Non-invasive approaches to functional recovery after spinal cord injury: Therapeutic targets and multimodal device interventions

Pizzolato, Claudio; Gunduz, Mehmet A.; Palipana, Dinesh; Wu, Jiada; Grant, Gary; Hall, Susan; Dennison, Rachel; Zafonte, Ross; Lloyd, David G.; Teng, Yang D.

doi:10.1016/j.expneurol.2021.113612

Cited by 25 publications

(19 citation statements)

References 223 publications

(224 reference statements)

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“…All ECGs in this study were taken in an ascending position to avoid the effect that body position could have on the ECG. Some ECG abnormalities, such as sinus stretching, can be attributed to the level of spinal cord injury and associated autonomic disability, but the remaining abnormalities cannot be fully explained by spinal cord injury and autonomic disability, as none of the participants in the study had an ECG injury or a medical condition [ 15 , 16 ]. Standard measures were used in all patients when the ECG was performed, and a number of ECG series were considered as confirmation of abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic Abnormalities in Patients With Spinal Cord Injury With Deranged Lipid Profile

Syed

Khan

Zulfiqar

et al. 2021

Cureus

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Section: Discussionmentioning

confidence: 99%

Electrocardiographic Abnormalities in Patients With Spinal Cord Injury With Deranged Lipid Profile

Syed

Khan

Zulfiqar

et al. 2021

Cureus

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“…The ability of the brain to properly combine external information to assist motor program execution is called sensorimotor integration [2]. The deterioration of this function due to ageing, traumatic events, or pathologies may lead to a wide range of motor impairments affecting the quality of life [3]- [5]. Although the neural control of movement in healthy and pathological individuals has been widely investigated during the last few decades, the way humans control their interactions with the environment remains one of the unsolved neuroscience research questions, because it often requires performing dynamic tasks in naturalistic conditions [6].…”

Section: Introductionmentioning

confidence: 99%

Design and Validation of a Wireless Body Sensor Network for Integrated EEG and HD-sEMG Acquisitions

Cerone

Giangrande

Ghislieri

et al. 2022

IEEE Trans. Neural Syst. Rehabil. Eng.

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Sensorimotor integration is the process through which the human brain plans the motor program execution according to external sources. Within this context, corticomuscular and corticokinematic coherence analyses are common methods to investigate the mechanism underlying the central control of muscle activation. This requires the synchronous acquisition of several physiological signals, including EEG and sEMG. Nevertheless, physical constraints of the current, mostly wired, technologies limit their application in dynamic and naturalistic contexts. In fact, although many efforts were made in the development of biomedical instrumentation for EEG and HD-sEMG signal acquisition, the need for an integrated wireless system is emerging. We hereby describe the design and validation of a new fully wireless body sensor network for the integrated acquisition of EEG and HD-sEMG signals. This Body Sensor Network is composed of wireless bio-signal acquisition modules, named sensor units, and a set of synchronization modules used as a general-purpose system for time-locked recordings. The system was characterized in terms of accuracy of the synchronization and quality of the collected signals. An in-depth characterization of the entire system and an end-to-end comparison of the wireless EEG sensor unit with a wired benchmark EEG device were performed. The proposed device represents an advancement of the State-of-the-Art technology allowing the integrated acquisition of EEG and HD-sEMG signals for the study of sensorimotor integration.

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“…The most common cause for SCI is motor vehicle crashes, and males account for 78% of new SCI cases ( 3 ). Recovery of upper and lower extremity function is a top priority for individuals with SCI ( 4 , 5 ); however, the neurophysiological mechanisms underlying movement impairments are poorly understood ( 6 , 7 ). A better understanding of the neurophysiological mechanisms underlying movement impairments and recovery can help in better prognostication and allow for more targeted and individualized therapies to improve motor recovery.…”

Section: Introductionmentioning

confidence: 99%

Utility of transcranial magnetic stimulation in the assessment of spinal cord injury: Current status and future directions

Arora

Desai

Kirshblum

et al. 2022

Front. Rehabilit. Sci.

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Comprehensive assessment following traumatic spinal cord injury (SCI) is needed to improve prognostication, advance the understanding of the neurophysiology and better targeting of clinical interventions. The International Standards for Neurological Classification of Spinal Cord Injury is the most common clinical examination recommended for use after a SCI. In addition, there are over 30 clinical assessment tools spanning across different domains of the International Classification of Functioning, Disability, and Health that have been validated and recommended for use in SCI. Most of these tools are subjective in nature, have limited value in predicting neurologic recovery, and do not provide insights into neurophysiological mechanisms. Transcranial magnetic stimulation (TMS) is a non-invasive neurophysiology technique that can supplement the clinical assessment in the domain of body structure and function during acute and chronic stages of SCI. TMS offers a better insight into neurophysiology and help in better detection of residual corticomotor connectivity following SCI compared to clinical assessment alone. TMS-based motor evoked potential and silent period duration allow study of excitatory and inhibitory mechanisms following SCI. Changes in muscle representations in form of displacement of TMS-based motor map center of gravity or changes in the map area can capture neuroplastic changes resulting from SCI or following rehabilitation. Paired-pulse TMS measures help understand the compensatory reorganization of the cortical circuits following SCI. In combination with peripheral stimulation, TMS can be used to study central motor conduction time and modulation of spinal reflexes, which can be used for advanced diagnostic and treatment purposes. To strengthen the utility of TMS in SCI assessment, future studies will need to standardize the assessment protocols, address population-specific concerns, and establish the psychometric properties of TMS-based measurements in the SCI population.

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Non-invasive approaches to functional recovery after spinal cord injury: Therapeutic targets and multimodal device interventions

Cited by 25 publications

References 223 publications

Electrocardiographic Abnormalities in Patients With Spinal Cord Injury With Deranged Lipid Profile

Electrocardiographic Abnormalities in Patients With Spinal Cord Injury With Deranged Lipid Profile

Design and Validation of a Wireless Body Sensor Network for Integrated EEG and HD-sEMG Acquisitions

Utility of transcranial magnetic stimulation in the assessment of spinal cord injury: Current status and future directions

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