Altered nerve excitability properties after stroke are potentially associated with reduced neuromuscular activation

C. S. Klein*, W. Z. Rymer, M. A. Fisher

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: To determine limb differences in motor axon excitability properties in stroke survivors and their relation to maximal electromyographic (EMG) activity. Methods: The median nerve was stimulated to record compound muscle action potentials (CMAP) from the abductor pollicis brevis (APB) in 28 stroke subjects (57.3 ± 7.5 y) and 24 controls (56.7 ± 9.3 y). Results: Paretic limb axons differed significantly from non-paretic limb axons including (1) smaller superexcitability and subexcitability, (2) higher threshold during subthreshold depolarizing currents, (3) greater accommodation (S3) to hyperpolarization, and (4) a larger stimulus-response slope. There were smaller differences between the paretic and control limbs. Responses in the paretic limb were reproduced in a model by a 5.6 mV hyperpolarizing shift in the activation voltage of Ih (the current activated by hyperpolarization), together with an 11.8% decrease in nodal Na+ conductance or a 0.9 mV depolarizing shift in the Na+ activation voltage. Subjects with larger deficits in APB maximal voluntary EMG had larger limb differences in excitability properties. Conclusions: Stroke leads to altered modulation of Ih and altered Na+ channel properties that may be partially attributed to a reduction in neuromuscular activation. Significance: Plastic changes occur in the axon node and internode that likely influence axon excitability.

Original languageEnglish (US)
Pages (from-to)1407-1418
Number of pages12
JournalClinical Neurophysiology
Issue number6
StatePublished - Jun 2020


  • Activity
  • Axon
  • HCN
  • Ion channels
  • Muscle
  • Stroke

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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