Content » Vol 48, Issue 7

Original report

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
DOI: 10.2340/16501977-2101

Abstract

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.

Lay Abstract

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