EEG Responses to Upper Limb Pinprick Stimulation in Acute and Early Subacute Motor and Sensorimotor Stroke

Background Electroencephalography (EEG) during pinprick stimulation has the potential to unveil neural mechanisms underlying sensorimotor impairments post-stroke. This study explored event-related peak pinprick amplitude and oscillatory responses in healthy controls, in people with motor and sensorimotor in acute and early subacute stroke, their relationship and to what extent EEG somatosensory responses can predict sensorimotor impairment. Methods In this study, involving 26 individuals, 10 people with a (sub-)acute sensorimotor stroke, 6 people with a (sub)acute motor stroke and 10 age-matched controls, pinpricks were applied to the dorsa of the impaired hand to collect somatosensory evoked potentials. Time(-frequency) analyses of somatosensory evoked potential (SEP) data at electrodes C3 and C4 explored peak pinprick amplitude and oscillatory responses across the three groups. Also, in stroke, (sensori-)motor impairments were assessed at baseline Fugl Meyer Assessment Upper Extremity (FMA-UE) and Erasmus modified Nottingham Sensory Assessment (EmNSA) at baseline and 7 to 14 days later including Fugl Meyer Assessment Upper Extremity (FMA-UE) and Erasmus modified Nottingham Sensory Assessment (EmNSA). Mixed model analyses were used to address objectives. Results It was demonstrated that increased beta desynchronization magnitude correlated with milder motor impairments (R 2 =0.213), whereas increased beta resynchronization and delta power were associated to milder somatosensory impairment (R 2 =0.550). At the second session, larger peak-to-peak SEP amplitude and beta band resynchronization at baseline were related to greater improvements in EMNSA and FMA-UE score, respectively, in sensorimotor stroke group. Conclusions These findings highlight the potential of EEG combined with somatosensory stimuli to differentiate between sensorimotor and motor impairments in stroke, offering preliminary insights into both diagnostic and prognostic aspects of upper limb recovery.