Motor Score Patterns Complement the AIS Grade in the Analysis of Segmental Motor Recovery after Spinal Cord Injury

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Spinal cord injury (SCI) recovery is typically assessed using broad metrics like the American Spinal Injury Association Impairment Scale (AIS) grade.
• Segmental motor scores offer more detailed insights into injury extent and recovery patterns.
• Novel methods are needed to refine the understanding of localized motor recovery post-SCI.

Purpose of the Study:

• To introduce and validate a new qualitative descriptor for local motor score patterns.
• To investigate the relationship between these patterns and segmental motor recovery.
• To assess the predictive value of these patterns compared to the established AIS grade.

Main Methods:

• Utilized data from 1385 patients in the European Multicenter Study about SCI.
• Defined local motor score patterns based on rostrocaudal changes in upper/lower extremity myotomes below the neurological level of injury (NLI).
• Compared predictive performance of models using AIS grade versus local motor score patterns for segmental motor scores at 6 months post-injury.

Main Results:

• Found an increased probability of full motor recovery in myotomes with higher motor scores in the caudal direction.
• Models incorporating local motor score patterns showed predictive performance comparable to the AIS grade (RMSE median 0.80 vs. 0.79).
• Local motor score patterns require examination of only 10 key muscles, unlike the extensive testing needed for AIS grade determination.

Conclusions:

• Local motor score patterns provide valuable insights into SCI motor recovery.
• These patterns can serve as an effective alternative or complement to the AIS grade in predictive models.
• Supports the use of abbreviated sensorimotor examinations for early SCI assessment.