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Non-paretic leg movements can facilitate cortical drive to the paretic leg in severe stroke: implications for motor priming
  • Hyosok Lim,
  • Sangeetha Madhavan
Hyosok Lim
University of Illinois Chicago
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Sangeetha Madhavan
University of Illinois Chicago

Corresponding Author:[email protected]

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Background: Cross-education, a phenomenon where unilateral strength (or skill) training enhances strength (or skill) in the contralateral untrained limb, has been well studied in able-bodied individuals. However, whether non-paretic leg movements can modulate corticomotor excitability (CME) and improve motor control of the paretic leg in stroke remains unclear. Objective: To determine the effects of non-paretic leg movements on corticomotor responses and motor control of the paretic leg in persons with severe stroke. Methods: Seventeen post stroke individuals with severe leg motor impairment performed three 20-min motor trainings using their non-paretic ankle: skill (targeted dynamic movements), strength (isometric resistance), and sham (sub-threshold electrical nerve stimulation). Transcranial magnetic stimulation measured CME of the contralateral pathways from the non-lesioned motor cortex (M1) to the non-paretic tibialis anterior (TA) muscle, ipsilateral pathways to the paretic TA, and transcallosal inhibition (TCI) from the non-lesioned to lesioned M1. Paretic ankle motor control was measured using a reaction time paradigm. Results: CME of the non-paretic TA increased after skill (23%) and strength (19%) training (p<0.01). Ipsilateral CME of the paretic TA (23%) and TCI (36%) increased after skill (p<0.05) but not strength training. Reaction time of the paretic ankle improved after skill and strength training (~12%; p<0.05) and was sustained at 60 minutes. No changes were observed during the sham condition. Conclusion: Our findings may inform future studies for using non-paretic leg movements as a priming modality, especially for those who are contraindicated to other priming paradigms (e.g., brain stimulation) or unable to perform paretic leg movements.
03 Mar 2023Submitted to European Journal of Neuroscience
03 Mar 2023Submission Checks Completed
03 Mar 2023Assigned to Editor
03 Mar 2023Review(s) Completed, Editorial Evaluation Pending
03 Mar 2023Reviewer(s) Assigned
01 Apr 2023Editorial Decision: Revise Major
29 Apr 20231st Revision Received
02 May 2023Submission Checks Completed
02 May 2023Assigned to Editor
02 May 2023Review(s) Completed, Editorial Evaluation Pending
02 May 2023Reviewer(s) Assigned
04 Jun 2023Editorial Decision: Revise Major
07 Jun 20232nd Revision Received
08 Jun 2023Submission Checks Completed
08 Jun 2023Assigned to Editor
08 Jun 2023Review(s) Completed, Editorial Evaluation Pending
11 Jun 2023Editorial Decision: Accept