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    Intracortical Circuits in the Contralesional Primary Motor Cortex in Patients With Chronic Stroke After Botulinum Toxin Type A Injection: Case Studies

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    Author
    Zoghi, M; Hafezi, P; Amatya, B; Khan, F; Galea, MP
    Date
    2020-08-24
    Source Title
    Frontiers in Human Neuroscience
    Publisher
    FRONTIERS MEDIA SA
    University of Melbourne Author/s
    Khan, Farees; Galea, Mary; Amatya, Bhasker
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Zoghi, M., Hafezi, P., Amatya, B., Khan, F. & Galea, M. P. (2020). Intracortical Circuits in the Contralesional Primary Motor Cortex in Patients With Chronic Stroke After Botulinum Toxin Type A Injection: Case Studies. FRONTIERS IN HUMAN NEUROSCIENCE, 14, https://doi.org/10.3389/fnhum.2020.00342.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/251635
    DOI
    10.3389/fnhum.2020.00342
    Abstract
    Spasticity and motor recovery are both related to neural plasticity after stroke. A balance of activity in the primary motor cortex (M1) in both hemispheres is essential for functional recovery. In this study, we assessed the intracortical inhibitory and facilitatory circuits in the contralesional M1 area in four patients with severe upper limb spasticity after chronic stroke and treated with botulinum toxin-A (BoNT-A) injection and 12 weeks of upper limb rehabilitation. There was little to no change in the level of spasticity post-injection, and only one participant experienced a small improvement in arm function. All reported improvements in quality of life. However, the levels of intracortical inhibition and facilitation in the contralesional hemisphere were different at baseline for all four participants, and there was no clear pattern in the response to the intervention. Further investigation is needed to understand how BoNT-A injections affect inhibitory and facilitatory circuits in the contralesional hemisphere, the severity of spasticity, and functional improvement.

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