Somatosensory evoked potential N20 in evaluating different brain regions of patients with stroke for the prognostic study of upper limb functional recovery
Somatosensory evoked potential N20 in evaluating different brain regions of patients with stroke for the prognostic study of upper limb functional recovery
Objective To explore the role of somatosensory evoked potential(SEP)-N20 index at different brain regions in the recovery of upper limb function for patients with stroke and evaluate its value in predicting post-stroke upper limb function recovery.Methods Sixty-four patients with stroke were selected from the department of Rehabilitation Medicine of Ruijin Hospital and Ruijin Rehabilita-tion Hospital from Sep.2021 to Jan.2024.The patients were classified into basal ganglia stroke group(n=32)and thalamic stroke group(n=32).After admission,all patients underwent SEP de-tection for bilateral upper limbs.The latency and amplitude data of bilateral N20 waves were recorded.The difference in N20 index was compared between two groups.After admission,the patients received routine rehabilitation training of limb function.At admission and 3 months after routine treatment,the patients were evaluated for simplified Fugl-Meyer motor function score(FMA-UE)for the upper limb,modified Ashworth scale(MAS)and modified Barthel score(MBI).Abnormal situation of N20 wave and the difference in limb function score changes between two groups of the patients were ana-lyzed.Results Abnormal N20 wave were observed in the patients with stroke,mainly including pro-longed latency,decreased amplitude or inability to elicit.The latency and amplitude of N20 on the af-fected side of patients in both groups were significantly worse than those on the intact side(P＜0.01).The amplitude of N20 waves in the affected sides was obviously decreased when compared to basal ganglia stroke group(P＜0.05),while there was no statistically significant difference in the la-tency of N20 waves in the affected sides between two groups(P＞0.05).In basal ganglia stroke group,there were 15 cases with normal N20 waves and 17 cases with abnormal N20 waves.After 3 months of rehabilitation treatment,the improvement of FMA-UE was significantly higher in the pa-tients with normal SEP-N20 wave than that in the patients with abnormal SEP-N20 wave(28.9±3.7 vs 4.9±1.3,P＜0.01),however,the difference between initial FMA-UE and final FMA-UE scores,MAS and MBI scores had no remarkable changes(P＞0.05).In thalamic stroke group,there were 12 cases with normal N20 waves and 20 cases with abnormal N20 waves.Initial FMA-UE and final FMA-UE scores were significantly higher in the patients with normal SEP-N20 wave than those in the pa-tients with abnormal SEP-N20 wave(initial FMA-UE score 47.9±5.7 vs 23.4±5.1,final FMA-UE score 56.8±4.2 vs 39.8±5.3,P＜0.01).After 3 months of rehabilitation treatment,there were no significant differences in the improvement degree of FMA-UE score,MAS and MBI scores(P＞0.05).Conclusion There is no difference between the abnormal situation of SEP-N20 index and the changes of functional scale in patients with thalamic stroke,indicating that its role in evaluating the prognosis of upper limb function is limited.N20 wave index of patients with basal ganglia stroke is as-sociated with the patients FMA-UE score result and can be used as one of the indexes to evaluate the prognosis of upper limb function at certain extent.
关键词
脑卒中/体感诱发电位/运动功能恢复/丘脑/基底节
Key words
stroke/somatosensory evoked potential/motor function recovery/thalamus/bas-al ganglia
维普
万方数据