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Prognostic value of motor evoked potentials in motor function recovery of upper limb after stroke
Journal of Rehabilitation Medicine, 07/02/09

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.

• 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

• 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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