Motor Evoked Potentials Correlate With Magnetic Resonance Imaging and Early Recovery After Acute Spinal Cord Injury

Dhall, Sanjay S.; Haefeli, Jenny; Talbott, Jason F.; Ferguson, Adam R.; Readdy, William J; Bresnahan, Jacqueline C.; Beattie, Michael S.; Pan, Jonathan Z.; Manley, Geoffrey T.; Whetstone, William D.

doi:10.1093/neuros/nyx320

Cited by 36 publications

(26 citation statements)

References 20 publications

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“…Biomarkers derived from advanced magnetic resonance imaging techniques, neurophysiological assessments, and cerebral spinal fluid or serum may help to identify subjects with similar potential for improvement, but further research in this area is needed. [29][30][31][32][33] Although the largest increase in conversions observed in this study were to sensory incomplete (AIS-B), it is promising to see conversions to motor incomplete nearly triple from 5.8% in 1995-1997 to 16.4% in 2013-2015. This change was even more pronounced in persons with tetraplegia, increasing from 9.4% to 28.1% in those time periods.…”

Section: Discussionmentioning

confidence: 64%

Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Marino

Leff

Cardenas

et al. 2020

Neurotrauma Reports

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Section: Discussionmentioning

confidence: 64%

Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Marino

Leff

Cardenas

et al. 2020

Neurotrauma Reports

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“…Results from very early examinations within four hours of injury probably should be interpreted with caution, because they may not be stable enough to determine a definitive neurologically complete injury. Further systematic study of the early examination, perhaps in concert with other diagnostic aids such as MRI 54 and intraoperative neurophysiology 55 appears warranted.…”

Section: Timing Of Assessment and Predicting Outcomementioning

confidence: 99%

Characterizing Natural Recovery after Traumatic Spinal Cord Injury

Kirshblum

Snider

Eren

et al. 2021

Journal of Neurotrauma

131

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The predominant tool used to predict outcomes after traumatic spinal cord injury (SCI) is the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), in association with the American Spinal Injury Association (ASIA) Impairment Scale (AIS). These measures have evolved based on analyses of large amounts of longitudinal neurological recovery data published in numerous separate studies. This article reviews and synthesizes published data on neurological recovery from multiple sources, only utilizing data in which the sacral sparing definition was applied for determination of completeness. Conversion from a complete to incomplete injury is more common in tetraplegia than paraplegia. The majority of AIS conversion and motor recovery occurs within the first 6-9 months, with the most rapid rate of motor recovery occurring in the first three months after injury. Motor score changes, as well as recovery of motor levels, are described with the initial strength of muscles as well as the levels of the motor zone of partial preservation influencing the prognosis. Total motor recovery is greater for patients with initial AIS B than AIS A, and greater after initial AIS C than with motor complete injuries. Older age has a negative impact on neurological and functional recovery after SCI; however, the specific age (whether >50 or >65 years) and underlying reasons for this impact are unclear. Penetrating injury is more likely to lead to a classification of a neurological complete injury compared with blunt trauma and reduces the likelihood of AIS conversion at one year. There are insufficient data to support gender having a major effect on neurological recovery after SCI.

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“…The next study that researched on the usefulness of the MEP response as a prognostic tool for spine surgeries was conducted by Dhall et al [ 16 ]. The 32 patients' data that were selected had decompression and instrumented stabilization surgeries.…”

Section: The Significance Of Mep Improvementmentioning

confidence: 99%

Transcranial Electrical Motor Evoked Potential in Predicting Positive Functional Outcome of Patients after Decompressive Spine Surgery: Review on Challenges and Recommendations towards Objective Interpretation

Jamaludin

Lai

Chuah

et al. 2021

Behavioural Neurology

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Spine surgeries impose risk to the spine’s surrounding anatomical and physiological structures especially the spinal cord and the nerve roots. Intraoperative neuromonitoring (IONM) is a technology developed to monitor the integrity of the spinal cord and the nerve roots via the surgery. Transcranial motor evoked potential (TcMEP) (one of the IONM modalities) is adopted to monitor the integrity of the motor pathway of the spinal cord and the motor nerve roots. Recent research suggested that the IONM is conducive as a prognostic tool towards the patient’s functional outcome. This paper summarizes the researches of IONM being adopted as a prognostic tool. In addition, this paper highlights the problems associated with the signal parameters as the improvement criteria in the previous researches. Lastly, we review the challenges of TcMEP to achieve a prognostic tool focusing on the factors that could interfere with the generation of a stable TcMEP response. The final section will discuss recommendations for IONM technology to achieve an objective prognostic tool.

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Motor Evoked Potentials Correlate With Magnetic Resonance Imaging and Early Recovery After Acute Spinal Cord Injury

Abstract: In patients with severe SCI, MEPs predicted neurological improvement and correlated with axial MRI grade. These significant findings warrant future prospective studies of MEPs as a prognostic tool in SCI.

Cited by 36 publications

References 20 publications

Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Trends in Rates of ASIA Impairment Scale Conversion in Traumatic Complete Spinal Cord Injury

Characterizing Natural Recovery after Traumatic Spinal Cord Injury

Transcranial Electrical Motor Evoked Potential in Predicting Positive Functional Outcome of Patients after Decompressive Spine Surgery: Review on Challenges and Recommendations towards Objective Interpretation

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