Correlation between functional and electrophysiological recovery in acute ischemic stroke

Background and Purpose-There is still controversy about the prognostic valu e of motor evoked potentials (MEPs) in the assessment of hemiplegia. The ai ms of this study are to determine the relationship between functional and e lectrophysiological recovery and thus the value of MEP as a prognostic indi cator of clinical outcome in acute ischemic stroke. Methods-Seventeen healthy subjects and 38 stroke patients were included in this study. Functional recovery was assessed with the Modified Canadian Neu rological Scale (MCNS), the Barthel Activities of Daily Living Index (BI), and the Rankin scale. Transcranial magnetic stimulation was used to determi ne the change in central motor conduction time (CMCT). Stroke outcome was a ssessed at the end of 2 weeks. One-way ANOVA with post hoc comparisons usin g the Scheffe procedure as well as t tests were used to assess the signific ance of the results in this study. Results-Unpaired t test showed significantly higher mean scores of the MCNS (2P = 0.001), BT (2P = 0.002), and Rankin scale (P<0.001) at day 14 in the group of patients with recordable MEP at day 1. A better clinical improvem ent with a higher mean score of the MCNS (2P<0.001), BI (2P<0.001), and the Rankin scale (2P<0.001) was also observed in the patients in whom the CMCT improved. Conclusions-These data show that there is a close relationship between clin ical and electrophysiological improvement and that MEP is a useful prognost ic indicator of clinical outcome.