Abstract
Study design:
Prospective longitudinal experimental study.
Objectives:
The aim of this study was to assess the sensitivity to change of the electrical perceptual threshold (EPT) test during the longitudinal monitoring of neurological changes in patients with incomplete spinal cord injury (SCI).
Setting:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Hospitals NHS Trust, Buckinghamshire, UK.
Methods:
Perceptual threshold to 3 Hz cutaneous electrical stimulation was measured in 11 patients with incomplete SCI at selected American Spinal Injuries Association (ASIA) sensory key points on four occasions. The first three measurements were performed within a 5-day period (baseline) and the fourth measurement (follow-up) at least 9 months later. The results were tested for statistical significance and the effect sizes were calculated.
Results:
There were no significant differences between the EPT results of the three baseline assessments. When the mean baseline and follow-up EPT results were compared, there were no significant differences in EPT values above the sensory level of lesion, but a significant difference (reduction in threshold values) was found at and below the level of SCI, with medium and large effect sizes, respectively.
Conclusion:
The EPT test showed good sensitivity to change in dermatomes at and directly below the sensory level of the SCI. This makes it a potentially useful quantitative sensory instrument for detecting changes in sensory function during longitudinal monitoring of patients with SCI.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Davey NJ, Nowicky AV, Zaman R . Somatopy of perceptual threshold to cutaneous electrical stimulation in man. Exp Physiol 2001; 86: 127–130.
Savic G, Bergstrom EM, Frankel HL, Jamous MA, Ellaway PH, Davey NJ . Perceptual threshold to cutaneous electrical stimulation in patients with spinal cord injury. Spinal Cord 2006; 44: 560–566.
King NK, Savic G, Frankel H, Jamous A, Ellaway P . Reliability of cutaneous electrical perceptual threshold in the assessment of sensory perception in patients with spinal cord injury. J Neurotrauma 2009; 26: 1061–1068.
Ellaway PH, Anand P, Bergstrom EMK, Catley M, Davey NJ, Frankel HL et al. Towards improved clinical and physiological assessments of recovery in spinal cord injury: a clinical initiative. Spinal Cord 2004; 42: 325–337.
Savic G, Bergström EMK, Davey NJ, Ellaway PH, Frankel HL, Jamous MA et al. Quantitative sensory tests (perceptual thresholds) in patients with spinal cord injury. J Rehabil Res Dev 2007; 44: 77–82.
Steeves JD, Lammertse D, Curt A, Fawcett JW, Tuszynski MH, Ditunno JF et al. Guidelines for the conduct of clinical trials for spinal cord injury (SCI) as developed by the ICCP panel: clinical trial outcome measures. Spinal Cord 2007; 45: 206–221.
Alexander MS, Anderson KD, Biering-Sorensen F, Blight AR, Brannon R, Bryce TN et al. Outcome measures in spinal cord injury: recent assessments and recommendations for future directions. Spinal Cord 2009; 47: 582–591.
Marino RJ, Barros T, Biering-Sorensen F, Burns SP, Donovan WH, Graves DE, et al., ASIA Neurological Standards Committee 2002. International standards for neurological classification of spinal cord injury. J Spinal Cord Med 2003; 26 (Suppl 1): S50–S56.
Cohen J . A power primer. Psychol Bull 1992; 112: 155–159.
Leong WS, Gorrie CA, Ng K, Rutkowski S, Waite PME . Electrical perceptual threshold testing: a validation study. J Spinal Cord Med 2009; 32: 140–146.
Kramer JLK, Moss AJ, Taylor P, Curt A . Assessment of posterior spinal cord function with electrical perception threshold in spinal cord injury. J Neurotrauma 2008; 25: 1019–1026.
Kramer JK, Taylor P, Steeves JD, Curt A . Dermatomal somatosensory evoked potentials and electrical perception thresholds during recovery from cervical spinal cord injury. Neurorehabil Neural Repair 2010; 24: 309–317.
Acknowledgements
We thank all the patient volunteers for taking part in the study. This work was supported by the Davenport Award from the Buckinghamshire Hospitals NHS Trust and by the Nathalie Rose Barr PhD Studentship from the ISRT, UK.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Savic, G., Frankel, H., Jamous, M. et al. Sensitivity to change of the cutaneous electrical perceptual threshold test in longitudinal monitoring of spinal cord injury. Spinal Cord 49, 439–444 (2011). https://doi.org/10.1038/sc.2010.123
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2010.123
Keywords
This article is cited by
-
Discrepancies between clinical assessments of sensory function and electrical perceptual thresholds after incomplete chronic cervical spinal cord injury
Spinal Cord (2016)
-
Reliability of the electrical perceptual threshold and Semmes-Weinstein monofilament tests of cutaneous sensibility
Spinal Cord (2013)
-
The Sir Ludwig Guttmann Lecture 2012: the contribution of Stoke Mandeville Hospital to spinal cord injuries
Spinal Cord (2012)