Motor cortex excitability after thalamic infarction

Objective We examined 8 patients with hemihypesthesia due to an ischemic thalamic lesion to explore the effects of a central sensory dysfunction on motor cortex excitability. Methods Motor excitability was assessed using transcranial magnetic stimulation techniques and electrical peripheral nerve stimulation. Motor function was evaluated by the Nine-Hole-Peg Test and measurement of hand grip strength. The affected side was compared with the non-lesioned side and with an age-matched control group. Results Patients had a loss of inhibition and an increase of facilitation in the motor cortex of the affected side. The silent period was prolonged and motor function was impaired on the affected side. Conclusions A thalamic lesion can modulate motor cortical excitability. Significance This study suggests that, under normal conditions, somatosensory afferents influence inhibitory and excitatory properties in the motor cortex.