Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke

To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establis...

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Main Authors:	Hayward, Kathryn S, Schmidt, Julia, Lohse, Keith R, Peters, Sue, Bernhardt, Julie, Lannin, Natasha A, Boyd, Lara A
Format:	Online
Language:	English
Published:	Elsevier 2016
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198729/

id	pubmed-5198729
recordtype	oai_dc
spelling	pubmed-51987292017-01-04 Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke Hayward, Kathryn S Schmidt, Julia Lohse, Keith R Peters, Sue Bernhardt, Julie Lannin, Natasha A Boyd, Lara A Regular Article To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establish relationship(s) between biomarkers and motor recovery. Three electronic databases were searched up to October 2, 2015. Eligible studies included adults with severe arm impairment after stroke. Descriptive statistics were calculated to characterize brain biomarkers, and pooling of individual patient data was performed using mixed-effects linear regression to examine relationships between brain biomarkers and motor outcome and recovery. Thirty-eight articles including individual data from 372 people with severe arm impairment were analysed. The majority of individuals were in the chronic (> 6 months) phase post stroke (51%) and had a subcortical stroke (49%). The presence of a motor evoked potential (indexed by transcranial magnetic stimulation) was the only biomarker related to better motor outcome (p = 0.02). There was no relationship between motor outcome and stroke volume (cm3), location (cortical, subcortical, mixed) or side (left vs. right), and corticospinal tract asymmetry index (extracted from diffusion weighted imaging). Only one study had longitudinal data, thus no data pooling was possible to address change over time (preventing our third objective). Based on the available evidence, motor evoked potentials at rest were the only biomarker that predicted motor outcome in individuals with severe arm impairment following stroke. Given that few biomarkers emerged, this review highlights the need to move beyond currently known biomarkers and identify new indices with sufficient variability and sensitivity to guide recovery models in individuals with severe motor impairments following stroke. PROSPERO: CRD42015026107. Elsevier 2016-09-24 /pmc/articles/PMC5198729/ /pubmed/28053857 http://dx.doi.org/10.1016/j.nicl.2016.09.015 Text en © 2016 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Hayward, Kathryn S Schmidt, Julia Lohse, Keith R Peters, Sue Bernhardt, Julie Lannin, Natasha A Boyd, Lara A
spellingShingle	Hayward, Kathryn S Schmidt, Julia Lohse, Keith R Peters, Sue Bernhardt, Julie Lannin, Natasha A Boyd, Lara A Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
author_facet	Hayward, Kathryn S Schmidt, Julia Lohse, Keith R Peters, Sue Bernhardt, Julie Lannin, Natasha A Boyd, Lara A
author_sort	Hayward, Kathryn S
title	Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
title_short	Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
title_full	Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
title_fullStr	Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
title_full_unstemmed	Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
title_sort	are we armed with the right data? pooled individual data review of biomarkers in people with severe upper limb impairment after stroke
description	To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1) characterize brain biomarkers; 2) determine relationship(s) between biomarkers and motor outcome; and 3) establish relationship(s) between biomarkers and motor recovery. Three electronic databases were searched up to October 2, 2015. Eligible studies included adults with severe arm impairment after stroke. Descriptive statistics were calculated to characterize brain biomarkers, and pooling of individual patient data was performed using mixed-effects linear regression to examine relationships between brain biomarkers and motor outcome and recovery. Thirty-eight articles including individual data from 372 people with severe arm impairment were analysed. The majority of individuals were in the chronic (> 6 months) phase post stroke (51%) and had a subcortical stroke (49%). The presence of a motor evoked potential (indexed by transcranial magnetic stimulation) was the only biomarker related to better motor outcome (p = 0.02). There was no relationship between motor outcome and stroke volume (cm3), location (cortical, subcortical, mixed) or side (left vs. right), and corticospinal tract asymmetry index (extracted from diffusion weighted imaging). Only one study had longitudinal data, thus no data pooling was possible to address change over time (preventing our third objective). Based on the available evidence, motor evoked potentials at rest were the only biomarker that predicted motor outcome in individuals with severe arm impairment following stroke. Given that few biomarkers emerged, this review highlights the need to move beyond currently known biomarkers and identify new indices with sufficient variability and sensitivity to guide recovery models in individuals with severe motor impairments following stroke. PROSPERO: CRD42015026107.
publisher	Elsevier
publishDate	2016
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198729/
_version_	1613843886288928768

Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke

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