Background: The predictive value of neurophysiologic assessment on patients' outcome after acute cerebral infarction is poorly understood. The aim of this study was to investigate the prognostic value of motor-evoked potentials (MEPs) and the silent period (SP) on clinical outcome.
Methods: A total of 202 patients with acute cerebral infarction were prospectively recruited. MEP and SP were recorded from the abductor pollicis brevis of the affected side within 10 days after stroke onset. Patient outcome was measured as the dependency rate.
Results: Cortical MEP was induced in 78 patients whereas it was absent in 82 patients. The initial NIHSS (National Institutes of Health Stroke Scale) score was significantly lower in patients with MEP than in those without MEP (P < .001). Regression analysis demonstrated that a left-sided lesion (OR = .391, 95% CI .178-.858, P = .019), NIHSS at admission (OR = .826, 95% CI .744-.917, P < .001), and presence of MEP (OR = 3.918, 95% CI 1.770-8.672, P < .001) were independent predictors of outcome 3 months after stroke. Among patients with MEP, only the contralateral cortical SP value was significantly shorter in the good outcome subgroup (t = 2.541, P = .013). Receiver operating characteristic curve analysis demonstrated that SP was able to predict patients at higher risk of unfavorable outcome 3 months after stroke onset (area under the curve .721, 95% CI .58-.86, P = .008).
Conclusions: These data suggested that MEP and SP were useful tools to predict patients' acute outcomes following cerebral infarction.
Keywords: Cerebral infarction; motor-evoked potentials; outcome; silent period; transcranial magnetic stimulation.
Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.