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@ARTICLE{Tscherpel:875258,
      author       = {Tscherpel, Caroline and Dern, Sebastian and Hensel, Lukas
                      and Ziemann, Ulf and Fink, Gereon R and Grefkes, Christian},
      title        = {{B}rain responsivity provides an individual readout for
                      motor recovery after stroke},
      journal      = {Brain},
      volume       = {143},
      number       = {6},
      issn         = {1460-2156},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {FZJ-2020-01902},
      pages        = {1873–1888},
      year         = {2020},
      abstract     = {Promoting the recovery of motor function and optimizing
                      rehabilitation strategies for stroke patients is closely
                      associated with the challenge of individual prediction. To
                      date, stroke research has identified critical
                      pathophysiological neural underpinnings at the cellular
                      level as well as with regard to network reorganization.
                      However, in order to generate reliable readouts at the level
                      of individual patients and thereby realize translation from
                      bench to bedside, we are still in a need for innovative
                      methods. The combined use of transcranial magnetic
                      stimulation (TMS) and EEG has proven powerful to record both
                      local and network responses at an individual’s level. To
                      elucidate the potential of TMS-EEG to assess motor recovery
                      after stroke, we used neuronavigated TMS-EEG over
                      ipsilesional primary motor cortex (M1) in 28 stroke patients
                      in the first days after stroke. Twenty-five of these
                      patients were reassessed after >3 months post-stroke. In the
                      early post-stroke phase (6.7 ± 2.5 days), the
                      TMS-evoked EEG responses featured two markedly different
                      response morphologies upon TMS to ipsilesional M1. In the
                      first group of patients, TMS elicited a differentiated and
                      sustained EEG response with a series of deflections
                      sequentially involving both hemispheres. This response type
                      resembled the patterns of bilateral activation as observed
                      in the healthy comparison group. By contrast, in a subgroup
                      of severely affected patients, TMS evoked a slow and
                      simplified local response. Quantifying the TMS-EEG responses
                      in the time and time-frequency domain revealed that stroke
                      patients exhibited slower and simple responses with higher
                      amplitudes compared to healthy controls. Importantly, these
                      patterns of activity changes after stroke were not only
                      linked to the initial motor deficit, but also to motor
                      recovery after >3 months post-stroke. Thus, the data
                      revealed a substantial impairment of local effects as well
                      as causal interactions within the motor network early after
                      stroke. Additionally, for severely affected patients with
                      absent motor evoked potentials and identical clinical
                      phenotype, TMS-EEG provided differential response patterns
                      indicative of the individual potential for recovery of
                      function. Thereby, TMS-EEG extends the methodological
                      repertoire in stroke research by allowing the assessment of
                      individual response profiles.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32375172},
      UT           = {WOS:000541788700030},
      doi          = {10.1093/brain/awaa127},
      url          = {https://juser.fz-juelich.de/record/875258},
}