Continuous Quantitative Motor Evoked Potentials for Spinal Cord Injury Detection

Zhang, Hongxuan; Oweis, Y.; Mozaffari-Naeini, H.; Venkatesha, S.; Thakor, Nitish V.; Natarajan, A.

doi:10.1109/cne.2005.1419651

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…They represent the integrity of the entire ascending sensory pathway from the periphery to the brain (Fig 1) [34][35][36][37]. Likewise, monitoring Motor Evoked Potential (MEP) enables assessing descending motor pathways via stimulating higher structures of the central nervous system and recording signals from the corresponding muscles or lower motor pathways in the periphery [38][39][40]. Joint SSEP and MEP monitoring allows quantitative and qualitative assessment of the natural history of injury via monitoring ascending sensory and descending motor pathways [41].…”

Section: Monitoring Somatosensory Evoked Potential (Ssep)mentioning

confidence: 99%

Hypothermia effects on neuronal plasticity post spinal cord injury

Al-Nashash,

Wong,

ALL

2024

PLoS ONE

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Background SCI is a time-sensitive debilitating neurological condition without treatment options. Although the central nervous system is not programmed for effective endogenous repairs or regeneration, neuroplasticity partially compensates for the dysfunction consequences of SCI. Objective and hypothesis The purpose of our study is to investigate whether early induction of hypothermia impacts neuronal tissue compensatory mechanisms. Our hypothesis is that although neuroplasticity happens within the neuropathways, both above (forelimbs) and below (hindlimbs) the site of spinal cord injury (SCI), hypothermia further influences the upper limbs’ SSEP signals, even when the SCI is mid-thoracic. Study design A total of 30 male and female adult rats are randomly assigned to four groups (n = 7): sham group, control group undergoing only laminectomy, injury group with normothermia (37°C), and injury group with hypothermia (32°C +/-0.5°C). Methods The NYU-Impactor is used to induce mid-thoracic (T8) moderate (12.5 mm) midline contusive injury in rats. Somatosensory evoked potential (SSEP) is an objective and non-invasive procedure to assess the functionality of selective neuropathways. SSEP monitoring of baseline, and on days 4 and 7 post-SCI are performed. Results Statistical analysis shows that there are significant differences between the SSEP signal amplitudes recorded when stimulating either forelimb in the group of rats with normothermia compared to the rats treated with 2h of hypothermia on day 4 (left forelimb, p = 0.0417 and right forelimb, p = 0.0012) and on day 7 (left forelimb, p = 0.0332 and right forelimb, p = 0.0133) post-SCI. Conclusion Our results show that the forelimbs SSEP signals from the two groups of injuries with and without hypothermia have statistically significant differences on days 4 and 7. This indicates the neuroprotective effect of early hypothermia and its influences on stimulating further the neuroplasticity within the upper limbs neural network post-SCI. Timely detection of neuroplasticity and identifying the endogenous and exogenous factors have clinical applications in planning a more effective rehabilitation and functional electrical stimulation (FES) interventions in SCI patients.

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Section: Monitoring Somatosensory Evoked Potential (Ssep)mentioning

confidence: 99%

Hypothermia effects on neuronal plasticity post spinal cord injury

Al-Nashash,

Wong,

ALL

2024

PLoS ONE

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Spinal Cord Injury Detection and Monitoring Using Spectral Coherence

Al‐Nashash

Fatoo

Mirza

et al. 2009

IEEE Trans. Biomed. Eng.

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In this paper, spectral coherence (SC) is used to study the somatosensory evoked potential (SEP) signals in rodent model before and after spinal cord injury (SCI). The SC technique is complemented with the Basso, Beattie, and Bresnahan (BBB) behavior analysis method to help us assess the status of the motor recovery. SC can be used to follow the effects of SCI without any preinjury baseline information. In this study, adult female Fischer rats received contusion injury at T8 level with varying impact heights using the standard New York University impactor. The results show that the average SC between forelimb and hindlimb SEP signals before injury was relatively high ( > or =0.7). Following injury, the SC between the forelimb and hindlimb SEP signals dropped to various levels ( < or =0.7) corresponding to the severity of SCI. The SC analysis gave normalized quantifiable results for the evaluation of SCI and recovery thereafter using the forelimb signals as an effective control, without the need of any baseline data. This technique solves the problems associated with the commonly used time-domain analysis like the need of a trained neurophysiologist to interpret the data and the need for baseline data. We believe that both SC and BBB may provide a comprehensive and complementary picture of the health status of the spinal cord after injury. The presented method is applicable to SCIs not affecting the forelimb SEP signals.

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Neuroprotective Role of Hypothermia in Acute Spinal Cord Injury

Al‐Nashash

All

2022

Biomedicines

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Even nowadays, the question of whether hypothermia can genuinely be considered therapeutic care for patients with traumatic spinal cord injury (SCI) remains unanswered. Although the mechanisms of hypothermia action are yet to be fully explored, early hypothermia for patients suffering from acute SCI has already been implemented in clinical settings. This article discusses measures for inducing various forms of hypothermia and summarizes several hypotheses describing the likelihood of hypothermia mechanisms of action. We present our objective neuro-electrophysiological results and demonstrate that early hypothermia manifests neuroprotective effects mainly during the first- and second-month post-SCI, depending on the severity of the injury, time of intervening, duration, degree, and modality of inducing hypothermia. Nevertheless, eventually, its beneficial effects gradually but consistently diminish. In addition, we report potential complications and side effects for the administration of general hypothermia with a unique referment to the local hypothermia. We also provide evidence that instead of considering early hypothermia post-SCI a therapeutic approach, it is more a neuroprotective strategy in acute and sub-acute phases of SCI that mostly delay, but not entirely avoid, the natural history of the pathophysiological events. Indeed, the most crucial rationale for inducing early hypothermia is to halt these devastating inflammatory and apoptotic events as early and as much as possible. This, in turn, creates a larger time-window of opportunity for physicians to formulate and administer a well-designed personalized treatment for patients suffering from acute traumatic SCI.

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Continuous Quantitative Motor Evoked Potentials for Spinal Cord Injury Detection

Cited by 3 publications

References 5 publications

Hypothermia effects on neuronal plasticity post spinal cord injury

Hypothermia effects on neuronal plasticity post spinal cord injury

Spinal Cord Injury Detection and Monitoring Using Spectral Coherence

Neuroprotective Role of Hypothermia in Acute Spinal Cord Injury

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