable motor evoked potentials showed a good functional recovery (positive predictive value 94%)
- Absence of motor evoked potentials did not exclude muscular strength recovery (negative predictive value 95%)
- Motor evoked potentials had higher positive predictive value vs MRC only in pts with MRC <2
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