1. Motor Evoked Potentials as Potential Biomarkers of Early Atypical Corticospinal Tract Development in Infants with Perinatal Stroke
- Author
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Mo Chen, Marie Hickey, Jesse L. Kowalski, Kyle Rudser, Bernadette T. Gillick, Michael K. Georgieff, Elizabeth Zorn, Raghavendra Rao, Samuel T. Nemanich, Tanjila Nawshin, and Colleen Peyton
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non-invasive brain stimulation ,medicine.medical_specialty ,pediatrics ,medicine.medical_treatment ,perinatal stroke ,lcsh:Medicine ,Article ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Neuroimaging ,transcranial magnetic stimulation ,Perinatal stroke ,Medicine ,030212 general & internal medicine ,cerebral palsy ,Rehabilitation ,business.industry ,lcsh:R ,General Medicine ,medicine.disease ,infant ,Transcranial magnetic stimulation ,Potential biomarkers ,Corticospinal tract ,Biomarker (medicine) ,business ,030217 neurology & neurosurgery - Abstract
Diagnosis of cerebral palsy (CP) after perinatal stroke is often delayed beyond infancy, a period of rapid neuromotor development with heightened potential for rehabilitation. This study sought to assess whether the presence or absence of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) could be an early biomarker of atypical development within the first year of life. In 10 infants with perinatal stroke, motor outcome was assessed with a standardized movement assessment. Single-pulse TMS was utilized to assess presence of MEPs. Younger infants (3&ndash, 6 months CA, n = 5, 4/5 (80%)) were more likely to present with an MEP from the more-affected hemisphere (MAH) compared to older infants (7&ndash, 12 months CA, n = 5, 0/5, (0%)) (p = 0.048). Atypical movement was demonstrated in the majority of infants with an absent MEP from the MAH (5/6, 83%) compared to those with a present MEP (1/4, 25%) (p = 0.191). We found that age influences the ability to elicit an MEP from the MAH, and motor outcome may be related to MAH MEP absence. Assessment of MEPs in conjunction with current practice of neuroimaging and motor assessments could promote early detection and intervention in infants at risk of CP.
- Published
- 2019
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