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Influence of post-stroke fatigue on reaction times and corticospinal excitability during movement preparation

De Doncker, W; Brown, KE; Kuppuswamy, A; (2021) Influence of post-stroke fatigue on reaction times and corticospinal excitability during movement preparation. Clinical Neurophysiology , 132 (1) pp. 191-199. 10.1016/j.clinph.2020.11.012. Green open access

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Abstract

OBJECTIVES: Reduced corticospinal excitability at rest is associated with post-stroke fatigue (PSF). However, it is not known if corticospinal excitability prior to a movement is also altered in fatigue which may then influence subsequent behaviour. We hypothesized that the levels of PSF can be explained by differences in modulation of corticospinal excitability during movement preparation. METHODS: 73 stroke survivors performed an auditory reaction time task. Corticospinal excitability was measured using transcranial magnetic stimulation. Fatigue was quantified using the fatigue severity scale. The effect of time and fatigue on corticospinal excitability and reaction time was analysed using a mixed effects model. RESULTS: Those with greater levels of PSF showed reduced suppression of corticospinal excitability during movement preparation and increased facilitation immediately prior to movement onset (β = -0.0066, t = -2.22, p = 0.0263). Greater the fatigue, slower the reaction times the closer the stimulation time to movement onset (β = 0.0024, t = 2.47, p = 0.0159). CONCLUSIONS: Lack of pre-movement modulation of corticospinal excitability in high fatigue may indicate poor sensory processing supporting the sensory attenuation model of fatigue. SIGNIFICANCE: We take a systems-based approach and investigate the motor system and its role in pathological fatigue allowing us to move towards gaining a mechanistic understanding of chronic pathological fatigue.

Type: Article
Title: Influence of post-stroke fatigue on reaction times and corticospinal excitability during movement preparation
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.clinph.2020.11.012
Publisher version: https://doi.org/10.1016/j.clinph.2020.11.012
Language: English
Additional information: Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Fatigue, Movement preparation, Stroke, TMS
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10120759
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