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Open Access

Altered excitability of motor neuron pathways after stroke: more than upper motor neuron impairments

Pingping Li, Chunyong Chen, Baozi Huang, Zimu Jiang, Jiating Wei, Jinsheng Zeng
DOI: 10.1136/svn-2022-001568 Published 20 December 2022
Pingping Li
1 Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2 Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Chunyong Chen
1 Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2 Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Baozi Huang
1 Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
2 Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Zimu Jiang
1 Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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Jiating Wei
1 Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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Jinsheng Zeng
1 Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
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    Figure 1

    Hill and Valley Task of cynomolgus monkeys.Note: A: Hill Task of right hand; B: Hill Task of left hand; C: Valley Task of right hand; D: Valley Task of left hand.

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    Figure 2

    Stimulation sites of magnetic stimulation and recording locations of motor evoked potentials.

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    Figure 3

    MRA and T2-weighted MRI of cynomolgus monkeys 2 weeks after MCAO.Note: A: MRA indicated that the left middle cerebral artery was blocked (white arrow); B: high signal infarct lesion of left hemisphere was shown on the T2-weighted MRI.

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    Figure 4

    pPS and motor function assessment.Note: A: pRS score; B: Skeletal muscle coordination scale score; C: Hill Task time; D: Valley Task time. * represents p value less than 0.05 compared with baseline; ** represents p value less than 0.001 compared with baseline. pRS, primate Rankin Scale.

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    Figure 5

    MEP waveforms and amplitude dynamic evolution.Note: A+B: a single-onset MEP waveforms in a single monkey; A: MEP waveforms of the affected motor cortex; B: MEP waveforms of the paretic side median nerve. The red triangle indicated the stimulation start time. The length of each small square in A represented 5ms and the height represented 1000μV. The length of each small square in B represented 5ms and the height represented 2000μV. O indicated the MEP onset time and P represented the wave crest. Latency refers to the time from the onset of magnetic stimulation (red triangle) to the onset of MEP (O point), and amplitude refers to the longitudinal distance between the wave crest and the wave trough. C: Dynamic evolution of amplitude at different preoperative and postoperative time points.

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    Figure 6

    HE staining and LFB staining of median nerve.Note: A+C: HE staining and LFB staining of nonparetic side median nerve with tight and regular arrangement of myelin sheaths; B+D: HE staining and LFB staining of paretic side median nerve with sparse and disorganized arrangement of myelin sheaths. LFB: LuxolFastBlue.

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    Figure 7

    Immunofluorescence Double-labeling of Median Nerve.Note: In contrast to the nonparetic side median nerve, the MBP+ expression of the paretic side median nerve was less with disturbed arrangement of myelin structures.

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    Figure 8

    Correlation analysis.Note: A: positive correlation between RMT of affected motor cortex and Hill Task of right hand at 2w; B: positive correlation between RMT of affected motor cortex and Hill Task of right hand at 4w; C: positive correlation between RMT of affected motor cortex and Hill Task of right hand at 8w; D: negative correlation between amplitude of affected motor cortex and Hill Task of right hand at 4w; E: automatic linear modeling of RMT of affected motor cortex (4w) and pRS (12w) with positive correlation; F: automatic linear modeling of RMT lateralization (4w) and pRS (12w) with negative correlation; G: automatic linear modelling of RMT lateralization (4w) and SMCS (4w) with negative correlation; H: automatic linear modeling of latency of affected motor cortex (2w) and SMCS (2w) with positive correlation. RMT, resting motor threshold. pRS, primate Rankin Scale. SMCS, Skeletal Muscle Coordination Scale.

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    [svn-2022-001568supp001.pdf]

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Stroke and Vascular Neurology: 7 (6)
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Altered excitability of motor neuron pathways after stroke: more than upper motor neuron impairments
Pingping Li, Chunyong Chen, Baozi Huang, Zimu Jiang, Jiating Wei, Jinsheng Zeng
Stroke and Vascular Neurology Dec 2022, 7 (6) 518-526; DOI: 10.1136/svn-2022-001568

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Altered excitability of motor neuron pathways after stroke: more than upper motor neuron impairments
Pingping Li, Chunyong Chen, Baozi Huang, Zimu Jiang, Jiating Wei, Jinsheng Zeng
Stroke and Vascular Neurology Dec 2022, 7 (6) 518-526; DOI: 10.1136/svn-2022-001568
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Altered excitability of motor neuron pathways after stroke: more than upper motor neuron impairments
Pingping Li, Chunyong Chen, Baozi Huang, Zimu Jiang, Jiating Wei, Jinsheng Zeng
Stroke and Vascular Neurology Dec 2022, 7 (6) 518-526; DOI: 10.1136/svn-2022-001568
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