Abstract
Study designObservational, cohort study.Objectives(1) Determine the feasibility and relevance of assessing corticospinal, sensory, and spinal pathways early after traumatic spinal cord injury (SCI) in a rehabilitation setting. (2) Validate whether electrophysiological and magnetic resonance imaging (MRI) measures taken early after SCI could identify preserved neural pathways, which could then guide therapy.SettingIntensive functional rehabilitation hospital (IFR).MethodsFive individuals with traumatic SCI and eight controls were recruited. The lower extremity motor score (LEMS), electrical perceptual threshold (EPT) at the S2 dermatome, soleus (SOL) H-reflex, and motor evoked potentials (MEPs) in the tibialis anterior (TA) muscle were assessed during the stay in IFR and in the chronic stage (>6 months post-SCI). Control participants were only assessed once. Feasibility criteria included the absence of adverse events, adequate experimental session duration, and complete dataset gathering. The relationship between electrophysiological data collected in IFR and LEMS in the chronic phase was studied. The admission MRI was used to calculate the maximal spinal cord compression (MSCC).ResultsNo adverse events occurred, but a complete dataset could not be collected for all subjects due to set-up configuration limitations and time constraints. EPT measured at IFR correlated with LEMS in the chronic phases (r = −0.67), whereas SOL H/M ratio, H latency, MEPs and MSCC did not.ConclusionsAdjustments are necessary to implement electrophysiological assessments in an IFR setting. Combining MRI and electrophysiological measures may lead to better assessment of neuronal deficits early after SCI.
Highlights
Individuals with traumatic spinal cord injury (SCI) experience various long-term disabilities that lead to an impaired quality of life [1–4]
The lower extremity motor score (LEMS), electrical perceptual threshold (EPT) at the S2 dermatome, soleus (SOL) H-reflex, and motor evoked potentials (MEPs) in the tibialis anterior (TA) muscle were assessed during the stay in Intensive functional rehabilitation hospital (IFR) and in the chronic stage (>6 months post-SCI)
As a 3 h session could be tiresome at the early IFR time point, we performed data collection over two sessions for participants #3 and #4, which was well tolerated
Summary
Individuals with traumatic spinal cord injury (SCI) experience various long-term disabilities that lead to an impaired quality of life [1–4]. As neuronal pathways are topographically distributed within each spinal segment, the ability to identify those impaired by the lesion would highlight the potential functional losses [8, 9] Techniques such as magnetic resonance imaging (MRI) can assess the integrity of the spinal cord tissue and enable visualisation of the lesioned area [10–13]. In individuals with SCI (>1 year post lesion), foot drop and decreased gait speed were correlated with lesions involving the corticospinal tract, whereas decreased balance control was correlated, in part, with impairment to the vestibulospinal system [16]. These studies emphasise that lesions in a specific pathway can be related to a specific set of functional deficits. Obtaining this information early in the rehabilitation process could guide treatment and optimise functional recovery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
