Cortical and vestibular stimulation reveal preserved descending motor pathways in individuals with motor-complete spinal cord injury

J Squair, A Bjerkefors, J Inglis, T Lam, M Carpenter
2016 Journal of Rehabilitation Medicine  
Cortical and vestibular stimulation reveal preserved descending motor pathways in individuals with motor-complete spinal cord injury.. Medicine, 48 (7) : 589-596 http://dx.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 vestibularevoked myogenic potentials were used to investigate whether there was any
more » ... r 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. Journal of Rehabilitation
doi:10.2340/16501977-2101 pmid:27292455 fatcat:wgu7larmbzglfkdz23zzeeaof4