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Influence of somatosensory input on motor function in patients with chronic stroke

Authors

  • Agnes Floel MD,

    1. Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
    2. Department of Neurology, University of Münster, Münster
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  • Ulrike Nagorsen BS,

    1. Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
    2. Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen
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  • Konrad J. Werhahn MD,

    1. Department of Neurology, University of Mainz, Mainz, Germany
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  • Shashi Ravindran RN, MPH,

    1. Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
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  • Niels Birbaumer PhD,

    1. Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen
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  • Stefan Knecht MD,

    1. Department of Neurology, University of Münster, Münster
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  • Leonardo G. Cohen MD

    Corresponding author
    1. Human Cortical Physiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
    • Human Cortical Physiology Section, NINDS, NIH, Bethesda, MD 20817
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Abstract

In healthy volunteers, reduction of somatosensory input from one hand leads to rapid performance improvements in the other hand. Thus, it is possible that reduction of somatosensory input from the healthy hand can influence motor function in the paretic hand of chronic stroke patients with unilateral hand weakness. To test this hypothesis, we had 13 chronic stroke patients perform motor tasks with the paretic hand and arm during cutaneous anesthesia of the healthy hand and healthy foot in separate sessions. Performance of a finger tapping task, but not a wrist flexion task, improved significantly with anesthesia of the hand, but not the foot. This effect progressed with the duration of anesthesia and correlated with baseline motor function. We conclude that cutaneous anesthesia of the healthy hand elicits transient site-specific improvements in motor performance of the moderately paretic hand in patients with chronic stroke, consistent with interhemispheric competition models of sensorimotor processing. Ann Neurol 2004;56:206–212

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