Segmental motor recovery after cervical spinal cord injury relates to density and integrity of corticospinal tract projections

Nature Communications, 2023 · DOI: 10.1038/s41467-023-36390-7 · Published: January 27, 2023

Simple Explanation

This study investigates muscle-specific recovery after cervical spinal cord injury, focusing on factors determining individual muscle recovery, which are poorly understood. The research reveals associations between the sparing of the corticospinal tract (CST) and the recovery of the upper extremity function. The findings suggest that to better assess muscle-specific motor recovery in acute spinal cord injury, it is important to account for CST sparing.

Study Duration

Not specified

Participants

748 individuals from the European Multicenter Study about Spinal Cord Injury (NCT01571531)

Evidence Level

Not specified

Key Findings

1
Distal muscles of the upper limb show limited and delayed strength recovery compared to proximal muscles after cervical SCI.
2
The recovery of hand muscle strength is hard to predict and is dependent on the severity of spinal cord damage.
3
CST and LMN integrity indicates impairment and recovery after SCI. Individuals with absent MEP at baseline lack CST or LMN integrity and display greater initial impairment with limited strength recovery.

Research Summary

This study explores segmental strength recovery in upper limb muscles after cervical SCI, identifying factors predictive of recovery. Findings indicate a proximal-to-distal gradient in strength recovery, with distal muscles showing limited and delayed recovery. The study highlights the importance of CST and LMN integrity in spinal cord dysfunction and recovery, evidenced by residual strength and MEP at baseline.

Practical Implications

Assessment Strategies

Accounting for CST sparing improves muscle-specific motor recovery assessment in acute spinal cord injury.

Rehabilitation

Optimizing rehabilitation for muscles with potential to recover early after SCI.

Clinical Trials

The segmental analysis employed constitutes an alternative method to quantify recovery rates in future clinical trials.

Study Limitations

1
The assessments available in our dataset did not provide a complete assessment of LMN function for all muscles.
2
The inability to fully account for LMN damage in the predictive models
3
Cannot fully account for the role of other descending spinal tracts, which have differential effects on proximal and distal upper limb control

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