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Corticospinal function studied over time following incomplete spinal cord injury
H C Smith1, G Savic, H L Frankel
1Division of Neuroscience & Psychological Medicine, Imperial College School of Medicine, Charing Cross Hospital, London W6 8RF, UK.
Spinal Cord
|May 24, 2000
Summary
Neurological function and corticospinal excitability were monitored in patients with incomplete spinal cord injury (iSCI). Recovery plateaued around 300 days, with no significant changes in electrophysiological measures after initial injury.
Area of Science:
- Neuroscience
- Clinical Neurology
- Rehabilitation Medicine
Background:
- Incomplete spinal cord injury (iSCI) presents complex challenges in predicting functional recovery.
- Understanding the temporal dynamics of both clinical and electrophysiological changes post-iSCI is crucial for effective management.
Purpose of the Study:
- To characterize the longitudinal changes in clinical neurological function after iSCI.
- To assess the time-course of corticospinal electrophysiological function following iSCI.
- To investigate the correlation between clinical and electrophysiological findings in iSCI patients.
Main Methods:
- A longitudinal study involving 21 iSCI patients (ASIA C-D) and 10 healthy controls.
- Neurological assessments followed ASIA/IMSOP standards.
- Corticospinal function was evaluated using transcranial magnetic stimulation (TMS) and electromyography (EMG) recordings of thenar muscles.
Main Results:
- Neurological scores improved progressively, stabilizing around 300 days post-injury.
- Motor evoked potentials (MEPs) and EMG inhibition differed significantly from controls initially, but showed no significant changes over time.
- No significant correlation was found between clinical assessments and electrophysiological data.
Conclusions:
- Weakened corticospinal inhibition post-iSCI is established early, within days of trauma.
- Reduced corticospinal inhibition may be a prerequisite for regaining useful motor function after iSCI.