Motor Imagery and Paired Associative Stimulation in Poststroke Rehabilitation: Dissociating Motor and Electrophysiological Effects

Paired associative stimulation (PAS) is an intervention that modulates cortical plasticity. Motor imagery (MI) used in the rehabilitation of stroke patients. We aimed to evaluate possible synergistic effect associating both interventions for potentiating motor recovery poststroke. MIPAS a single-center, randomized controlled trial enrolled 24 hemiparetic poststroke participants. Three single-session were tested crossover design: PAS/MI, PAS, and ShamPAS/MI during which affected Extensor Carpi Radialis (ECR) muscle was targeted. During MI, participants instructed imagine extending their paretic wrist. Sham, subthreshold ShamPAS. Changes ECR Motor-Evoked Potential (MEP) areas wrist Range Motion (aROM) active extension compared between interventions. observed no significant superior any intervention, neither on MEP nor aROM. A time assessment highlighted outcome measures, with MEP- aROM-measured post-interventions significantly higher than those measured pre-intervention. Despite beneficial each participant function, not always associated change, our results do highlight specific advantage combining PAS MI post-stroke rehabilitation.