Abstract
Objective: Emotional disturbance is a common complication of stroke significantly affecting functional recovery and quality of life. Identifying relevant neurophysiologic markers associated with post-stroke emotional disturbance may lead to a better understanding of this disabling condition, guiding the diagnosis, development of new interventions and the assessments of treatment response.Methods: Thirty-five subjects with chronic stroke were enrolled in this study. The emotion sub-domain of Stroke Impact Scale (SIS-Emotion) was used to assess post-stroke mood and emotional control. The relation between SIS-Emotion and neurophysiologic measures was assessed by using covariance mapping and univariate linear regression. Multivariate analyses were conducted to identify and adjust for potential confounders. Neurophysiologic measures included power asymmetry and coherence assessed by electroencephalography (EEG); and motor threshold, intracortical inhibition (ICI) and intracortical facilitation (ICF) measured by transcranial magnetic stimulation (TMS).Results: Lower scores on SIS-Emotion was associated with (1) frontal EEG power asymmetry in alpha and beta bands, (2) central EEG power asymmetry in alpha and theta bands, and (3) lower inter-hemispheric coherence over frontal and central areas in alpha band. SIS-Emotion also correlated with higher ICF and MT in the unlesioned hemisphere as measured by TMS.Conclusions: To our knowledge, this is the first study using EEG and TMS to index neurophysiologic changes associated with post-stroke mood and emotional control. Our results suggest that inter-hemispheric imbalance measured by EEG power and coherence, as well as an increased ICF in the unlesioned hemisphere measured by TMS might be relevant markers associated with post-stroke mood and emotional control which can guide future studies investigating new diagnostic and treatment modalities in stroke rehabilitation.
Highlights
Emotional disturbance is a common complication of stroke (Annoni et al, 2006)
These results indicate that patients who report having more depressive symptoms and anxiety have (1) higher inter-hemispheric imbalance in cortical activity as measured by EEG power and coherence and (2) higher intracortical excitability and motor threshold in the unlesioned hemisphere as measured by Transcranial magnetic stimulation (TMS) when adjusted for confounders
To our knowledge this is the first study that emphasizes the potential use of EEG and TMS to index neurophysiologic changes associated with post-stroke mood and emotional control
Summary
About 30% of stroke survivors develop anxiety and depressive symptoms critically affecting functional recovery (Parikh et al, 1990; Hackett and Anderson, 2005) and quality of life (Robinson, 1997; Jonsson et al, 2005). Investigation of neurophysiological markers associated with post-stroke mood and emotional control could have important implications in the development of new interventions as well as the assessment of current diagnostic and therapeutic modalities in stroke rehabilitation. Neurophysiologically guided interventions, such as EEG biofeedback entrainment, has already been shown to be effective in stroke patients with physical and cognitive impairments (Nelson, 2007). QEEG has been used to detect inter-hemispheric imbalance in cortical activity that has lead to the application of new therapeutic approaches such as TMS (transcranial magnetic stimulation) and tDCS (transcranial direct current stimulation; Rosenfeld et al, 1996; Linden, 2014)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
