Article

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.

Langue : ANGLAIS