Evaluation of objective methods for analyzing ipsilateral motor evoked potentials in stroke survivors with chronic upper extremity motor impairment

作者：Akhil Mohan, Xin Li, Bei Zhang, Jayme S. Knutson, Morgan Widina, Xiaofeng Wang, Ken Uchino, Ela B. Plow, David A. Cunningham · 发表于：Journal of Neural Engineering · 年份：2025 · DOI：10.1088/1741-2552/ada827 · 被引用次数：1 · 研究领域：EEG and Brain-Computer Interfaces、Transcranial Magnetic Stimulation Studies、Stroke Rehabilitation and Recovery

Abstract Objective. Ipsilateral motor evoked potentials (iMEPs) are believed to represent cortically evoked excitability of uncrossed brainstem-mediated pathways. In the event of extensive injury to (crossed) corticospinal pathways, which can occur following a stroke, uncrossed ipsilateral pathways may serve as an alternate resource to support the recovery of the paretic limb. However, iMEPs, even in neurally intact people, can be small, infrequent, and noisy, so discerning them in stroke survivors is very challenging. This study aimed to investigate the inter-rater reliability of iMEP features (presence/absence, amplitude, area, onset, and offset) to evaluate the reliability of existing methods for objectively analyzing iMEPs in stroke survivors with chronic upper extremity (UE) motor impairment. Approach. Two investigators subjectively measured iMEP features from thirty-two stroke participants with chronic UE motor impairment. Six objective methods based on standard deviation (SD) and mean consecutive differences (MCD) were used to measure the iMEP features from the same 32 participants. IMEP analysis used both trial-by-trial (individual signal) and average-signal analysis approaches. Inter-rater reliability of iMEP features and agreement between the subjective and objective methods were analyzed (percent agreement-PA and intraclass correlation coefficient-ICC). Main results. Inter-rater reliability was excellent for iMEP detection (PA > 85%), amplitude, and area (ICC &g...