ArticleHuman brain mapping2021
Evidence for interhemispheric imbalance in stroke patients as revealed by combining transcranial magnetic stimulation and electroencephalography.
Article in Human brain mapping, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 6 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- TMS-Derived Neurophysiological Measures of Corticospinal Excitability, Intracortical Excitability, and Interhemispheric Interactions Associated With Post-Stroke Motor Recovery: A Systematic Review.The European journal of neuroscience · 2026Pooled it
- Efficacy of repetitive transcranial magnetic stimulation for post-stroke spasticity: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Methodological Choices Matter: A Systematic Comparison of TMS-EEG Studies Targeting the Primary Motor Cortex.Human brain mapping · 2024Pooled it
- Global research trends in transcranial magnetic stimulation for stroke (1994-2023): promising, yet requiring further practice.Frontiers in neurology · 2024Pooled it
- Effects of Cerebellar Transcranial Direct Current Stimulation in Patients with Stroke: a Systematic Review.Cerebellum (London, England) · 2023Pooled it
- Prognostic accuracy of transcranial magnetic stimulation-induced motor evoked potentials on recovery of upper limb: a systematic review.Frontiers in neurologyPooled it
- Neural correlates of fine motor grasping skills: Longitudinal insights into motor cortex activation using fNIRS.Brain and behavior · 2024Trial
- May Dual Transcranial Direct Current Stimulation Enhance the Efficacy of Robot-Assisted Therapy for Promoting Upper Limb Recovery in Chronic Stroke?Neurorehabilitation and neural repair · 2022Trial
- Precuneus magnetic stimulation for Alzheimer's disease: a randomized, sham-controlled trial.Brain : a journal of neurology · 2022Trial
- Post-stroke rehabilitative mechanisms in individualized fatigue level-controlled treadmill training in rats.Neural regeneration research · 2026Article
- Effects of online motor cortex transcranial ultrasound stimulation on interhemispheric inhibition.The Journal of physiology · 2026Article
- Added Value of One-Month Clinical Data in Predicting Chronic-Stage Motor Function After Ischemic Stroke.Journal of clinical medicine · 2026Article
- Disrupted proprioceptive timing estimates contribute to upper limb motor impairment in chronic stroke.Experimental brain research · 2026Article
- Hemispheric Dissociation Revealed by Attentional Isolation and Transcranial Random Noise Stimulation.Journal of cognitive neuroscience · 2026Article
- Sleep architecture differences and predictive markers of sleep perception impairment in depression.Scientific reports · 2026Article
- Review
- Causal interhemispheric neuromodulation sharpens synaptic and neurobehavioral inhibition in stroke.Brain communications · 2026Article
- Research progress on the mechanisms and clinical applications of neuromodulation techniques for intervening in interhemispheric imbalance after stroke.Frontiers in neurology · 2026Review
- B-STARS2: Early contralesional continuous theta burst stimulation (cTBS) to promote upper limb recovery after stroke - Rationale and design of a phase-3 multicentre, randomised, sham-controlled, clinical trial.European stroke journal · 2026Article
- Bilateral Prefrontal Cortex Activation During Sensorimotor Tasks in People with Subacute Stroke - An Exploratory Functional Near-Infrared Spectroscopy Study.NeuroRehabilitation · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Interhemispheric interactions in stroke patients are frequently characterized by abnormalities, in terms of balance and inhibition. Previous results showed an impressive variability, mostly given to the instability of motor-evoked potentials when evoked from the affected hemisphere. We aim to find reliable interhemispheric measures in stroke patients with a not-evocable motor-evoked potential from the affected hemisphere, by combining transcranial magnetic stimulation (TMS) and electroencephalography. Ninteen stroke patients (seven females; 61.26 ± 9.8 years) were studied for 6 months after a first-ever stroke in the middle cerebral artery territory. Patients underwent four evaluations: clinical, cortical, corticospinal, and structural. To test the reliability of our measures, the evaluations were repeated after 3 weeks. To test the sensitivity, 14 age-matched healthy controls were compared to stroke patients. In stroke patients, stimulation of the affected hemisphere did not result in any inhibition onto the unaffected. The stimulation of the unaffected hemisphere revealed a preservation of the inhibition mechanism onto the affected. This resulted in a remarkable interhemispheric imbalance, whereas this mechanism was steadily symmetric in healthy controls. This result was stable when cortical evaluation was repeated after 3 weeks. Importantly, patients with a better recovery of the affected hand strength were the ones with a more stable interhemispheric balance. Finally, we found an association between microstructural integrity of callosal fibers, suppression of interhemispheric TMS-evoked activity and interhemispheric connectivity. We provide direct and sensitive cortical measures of interhemispheric imbalance in stroke patients. These measures offer a reliable means of distinguishing healthy and pathological interhemispheric dynamics.
Indexed as
Identifiers
What OpenQuestion holds
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.