Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Jan 2005
Comparative Study Clinical TrialHow salient is the silent period? The role of the silent period in the prognosis of upper extremity motor recovery after severe stroke.
Transcranial magnetic stimulation (TMS) has been successful in the prediction of motor recovery in acute stroke patients with initially severe paresis or paralysis of the upper extremity. Motor evoked potentials (MEP) appear to have a high specificity but a rather low sensitivity with regard to motor recovery. The silent period (SP) has been proposed as an additional factor to the MEP for predicting motor recovery that might optimize the sensitivity of TMS. ⋯ This review emphasizes the significance of the SP in predicting poststroke motor recovery and spasticity. Although the relation among the SP, recovery-related intracortical phenomena, and spasticity remains unclear, a neurophysiologic model underlying the SP is discussed. However, more research is needed on the value of the SP for predicting poststroke spasticity.