Prognostic value of cortical magnetic stimulation in spinal cord injury

Abstract

Cortical magnetic stimulation was performed in a consecutive series of 10 patients presenting within 15 days of traumatic spinal cord injury. In those patients with complete paraplegia or quadriplegia, motor evoked potentials at presentation were absent below the level of the lesion. Six months after the injury, potentials had returned in the biceps brachii and abductor pollicis brevis muscles in some quadriplegic cases, but remained absent from the tibialis anterior in all of this group. None of those with a complete lesion made a significant functional recovery. Of the three patients with incomplete quadri plegia, two showed a significant recovery after 6 months. Motor evoked potentials were recordable below the level of the lesion at presentation in these cases, although the latencies were prolonged. In the remaining patient who failed to improve, potentials were unrecordable throughout the study. This small pilot study suggests that cortical magnetic stimulation may be useful in refining the prognosis in patients with an incomplete spinal cord injury.

Motor evoked potentials (MEP) and evoked pressure curves (EPC) from the urethral compressive musculature (UCM) by functional magnetic stimulation in healthy volunteers and patients with neurogenic incontinence

“…Latency measurements of motor evoked potentials (MEP) after transcranial (tc) and lumbosacral (ls) magnetic nerve stimulation proved to be useful for distinguishing between peripheral and central corticospinal motor conduction disturbances [Merton and Morton, 1980;Cowan et al, 1984;Barker et al, 1985;Ingram et al, 1988;Eisen, 1992;Clarke et al, 1994;Curt et al, 1998]. By application of electrical or magnetic stimuli to the motor cortex or to peripheral nerves electrophysiological activity of the target muscle can be elicited and the amplitude and latency of these evoked potentials can be measured [Caramia et al, 1989;Dvorak et al, 1992].…”

Translation of the rat thoracic contusion model; part 2 — forward versus backward locomotion testing

“…Interestingly, MMEPs in rats are typically reported to not correlate with basic locomotion tests; 15 however, MMEP studies in human SCI patients found high sensitivities of MMEPs for spinal integrity and functional outcome. [16][17][18] Hence, the backward locomotion test seems to correlate with long tract function, which has translational value for locomotion function in humans.…”

Electrophysiological recordings in patients with spinal cord injury: significance for predicting outcome

“…By combining magnetic stimulation of cortical and peripheral nervous structures (spinal roots, plexus, peripheral nerves), lesions of spinal and/or peripheral nerves underlying a muscle paresis can be di erentiated. 16,17 Sympathetic skin response (SSR) The sympathetic skin response (SSR) is a simple and non-invasive electrophysiological test to examine the common e erent pathways of the sympathetic nervous system. Pathways from the spinal cord to the sudomotor sweat glands of hands (palmar), feet (plantar) and the perineal skin region transmitted by pre-and post-ganglionic sympathetic nerve ®bres can be evaluated.…”