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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.

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