MAGNETIC TRANSCRANIAL STIMULATION IN ACUTE STROKE - EARLY EXCITATION THRESHOLD AND FUNCTIONAL PROGNOSIS

Magnetic transcranial stimulation was used in 90 subjects (60 acute is chaemic sylvian strokes and 30 healthy controls) in order to evaluate the clinical value of the excitation threshold (ET) in the estimation of functional prognosis. ET mean values recorded 7, 30 and 90 days aft er stroke (at D-7, D-30 and D-90) in two distal muscles of the upper l imbs of the patients were compared with results obtained in 30 healthy control subjects. The data from the patients who ultimately achieved a satisfactory functional recovery at D-90 were compared with those fr om patients who had not recovered in that time. Our results suggest th at ET evolution differs according to functional outcome: (1) ET mean v alues were increased in the stroke patients at D-7, but ET was constan tly lower at D-30 and D-90 in patients who recovered than in those who did not. (2) ET temporal evolution showed a gradual decrease of the m ean values from D-7 to D-90 in both stroke groups. This ET decrease wa s more marked in the patients who recovered from D-30 to D-90, but wit h only minor change after D-30. (3) The localisation of the lesion had no significant effect on ET mean values at D-7, D-30 or D-90. We conc lude that the predictive value of ET estimation might be utilised at D -30 in patients with ischaemic sylvian strokes.