Article

There is growing interest to establish recovery biomarkers, especially
neurological biomarkers, in order to develop new therapies and prediction models
for the promotion of stroke rehabilitation and recovery. However, there is no
consensus among the neurorehabilitation community about which biomarker(s) have
the highest predictive value for motor recovery. Objective To review the evidence
and determine which neurological biomarker(s) meet the high evidence quality
criteria for use in predicting motor recovery. Methods We searched databases for
prognostic neuroimaging/neurophysiological studies. Methodological quality of
each study was assessed using a previously employed comprehensive 15-item rating
system. Furthermore, we used the GRADE approach and ranked the overall evidence
quality for each category of neurologic biomarker. Results Seventy-one articles
met our inclusion criteria; 5 categories of neurologic biomarkers were
identified: diffusion tensor imaging (DTI), transcranial magnetic stimulation
(TMS), functional magnetic resonance imaging (fMRI), conventional structural MRI
(sMRI), and a combination of these biomarkers. Most studies were conducted with
individuals after ischemic stroke in the acute and/or subacute stage (~70%). Less
than one-third of the studies (21/71) were assessed with satisfactory
methodological quality (80% or more of total quality score). Conventional
structural MRI and the combination biomarker categories ranked "high" in overall
evidence quality. Conclusions There were 3 prevalent methodological limitations:
(a) lack of cross-validation, (b) lack of minimal clinically important difference
(MCID) for motor outcomes, and (c) small sample size. More high-quality studies
are needed to establish which neurological biomarkers are the best predictors of
motor recovery after stroke. Finally, the quarter-century old methodological
quality tool used here should be updated by inclusion of more contemporary
methods and statistical approaches.
CI - (c) The Author(s) 2016.

Langue : ANGLAIS