Evidence map›Paper›PMID 32712080›Full record

ArticleClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2020

Stratifying chronic stroke patients based on the influence of contralesional motor cortices: An inter-hemispheric inhibition study.

Yin-Liang Lin, Kelsey A Potter-Baker, David A Cunningham, Manshi Li, Vishwanath Sankarasubramanian, John Lee, Stephen Jones, Ken Sakaie, Xiaofeng Wang, Andre G Machado and 1 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07049211 (Individualized Closed-Loop Neuromodulation With Repetitive Transcranial Magnetic Stimulation Synchronized Task Training for Upper Limb Motor Dysfunction in Stroke Patients), which is not on this map. Cited by 41 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 4 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07049211 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Individualized Closed-Loop Neuromodulation With Repetitive Transcranial Magnetic Stimulation Synchronized Task Training for Upper Limb Motor Dysfunction in Stroke Patients

TypeinterventionalSponsorRuijin HospitalRan2025 to 2028Enrolled51ConditionsUpper Extremity Dysfunction After the StrokeArmsIndividualized online stimulation, Non-individualized online stimulation, Sham stimulation
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 4 syntheses or guidelines pooled it, 60 citations in OpenAlex.

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  3. The effects of rTMS on motor recovery after stroke: a systematic review of fMRI studies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 2 countries.

Yin-Liang LinDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
Kelsey A Potter-BakerDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veteran's Affairs, Cleveland, OH, USA; Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Edinburg, TX, USA.
David A CunninghamDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH, USA; MetroHealth Rehabilitation Institute of Ohio, MetroHealth Medical Center, Cleveland, OH, USA; Cleveland Functional Electrical Stimulation Center, Louis Stokes Cleveland Department of Veteran's Affairs, Cleveland, OH, USA.
Manshi LiRespiratory Institute Biostatistics Core, Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Vishwanath SankarasubramanianDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
John LeeDepartment of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic, OH, USA.
Stephen JonesDepartment of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
Ken SakaieDepartment of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
Xiaofeng WangRespiratory Institute Biostatistics Core, Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Andre G MachadoNeurological Institute, Cleveland Clinic, OH, USA.
Ela B PlowDepartment of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic, OH, USA. Electronic address: plowe2@ccf.org.
Cleveland Clinic · USCleveland Clinic Lerner College of Medicine · USThe Neurological Institute · USMetroHealth · USNational Yang Ming Chiao Tung University · TWThe University of Texas Rio Grande Valley · US

Funding

Contralaterally Controlled FES Combined with Brain Stimulation for Severe Upper limb HemiplegiaR01HD098073 · NICHD · CLEVELAND CLINIC LERNER COM-CWRU · PI PLOW, ELA B · 2019 to 2024
$3.1M
Brain Stimulation- aided Stroke Rehabilitation: Neural Mechanisms of RecoveryK01HD069504 · NICHD · CLEVELAND CLINIC LERNER COM-CWRU · PI PLOW, ELA B · 2011 to 2015
$531k
NICHD NIH HHS K01 HD069504NICHD NIH HHS R01 HD098073
6 · The paper itself

Abstract

objectiveA recent "bimodal-balance recovery" model suggests that contralesional influence varies based on the amount of ipsilesional reserve: inhibitory when there is a large reserve, but supportive when there is a low reserve. Here, we investigated the relationships between contralesional influence (inter-hemispheric inhibition, IHI) and ipsilesional reserve (corticospinal damage/impairment), and also defined a criterion separating subgroups based on the relationships.

methodsTwenty-four patients underwent assessment of IHI using Transcranial Magnetic Stimulation (ipsilateral silent period method), motor impairment using Upper Extremity Fugl-Meyer (UEFM), and corticospinal damage using Diffusion Tensor Imaging and active motor threshold. Assessments of UEFM and IHI were repeated after 5-week rehabilitation (n = 21).

resultsRelationship between IHI and baseline UEFM was quadratic with criterion at UEFM 43 (95%conference interval: 40-46). Patients less impaired than UEFM = 43 showed stronger IHI with more impairment, whereas patients more impaired than UEFM = 43 showed lower IHI with more impairment. Of those made clinically-meaningful functional gains in rehabilitation (n = 14), more-impaired patients showed further IHI reduction.

conclusionsA criterion impairment-level can be derived to stratify patient-subgroups based on the bimodal influence of contralesional cortex. Contralesional influence also evolves differently across subgroups following rehabilitation. SIGNIFICANCE: The criterion may be used to stratify patients to design targeted, precision treatments.

Indexed as

AgedDiffusion Tensor ImagingFemaleFunctional LateralityHumansMagnetic Resonance ImagingMaleMiddle AgedMotor CortexNeural InhibitionRecovery of FunctionStrokeTranscranial Magnetic StimulationCorticospinalDiffusion Tensor Imaging (DTI)Inter-Hemispheric Inhibition (IHI)Motor functionRehabilitationStrokeTranscranial Magnetic Stimulation (TMS)Upper limb

Identifiers

PMID32712080
PMCPMC7487004
OpenAlexW3039420175

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.