Position-Cortical Coherence as a Marker of Afferent Pathway Integrity Early Poststroke: A Prospective Cohort Study.
Sarah B Zandvliet, Erwin E H van Wegen, S Floor Campfens and 3 others
PMID 32129142WHAT IT FOUND
A brain-wave marker of wrist position input changed over early stroke recovery but did not clearly separate patients who did not recover from those who did.
It may help research, not therapy.
Key findings
01The percentage of position-cortical coherence was higher at 12 weeks than at baseline, but that difference was no longer clear after accounting for hand and finger sensory scores and motor scores.
02The percentage of position-cortical coherence and the amplitude over the affected hemisphere were positively associated with hand and finger sensory scores.
03In recovery subgroups, percentage coherence was higher in low-baseline recoverers than high-baseline recoverers, and non-recoverers had lower percentage coherence than low-baseline recoverers that was not clear; affected-hemisphere amplitude was lower in non-recoverers than low-baseline recoverers.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study did not show that the coherence marker can predict recovery for an individual patient. Four coherence parameters were tested without adjustment for multiple comparisons. The percentage coherence had a narrow range and a ceiling effect, so it may not work as a continuous measure. The coherence measure may reflect cortical excitability as well as afferent pathway integrity. The subgroup results did not show a consistent pattern of lower coherence in non-recoverers. Some EEG measurements were missing or had poor data quality. Patients were required to sit with support and have no severe cognitive deficits, so it may not apply to more severely impaired or cognitively impaired patients. Subcortical lesion differences between recovery subgroups may affect interpretation.
Declared interests
The authors declared no potential conflicts of interest. The study was financially supported by a fellowship from the Dutch Brain Foundation and a European Research Council advanced grant.
The easy way to misread this
Do not use this marker to decide whether a patient will recover or to choose treatment. The percentage coherence changed over time but the change was not clear after accounting for sensory and motor scores, and the subgroup results did not show a consistent pattern of lower coherence in non-recoverers.