Cortical and vestibular stimulation reveal preserved descending motor pathways in individuals with motor-complete spinal cord injury
Jordan W. Squair, Anna Bjerkefors, J. Timothy Inglis, Tania Lam, Mark G. Carpenter
School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
Objective: To use a combination of electrophysiological techniques to determine the extent of preserved muscle activity below the clinically-defined level of motor-complete spinal cord injury.
Methods: Transcranial magnetic stimulation and vestibular-evoked myogenic potentials were used to investigate whether there was any preserved muscle activity in trunk, hip and leg muscles of 16 individuals with motor-complete spinal cord injury (C4–T12) and 16 able-bodied matched controls.
Results: Most individuals (14/16) with motor-complete spinal cord injury were found to have transcranial magnetic stimulation evoked, and/or voluntary evoked muscle activity in muscles innervated below the clinically classified lesion level. In most cases voluntary muscle activation was accompanied by a present transcranial magnetic stimulation response. Furthermore, motor-evoked potentials to transcranial magnetic stimulation could be observed in muscles that could not be voluntarily activated. Vestibular-evoked myogenic potentials responses were also observed in a small number of subjects, indicating the potential preservation of other descending pathways.
Conclusion: These results highlight the importance of using multiple electrophysiological techniques to assist in determining the potential preservation of muscle activity below the clinically-defined level of injury in individuals with a motor-complete spinal cord injury. These techniques may provide clinicians with more accurate information about the state of various motor pathways, and could offer a method to more accurately target rehabilitation.
Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors.
You need to login/create an account to comment on articles. Click here to login/create an account