Are neuroradiological or neurophysiological characteristics associated with upper-extremity hypertonia in severe ischaemia in supratentorial stroke?

Objective: The primary goal was to identify the neuro-radiological and neurophysiological risk factors for upper-extremity hypertonia in patients with severe ischaemic supratentorial stroke. Design: Inception cohort. Patients: Forty-three consecutive patients with an acute ischaemic supratentorial stroke and an initial upper-extremity paralysis admitted to an academic hospital recruited over a 1.5-year period. Main outcome measures: Upper-extremity hypertonia was assessed by the Ashworth scale and clinically relevant hypertonia was defined as Ashworth scale >= 2. Any association of (clinically relevant) hypertonia with neuroradiological (lesion side, extent of lesion, and stroke history), and neurophysiological (motor-evoked potential and silent period) characteristics was investigated. Results: Associations between hypertonia and the selected neuroradiological and neurophysiological risk factors were generally low. Univariate analyses yielded none of the selected neuroradiological or neurophysiological characteristics as significantly associated with hypertonia. Conclusion: Despite the high incidence of hypertonia in these patients, we could not identify any of the selected neuroradiological or neurophysiological characteristics as a risk factor for hypertonia.