Changes in electrical perception threshold within the first 6 months after traumatic spinal cord injury: a...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Sensory Neuroscience

Background:

• Assessing sensory function after spinal cord injury (SCI) is crucial for understanding recovery and guiding rehabilitation.
• The electrical perception threshold (EPT) is a potential tool for quantifying sensory deficits.
• Reliability and responsiveness of EPT in the context of SCI need thorough evaluation.

Purpose of the Study:

• To determine the reliability of EPT measurements in healthy individuals across different dermatomes.
• To assess the responsiveness of EPT in patients with traumatic SCI over a 6-month period.
• To compare EPT with light touch (LT) testing for sensory classification.

Main Methods:

• Reliability of EPT was assessed in 15 healthy volunteers (C3-S2).
• EPT was measured in 37 SCI patients at 1, 3, and 6 months post-injury in dermatomes at, above, and below the lesion level.
• Intraclass correlation coefficient (ICC) and standardized response mean (SRM) were used for reliability and responsiveness, respectively.

Main Results:

• EPT reliability varied significantly across dermatomes (ICC range: 0.00-0.86).
• EPT showed minimal changes in SCI patients within 6 months, indicating low responsiveness (small SRM values).
• Agreement between EPT and LT classifications ranged from 30% to 100%, with lowest agreement below the lesion level.

Conclusions:

• The reliability of EPT is dermatome-dependent in healthy individuals.
• Spontaneous sensory recovery is limited in the first 6 months post-SCI, particularly at and below the lesion.
• Sensory-incomplete tetraplegic patients may benefit from inclusion in trials targeting sensory perception improvement, as EPT may detect subtle changes in this subgroup.