Neuroimaging correlates of pathological changes in motor cortex electrophysiology: Convergence of fMRI and neuronavigated TMS in chronic stroke patients

Introduction: Functional magnetic resonance imaging (fMRI) studies demonstrated that chronic stroke patients show bilateral enhancement of neural activity in motor areas during movements of the affected hand but not during movements of the unaffected hand (Grefkes et al. 2008). However, little is known on how contralesional BOLD (blood oxygenation level dependent) signal relates to motor performance of the paretic hand and to electrophysiological TMS parameters reflecting neural excitability (e.g., active motor threshold=aMT) or plasticity, such as intrahemispheric (e.g., short-interval cortical inhibition=SICI)…