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Inter-hemispheric inhibition in stroke survivors is related to fatigue and cortical excitability

View ORCID ProfileSasha Ondobaka, View ORCID ProfileNick Ward, Annapoorna Kuppuswamy
doi: https://doi.org/10.1101/831511
Sasha Ondobaka
1Department of Clinical and Movement Neurosciences, University College London
2Institute of Cognitive Neuroscience, University College London
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  • For correspondence: ondobaka@gmail.com
Nick Ward
1Department of Clinical and Movement Neurosciences, University College London
3National Hospital for Neurology and Neurosurgery, London
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Annapoorna Kuppuswamy
1Department of Clinical and Movement Neurosciences, University College London
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ABSTRACT

Objective Persistent post-stroke fatigue is a major debilitating condition that has been linked to low corticomotor excitability and aberrant attention, both phenomena that are associated with the inter-hemispheric inhibition balance in the brain. In this study, we examined the relationship between inter-hemispheric inhibitory effective connectivity, motor cortex excitability and chronic persistence of post-stroke fatigue.

Methods We tested eighteen non-depressed stroke survivors with minimal motoric and cognitive impairments using spectral dynamic causal modelling (spDCM) of ‘resting state’ magnetic resonance imaging (rs-fMRI) and transcranial magnetic stimulation (TMS) measures of cortical excitability. We also assessed the levels of non-exercise induced, persistent fatigue using Fatigue Severity Scale (FSS) - a self-report questionnaire which has been widely applied and validated across different conditions. To understand neural effective connectivity mechanisms involved in fatigue and corticomotor excitability we examined the balance in inhibitory connectivity between homologue regions in M1, anterior insula, caudate and thalamus of the resting brain.

Results Inter-hemispheric inhibition balance between left and right M1 accounted for 67% of variability in the reported fatigue (R=.82, p<0.001). Inter-hemispheric inhibition balance in M1 also accounted for 54% of variability in the corticomotor excitability characterised by individual resting motor thresholds (R=.74, p<0.001), a measure that has been associated with subjective fatigue reports. Other examined inter-hemispheric connections did not show significant relationships with either fatigue or cortical excitability measures.

Conclusion Our findings suggest that the balance in inter-hemispheric effective connectivity between primary motor regions is involved in regulation of corticomotor excitability and could explain subjective post-stroke fatigue.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted November 11, 2019.
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Inter-hemispheric inhibition in stroke survivors is related to fatigue and cortical excitability
Sasha Ondobaka, Nick Ward, Annapoorna Kuppuswamy
bioRxiv 831511; doi: https://doi.org/10.1101/831511
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Inter-hemispheric inhibition in stroke survivors is related to fatigue and cortical excitability
Sasha Ondobaka, Nick Ward, Annapoorna Kuppuswamy
bioRxiv 831511; doi: https://doi.org/10.1101/831511

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