Skip to main content Skip to main navigation menu Skip to site footer

Intraarterial heparin flushing effect on motor evoked potentials in chronic ischemic stroke patients

  • Terawan Agus Putranto ,
  • Tugas Ratmono ,
  • Irawan Yusuf ,
  • Bachtiar Murtala ,
  • Andi Wijaya ,

Abstract

Background: Stroke has always been a complicated disease which affects not only the patient quality of life but also the patient family. In ischemic stroke patients, one of the most complicated outcomes was the disruption of motor function. Increased motor function is a visible positive outcome of stroke patients.

Aim: This study aims to measure the motor evoked potentials values which the results might give us more insights into how this disease affects the motor neuron pathway.

Methods: This study was an experimental pre-posttest study involved 75 patients diagnosed with chronic ischemic stroke (onset of more than 30 days). The MEPs value was measured by adjusting the IAHF procedure in 2015.

Results: There was no significant difference between motor evoked potential value (amplitude, latency, central motor conduction time) pre and post intraarterial heparin procedure (IAHF) (p>0.05). Occasionally, there was a significant difference in latency value in lacunar, subcortical, and cortical-subcortical area after IAHF (p<0.05).

Conclusion: This study shows that the size and localization of the affected area might determine the results of IAHF.

References

  1. Durran, AC, and Watts, C. Current Trends in Heparin Use during Arterial Vascular Interventional Radiology. Cardiovasc Intervent Radiol. 2012; 35: 1308-1314.
  2. Coutinho, J, de Bruijn, SFTM, deVeber, G, Stam, J. Anticoagulation for Cerebral Venous Sinus Thrombosis. Cochrane DB Syst Rev. 2011; 8: 1- 21.
  3. Barker A., and Freeston I. Transcranial magnetic stimulation. Scholarpedia. 2007;2:2936
  4. Barker AT, Jalinous R, Freeston IL. Non-invasive magnetic stimulation of human motor cortex. Lancet. 1985; 1(8437): 1106–1107.
  5. Janicak, PG and Mehmet ED. “Transcranial magnetic stimulation for the treatment of major depression†Neuropsychiatric Disease and Treatment. 2015; 11: 1549-60.
  6. Butler, AJ, and Wolf, SL. Transcranial Magnetic Stimulation to Assess Cortical Plasticity: A Critical Perspective for Stroke Rehabilitation. J Rehabil Med. 2003; Suppl. 41: 20–26.
  7. AliÅ¡auskienÄ—, M, Truffert, A, VaiÄienÄ—, N, Magistris, MR. Transcranial Magnetic Stimulation in Clinical Practice. Medicina (Kaunas): 2005; 41(10).
  8. Escudero, JV, Sancho, J, Bautista, D, Escudero, M, Lopez-Trigo, J. Stimulation in Motor Function Recovery in Patients With Acute Ischemic Stroke Prognostic Value of Motor Evoked Potential Obtained by Transcranial Magnetic Brain. Stroke 1998: 29:1854-1859.
  9. Wirata, G, Karmaya, INM, Muliarta, IM. Long-term visual deprivation inhibits the visual lobe neocortex cytoarchitecture increment in male 42-day-old rats (Rattus norvegicus): a stereological study. Indonesia Journal of Biomedical Science 2019; 13(1).
  10. Son, SY, Park, SH, Seo, JH, Ko, MH. Correlation of the motor evoked potentials amplitude and hand function of the affected side in stroke. J Korean Acad Rehabil Med. 2011; 35:34–41
  11. Hendricks, HT, Pasman, JW, Van Limbeek, J, Zwarts, MJ. Motor evoked potentials of the lower extremity in predicting motor recovery and ambulation after stroke: a cohort study. Arch Phys Med Rehabil. 2003; 84:1373–1379
  12. Talelli, P, Greenwood, RJ, Rothwell, JC. Arm function after stroke: neurophysiological correlates and recovery mechanisms assessed by transcranial magnetic stimulation. Clin Neurophysiol. 2006; 117:1641–1659
  13. Van Hedel, HJ, Murer, C, Dietz V, Curt, A. The amplitude of lower leg motor evoked potentials is a reliable measure when controlled for torque and motor task. J Neurol. 2007; 254:1089–1098
  14. Lee, RG, and Van Dondelaar, P. Mechanisms underlying functional recovery following stroke [Review]. Can J Neurol Sci. 1995; 22:257–263.
  15. Waxman, SG. Nonpyramidal motor systems and functional recovery after damage to the central nervous system. J. Neurol. Rehab. 1988: 2: 1-6
  16. Kim, GW, Won, YH, Park, SH, Seo, JH, Ko, MH. Can motor evoked potentials be an objective parameter to assess extremity function at the acute or subacute stroke stage? Ann Rehabil Med. 2015; 39(2):253-61
  17. Ratmono, T, Wijaya, A, Kaelan, C, Islam, AA, Sandra, F. Measurement of Motor Evoked Potential in Acute Ischemic Stroke: Based on Latency. Amplitude. Central Motor Conduction Time and Resting Motor Threshold. Indones Biomed J. 2016; 8(3):157-60.
  18. Putranto, T, Yusuf, I, Murtala, B, Wijaya, A. 2016. Intra Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient. Bali Medical Journal 5(2): 216-220.

How to Cite

Putranto, T. A., Ratmono, T., Yusuf, I., Murtala, B., & Wijaya, A. (2019). Intraarterial heparin flushing effect on motor evoked potentials in chronic ischemic stroke patients. Bali Medical Journal, 8(2), 540–544. https://doi.org/10.15562/bmj.v8i2.1493

HTML
0

Total
1

Share

Search Panel