Characterizing neurological status in individuals with tetraplegia using transcutaneous spinal stimulation

Scientific Reports, 2023 · DOI: 10.1038/s41598-023-48811-0 · Published: December 6, 2023

Simple Explanation

Transcutaneous spinal stimulation (TSS) is being explored as a way to assess the function of muscles in the arms of people with tetraplegia (paralysis of all four limbs). The study looks at how well upper limb muscles respond to TSS when the stimulation is applied above and below the location of the spinal cord injury. The aim is to see if the muscle response patterns can tell us about the severity of the injury and how well the person can still use their arms and hands.

Study Duration

Not specified

Participants

8 participants with tetraplegia due to cervical SCI

Evidence Level

Not specified

Key Findings

1
Responses in muscles below the injury were less sensitive to TSS compared to those above the lesion.
2
Muscle responses were often asymmetrical, meaning one arm responded differently than the other.
3
The muscle response patterns were related to the level, extent, and side of the spinal cord injury.

Research Summary

This study examined upper limb motor pool recruitment patterns using transcutaneous spinal stimulation (TSS) in individuals with tetraplegia following cervical spinal cord injury (SCI). TSS was delivered above and below the spinal lesion to characterize spinally evoked motor potentials in upper limb muscles, revealing reduced sensitivity and asymmetry in muscles innervated below the lesion. The electrophysiological data acquired through TSS offer insights into functional asymmetry, disruptions in neural pathways, and motor control changes following SCI, suggesting its potential to supplement clinical assessments.

Practical Implications

Enhanced Assessment

TSS can be used to provide a more detailed assessment of upper limb function in individuals with tetraplegia, potentially revealing deficits not detected by standard clinical assessments.

Personalized Rehabilitation

The electrophysiological data obtained from TSS can help tailor rehabilitation strategies to address specific impairments in motor control and asymmetry.

Predicting Recovery

Understanding the relationship between TSS-evoked responses and neurological status may improve the prediction of recovery potential following spinal cord injury.

Study Limitations

1
Relatively small sample size
2
Variations in threshold and magnitude of evoked potentials due to individual differences
3
Electrode placement may influence bilateral recruitment of UL motor pools

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