Article

The course of central and peripheral motor recovery
after cervical spinal cord injury (SCI) may be investigated by
electrophysiological measures. The goal of this study was to compare the 2 over
the first year after injury in relation to motor gains. METHODS: Compound motor
action potentials (CMAPs), motor-evoked potentials (MEPs), and F-waves were
recorded from the abductor digiti minimi and CMAP and F-waves from abductor
hallucis muscles in 305 patients at about 15 days, 1 month,
3 months, 6 months,
and 12 months following an acute traumatic SCI. RESULTS: The MEP amplitudes and
F-wave persistences were lower with more severe sensorimotor impairment. They
steadily increased in most subgroups within 6 months after SCI. The amplitude of
the CMAPs was low for the first 3 months in the most severely affected
participants. This was also found for CMAPs from tibial nerve originating well
below the cervical lesion level. Improvement in neurophysiological parameters
correlated with improved upper extremity motor scores. CONCLUSION: The results
point to a systematic interrelation of corticospinal transmission, spinal
motoneuron excitability, and its axon function, respectively.
Electrophysiological correlates of neural excitability show distinct spatial and
temporal interrelations within central and peripheral motor pathways following
acute cervical SCI. A strong secondary deterioration within the peripheral motor
system with incomplete or no recovery depends on anatomical distance caudal to
lesion and on lesion severity. Electrophysiological assessments may increase the
sensitivity of interventional studies in addition to clinical measures.

Langue : ANGLAIS