Increased baseline temperature improves the acquisition of contact heat evoked potentials after spinal cord injury

Kramer, John L.K.; Haefeli, Jenny; Curt, Armin; Steeves, John D.

doi:10.1016/j.clinph.2011.08.013

Cited by 47 publications

(47 citation statements)

References 49 publications

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“…2 LT scores for individual dermatomes could be matched with electrical perceptual thresholds 17 or dermatomal sensory evoked potentials, 18 and PP with temperature thresholds 19 or contact heat evoked potentials. 20 In the interim, the results are of significance regarding the importance of the PP test as a prognostic indicator for recovery. 5,6 With reference to the use of ISNCSCI assessments as outcome measures for trials promoting recovery of function, we suggest it would be useful in future to relate the degree of recovery to the pretreatment discrepancies in LT and PP scores.…”

Section: Discussionmentioning

confidence: 99%

Light touch and pin prick disparity in the International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI)

et al. 2013

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Study design: Retrospective review. Objectives: The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assesses cutaneous sensibility through light touch (LT) and sharp-dull discrimination, referred to as pin prick (PP). This project aimed to confirm a tendency for LT to score higher than PP in SCI subjects and discuss possible reasons for such disparity. Setting: Single site cohort study, the London Spinal Cord Injury Centre, United Kingdom. Methods: A retrospective analysis of LT and PP scores of 99 spinal cord injury subjects at the time of discharge (median 5 months) from acute care and rehabilitation in the London Spinal Cord Injury Centre was conducted. Subjects were aged 10-88 years (median 44 years; 78 men, 74 traumatic, 25 non-traumatic). There were 40 American Spinal Injury Association (ASIA) Impairment Scale (AIS) A, 7 B, 18 C and 34 D subjects. Results: A disparity (Po0.001) was found between LT (64.5 ± 3.2, mean ± s.e.) and PP (54.7 ± 2.9) AIS sensory scores. A similar difference in score (LT4PP) was registered both for traumatic and non-traumatic injury, but was greater for incomplete than for complete injury. Despite the difference, LT was well correlated with PP (R ¼ 0.87, Po0.001). Spinal segmental level of injury was determined more frequently by PP alone (43 of 99) than by LT (10 of 99) alone. Conclusion: The discrepancies between LT and PP could relate to the greater complexity of the PP test or a difference in the extent of injury to the posterior columns (LT) and spinothalamic (PP) tracts. Further interpretation would benefit from additional electrophysiological sensory tests.

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Section: Discussionmentioning

confidence: 99%

Light touch and pin prick disparity in the International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI)

et al. 2013

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“…Another limitation is the large thermode area (573 mm 2 ). In the present study a long interstimulus interval (ISI) of 32-40 s was used compared to other studies using similar recording procedures (Granovsky et al, 2005(Granovsky et al, , 2008Greffrath et al, 2007;Truini et al, 2007b;Kramer et al, 2012). With this long ISI it is less likely that sensitization will occur.…”

Section: Methodological Considerations and Limitationsmentioning

confidence: 95%

The effect of nerve compression and capsaicin on contact heat-evoked potentials related to Aδ- and C-fibers

Madsen¹,

Johnsen²,

Fuglsang-Frederiksen³

et al. 2012

Neuroscience

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“…In some SCI patients, a positive CHEPS may be elicited in a dermatome that lacks pin prick sensation on ASIA testing. 113 CHEPS are also useful in the assessment of neuropathic pain. 114 dSSEPs.…”

Section: Measures Of Spinal Cord Grey Matter Integritymentioning

confidence: 99%

Spinal Cord Injury: How Can We Improve the Classification and Quantification of Its Severity and Prognosis?

Krishna

Andrews

Varma

et al. 2014

Journal of Neurotrauma

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The preservation of functional neural tissue after spinal cord injury (SCI) is the basis for spontaneous neurological recovery. Some injured patients in the acute phase have more potential for recovery than others. This fact is problematic for the construction of clinical trials because enrollment of subjects with variable recovery potential makes it difficult to detect effects, requires large sample sizes, and risks Type II errors. In addition, the current methods to assess injury and recovery are non-quantitative and not sensitive. It is likely that therapeutic combinations will be necessary to cause substantially improved function after SCI, thus we need highly sensitive techniques to evaluate changes in motor, sensory, autonomic and other functions. We review several emerging neurophysiological techniques with high sensitivity. Quantitative methods to evaluate residual tissue sparing after severe acute SCI have not entered widespread clinical use. This reduces the ability to correlate structural preservation with clinical outcome following SCI resulting in enrollment of subjects with varying patterns of tissue preservation and injury into clinical trials. We propose that the inclusion of additional measures of injury severity, pattern, and individual genetic characteristics may enable stratification in clinical trials to make the testing of therapeutic interventions more effective and efficient. New imaging techniques to assess tract injury and demyelination and methods to quantify tissue injury, inflammatory markers, and neuroglial biochemical changes may improve the evaluation of injury severity, and the correlation with neurological outcome, and measure the effects of treatment more robustly than is currently possible. The ability to test such a multimodality approach will require a high degree of collaboration between clinical and research centers and government research support. When the most informative of these assessments is determined, it may be possible to identify patients with substantial recovery potential, improve selection criteria and conduct more efficient clinical trials.

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Increased baseline temperature improves the acquisition of contact heat evoked potentials after spinal cord injury

Cited by 47 publications

References 49 publications

Light touch and pin prick disparity in the International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI)

Light touch and pin prick disparity in the International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI)

The effect of nerve compression and capsaicin on contact heat-evoked potentials related to Aδ- and C-fibers

Spinal Cord Injury: How Can We Improve the Classification and Quantification of Its Severity and Prognosis?

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