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Following stroke, an abnormally high interhemispheric inhibitory drive from the contralesional to the ipsilesional primary motor cortex (M1) is evident during voluntary movement. Down-regulating motor excitability of the contralesional M1 using inhibitory neuromodulatory protocols has demonstrated a correlation between balanced interhemispheric interactions and increased motor recovery. In 2005, our...
It has been shown on hand muscles in normal subjects that paired associative stimulation (PAS) combining peripheral nerve stimulation and transcranial magnetic stimulation (TMS) induces lasting changes in cortical motor excitability (Stefan et al., Brain 123 (Pt3):572–584, 2000). Because the motor recovery of distal upper limb and particularly wrist extension in post-stroke patients is one of the...
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