Comparing Parameters of Motor Potentials Recordings Evoked Transcranially with Neuroimaging Results in Patients with Incomplete Spinal Cord Injury: Assessment and Diagnostic Capabilities

Biomedicines, 2023 · DOI: 10.3390/biomedicines11102602 · Published: September 22, 2023

Spinal Cord Injury Neuroimaging Physiology

Simple Explanation

This study investigates the relationship between the severity of incomplete spinal cord injuries (iSCI), as seen on MRI scans, and the results of non-invasive tests like electromyography (EMG) and motor-evoked potentials (MEP). The study uses MEP, EMG, and ENG assessments to unveil the correlations between the MEP amplitudes and the MRI injury scores. The spinal cord was divided into two halves (left and right) according to the midline, and each half was further divided into two quadrants.

Study Duration

1-2 months

Participants

85 iSCI patients (ASIA C = 24, and D = 61), 80 healthy volunteers

Evidence Level

Not specified

Key Findings

1
The study revealed consistent positive correlations in iSCI patients between the bilateral decrease of the spinal half injury MRI scores and a decrease of the transcranially-evoked MEP amplitudes.
2
Positive correlations are notably pronounced in the C3–C5, C6–Th1, and Th3–Th6 subgroups (mostly rs 0.5 and above with p < 0.05), while Th7–L1 presents distinct patterns (rs less than 0.5 and p being statistically insigniﬁcant) potentially inﬂuenced by unique structural compensation mechanisms.
3
We also revealed statistically signiﬁcant relationships between the decrease of the cumulative mcsEMG and MEP amplitudes and the cumulative ENG scores.

Research Summary

This study aimed to investigate the relationships between the different levels and degrees of incomplete spinal cord injury (iSCI) evaluated with magnetic resonance imaging (MRI) and the results of non-invasive electromyography (mcsEMG), motor-evoked potentials (MEP), and electroneurography (ENG). The study uses MEP, EMG, and ENG assessments to unveil the correlations between the MEP amplitudes and the MRI injury scores. We compared the MRI and diagnostic neurophysiological test results performed within 1–2 months after the injury. The study revealed consistent positive correlations in iSCI patients between the bilateral decrease of the spinal half injury MRI scores and a decrease of the transcranially-evoked MEP amplitudes, highlighting the complex relationship between neural pathways and functional outcomes.

Practical Implications

Enhanced Assessment

Electromyography and transcranially-evoked motor potentials can serve as complementary tools to enhance spinal cord injury assessment, alongside the structural evaluation in MRI in clinical studies.

Functional Evaluation

Understanding these relationships is vital for functional evaluation of the spinal cord function by the neurosurgeon or neurologist.

Tailored Rehabilitation

Understanding these relationships is vital for tailoring effective rehabilitation strategies, and optimising patient care.

Study Limitations

1
Limited sample size due to the complexity and rarity of spinal cord injuries.
2
The 0–4 scoring system for assessing spinal white and grey matter integrity lacks direct references in the literature.
3
The study focuses on the subacute phase of SCI, potentially limiting the generalizability to long-term outcomes.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury