Abstract
Study design:
Case report.
Objectives:
To identify preserved corticomotor connection in chronic spinal cord injury (SCI) in the absence of clinically observable movement.
Setting:
Rehabilitation Hospital and Medical Research Institute, NY, USA.
Methods:
The motor-evoked potential (MEP) response to transcranial magnetic stimulation (TMS) was recorded using surface electromyography from the right biceps brachii, extersor carpi radialis (ECR), flexor carpi radialis (FCR) and abductor pollicis brevis (APB) muscles in a 31-year-old male traumatic SCI chronic patient—ASIA B, injury level C5. Motor power scores were additionally obtained from a clinician blinded to the results of TMS.
Results:
TMS could consistently elicit MEPs of normal latency, phase and amplitude, in the severely affected ECR muscle but not the similarly affected FCR muscle. The response in proximal and unaffected biceps muscle was larger than the healthy subject, whereas no response was obtained in the distal APB muscle as expected.
Conclusion:
TMS can identify residual pathways not apparent from clinical assessment alone, which may have prescriptive value for rehabilitation.
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References
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Acknowledgements
The contents of the publication were developed under the NIH grants R01HD069776, R21HD060999 and K24 RR018875. We acknowledge Professor Frank Mastaglia for assistance in data interpretation and Dr Ana H Medeiros for assistance in the manuscript preparation.
Disclaimer
Dr Edwards developed the idea and was involved in each stage of experimental work and manuscript preparation. Dr Cortes and Ms Rykman contributed to data collection and manuscript preparation. Professor Pascual-Leone was involved in data interpretation and manuscript preparation. Professor Thickbroom was involved in the interpretation of the data and the drafting of the manuscript. Professor Volpe was involved with development of the idea, data interpretation and manuscript preparation.
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Edwards, D., Cortes, M., Thickbroom, G. et al. Preserved corticospinal conduction without voluntary movement after spinal cord injury. Spinal Cord 51, 765–767 (2013). https://doi.org/10.1038/sc.2013.74
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DOI: https://doi.org/10.1038/sc.2013.74
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