Quantitative electrophysiological assessments as predictive markers of lower limb motor recovery after spinal cord injury: a pilot study with an adaptive trial design

Spinal Cord Series and Cases, 2022 · DOI: https://doi.org/10.1038/s41394-022-00491-0 · Published: February 1, 2022

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

This study investigates the feasibility of using electrophysiological and MRI measurements early after spinal cord injury (SCI) to identify preserved neural pathways. The researchers assessed corticospinal, sensory, and spinal pathways in individuals with traumatic SCI during their stay in intensive functional rehabilitation (IFR) and in the chronic stage (>6 months post-SCI). The study found that electrical perceptual threshold (EPT) measured at IFR correlated with lower extremity motor score (LEMS) in the chronic phases, suggesting it could be a predictive marker for motor recovery.

Study Duration

1 Year, 8 Months

Participants

5 individuals with traumatic SCI and 8 controls

Evidence Level

Observational cohort study

Key Findings

1
Electrical perceptual threshold (EPT) measured at IFR correlated with LEMS in the chronic phases (r = −0.67).
2
SOL H/M ratio, H latency, MEPs and MSCC did not correlate with LEMS in the chronic phase.
3
Combining MRI and electrophysiological measures may lead to better assessment of neuronal deficits early after SCI.

Research Summary

This study aimed to determine the feasibility and relevance of assessing corticospinal, sensory, and spinal pathways early after traumatic SCI in a rehabilitation setting. The study validated whether electrophysiological and magnetic resonance imaging (MRI) measures taken early after SCI could identify preserved neural pathways, which could then guide therapy. The results suggest that adjustments are necessary to implement electrophysiological assessments in an IFR setting and that combining MRI and electrophysiological measures may lead to better assessment of neuronal deficits early after SCI.

Practical Implications

Predictive Models

Electrophysiological data, particularly EPT, could be included in statistical models to predict long-term motor recovery in SCI patients.

Personalized Therapy

Identifying spared neural pathways early after SCI can guide and optimize treatment strategies to enhance functional recovery.

Comprehensive Assessment

Combining electrophysiological and MRI measures provides a more comprehensive assessment of neuronal deficits, potentially leading to more accurate prognoses.

Study Limitations

1
Small sample size limited the statistical power of the correlation analyses.
2
Data collection for electrophysiological data was incomplete for some participants in early IFR due to interruptions and room configuration.
3
Only the LEMS was used; future studies should include both upper and LEMSs (total motor scores).

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