Correlation between severity of clinical signs and transcranial magnetic motor evoked potentials in dogs with intervertebral disc herniation

Amendt, HL; Siedenburg, JS; Steffensen, Nicole; Kordass, U; Rohn, Karl; Tipold, Andrea; Stein, Veronika M.

doi:10.1016/j.tvjl.2017.01.015

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…At 2nd follow‐up, onset latencies were significantly longer in non‐ambulatory compared to ambulatory dogs. However, the number of dogs with Grade III in comparison to Grade II and I at 2nd follow‐up was very low, thus the high impact of single values could bias this analysis, as these findings are in conflict with recently published data . The normalization of onset latencies in the present study, eliminating the effect of differing body size between patients could explain the differing results of these 2 studies as well.…”

Section: Discussioncontrasting

confidence: 79%

“…The low number of dogs that could be included for calculation could be a reason for non-significant differences and over-estimation of differences between these groups at the same time, limiting validity of these calculations.At 2nd follow-up, onset latencies were significantly longer in nonambulatory compared to ambulatory dogs. However, the number of dogs with Grade III in comparison to Grade II and I at 2nd follow-up was very low, thus the high impact of single values could bias this analysis, as these findings are in conflict with recently published data 53. The normalization of onset latencies in the present study, eliminating the effect of differing body size between patients could explain the differing results of these 2 studies as well.TMMEP amplitudes did not differ significantly between ambulatory and non-ambulatory dogs during follow-up.…”

contrasting

confidence: 80%

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Transcranial magnetic motor evoked potentials and magnetic resonance imaging findings in paraplegic dogs with recovery of motor function

Siedenburg

Wang‐Leandro

Amendt

et al. 2018

Veterinary Internal Medicne

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BackgroundTranscranial magnetic motor evoked potentials (TMMEP) are associated with severity of clinical signs and magnetic resonance imaging (MRI) findings in dogs with spinal cord disease.HypothesisThat in initially paraplegic dogs with thoracolumbar intervertebral disc herniation (IVDH), MRI findings before surgery and TMMEPs obtained after decompressive surgery are associated with long‐term neurological status and correlate with each other.AnimalsSeventeen client‐owned paraplegic dogs with acute thoracolumbar IVDH.MethodsProspective observational study. TMMEPs were obtained from pelvic limbs and MRI (3T) of the spinal cord was performed at initial clinical presentation. Follow‐up studies were performed ≤ 2 days after reappearance of motor function and 3 months later. Ratios of compression length, intramedullary hyperintensities' length (T2‐weighted hyperintensity length ratio [T2WLR]), and lesion extension (T2‐weighted‐lesion extension ratio) in relation to the length of the 2nd lumbar vertebral body were calculated.ResultsTMMEPs could be elicited in 10/17 (59%) dogs at 1st and in 16/17 (94%) dogs at 2nd follow‐up. Comparison of TMMEPs of 1st and 2nd follow‐up showed significantly increased amplitudes (median from 0.19 to 0.45 mV) and decreased latencies (from 69.38 to 40.26 ms; P = .01 and .001, respectively). At 2nd follow‐up latencies were significantly associated with ambulatory status (P = .024). T2WLR obtained before surgery correlated with latencies at 2nd follow‐up (P = .04).ConclusionsTMMEP reflect motor function recovery after severe spinal cord injury.

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Section: Discussioncontrasting

confidence: 79%

contrasting

confidence: 80%

Transcranial magnetic motor evoked potentials and magnetic resonance imaging findings in paraplegic dogs with recovery of motor function

Siedenburg

Wang‐Leandro

Amendt

et al. 2018

Veterinary Internal Medicne

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“…Transcranial magnetic motor evoked potentials (TMMEP) can be elicited reliably in dogs under sedation (92,93). However, they are extremely sensitive to spinal cord injury and are lost completely in dogs that are paraplegic (94,95). With less severe injuries, latency increases and amplitude decreases, but these values do not discriminate initial severity as well as clinical assessment and evaluation of MEPs at time of presentation does not provide prognostic information (94,95).…”

Section: Motor Evoked Potentialsmentioning

confidence: 99%

Prognostic Factors in Canine Acute Intervertebral Disc Disease

et al. 2020

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Knowledge of the prognosis of acute spinal cord injury is critical to provide appropriate information for clients and make the best treatment choices. Acute intervertebral disc extrusions (IVDE) are a common cause of pain and paralysis in dogs with several types of IVDE occurring. Important prognostic considerations are recovery of ambulation, return of urinary and fecal continence, resolution of pain and, on the negative side, development of progressive myelomalacia. Initial injury severity affects prognosis as does type of IVDE, particularly when considering recovery of continence. Overall, loss of deep pain perception signals a worse outcome. When considering Hansen type 1 IVDE, the prognosis is altered by the choice of surgical vs. medical therapy. Concentration of structural proteins in the plasma, as well as inflammatory mediators, creatine kinase, and myelin basic protein in the cerebrospinal fluid (CSF) can provide additional prognostic information. Finally, cross-sectional area and length of T2 hyperintensity and loss of HASTE signal on MRI have been associated with outcome. Future developments in plasma and imaging biomarkers will assist in accurate prognostication and optimization of patient management.

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“…While a variety of factors have been associated with the development of ambulation in dogs with absent pain perception, no predictors in the acute or subacute stage of its subsequent development have yet been established. Considerations worthy of further investigation include clinical parameters such as the onset of spasticity, imaging biomarkers such as DTI indices and tractography, electrodiagnostic evaluation of descending motor tract function or motor neuron pool excitability and serum and cerebrospinal fluid biomarkers of inflammation or structural spinal cord proteins (5,68,77,(89)(90)(91)(92)(93)(94)(95)(96)(97)(98). While specific markers in serum and cerebrospinal fluid have not been evaluated to predict spinal walking, serum glial fibrillary acidic protein (GFAP) and phosphorylated neurofilament heavy chain (pNFH) have been reported to be useful among deep pain negative dogs in predicting outcome and the development of progressive myelomalacia (96)(97)(98).…”

Section: Prediction and Facilitation Of Spinal Walkingmentioning

confidence: 99%

Ambulation in Dogs With Absent Pain Perception After Acute Thoracolumbar Spinal Cord Injury

2020

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Acute thoracolumbar spinal cord injury (SCI) is common in dogs frequently secondary to intervertebral disc herniation. Following severe injury, some dogs never regain sensory function to the pelvic limbs or tail and are designated chronically "deep pain negative." Despite this, a subset of these dogs develop spontaneous motor recovery over time including some that recover sufficient function in their pelvic limbs to walk independently without assistance or weight support. This type of ambulation is commonly known as "spinal walking" and can take up to a year or more to develop. This review provides a comparative overview of locomotion and explores the physiology of locomotor recovery after severe SCI in dogs. We discuss the mechanisms by which post-injury plasticity and coordination between circuitry contained within the spinal cord, peripheral sensory feedback, and residual or recovered supraspinal connections might combine to underpin spinal walking. The clinical characteristics of spinal walking are outlined including what is known about the role of patient or injury features such as lesion location, timeframe post-injury, body size, and spasticity. The relationship between the emergence of spinal walking and electrodiagnostic and magnetic resonance imaging findings are also discussed. Finally, we review possible ways to predict or facilitate recovery of walking in chronically deep pain negative dogs. Improved understanding of the mechanisms of gait generation and plasticity of the surviving tissue after injury might pave the way for further treatment options and enhanced outcomes in severely injured dogs.

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Correlation between severity of clinical signs and transcranial magnetic motor evoked potentials in dogs with intervertebral disc herniation

Cited by 5 publications

References 25 publications

Transcranial magnetic motor evoked potentials and magnetic resonance imaging findings in paraplegic dogs with recovery of motor function

Transcranial magnetic motor evoked potentials and magnetic resonance imaging findings in paraplegic dogs with recovery of motor function

Prognostic Factors in Canine Acute Intervertebral Disc Disease

Ambulation in Dogs With Absent Pain Perception After Acute Thoracolumbar Spinal Cord Injury

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