Corticospinal inhibition investigated in relation to upper extremity motor function in cervical spinal cord injury
Clinical Neurophysiology. 2024-05-01; 161: 188-197
DOI: 10.1016/j.clinph.2024.02.026
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1. Clin Neurophysiol. 2024 May;161:188-197. doi: 10.1016/j.clinph.2024.02.026.
Epub 2024 Feb 28.
Corticospinal inhibition investigated in relation to upper extremity motor
function in cervical spinal cord injury.
Arora T(1), Liu J(2), Mohan A(2), Li X(2), O’laughlin K(2), Bennett T(2),
Nemunaitis G(3), Bethoux F(3), Pundik S(4), Forrest G(5), Kirshblum S(6),
Kilgore K(7), Bryden A(8), Kristi Henzel M(9), Wang X(10), Baker K(11), Brihmat
N(5), Bayram M(5), Plow EB(12).
Author information:
(1)Department of Biomedical Engineering, Lerner Research Institute, Cleveland
Clinic Foundation, OH, USA; Department of Neurology, Division of Clinical
Neuroscience, Oslo University Hospital, Norway.
(2)Department of Biomedical Engineering, Lerner Research Institute, Cleveland
Clinic Foundation, OH, USA.
(3)Department of Physical Medicine and Rehabilitation, Neurological Institute,
Cleveland Clinic Foundation, OH, USA.
(4)Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio,
USA; Department of Neurology, Case Western Reserve University School of
Medicine, Cleveland OH, USA.
(5)Department of Physical Medicine and Rehabilitation, Rutgers New Jersey
Medical School, Newark, New Jersey, USA; Tim and Caroline Reynolds Center for
Spinal Stimulation, Kessler Foundation, West Orange, New Jersey, USA.
(6)Department of Physical Medicine and Rehabilitation, Rutgers New Jersey
Medical School, Newark, New Jersey, USA; Tim and Caroline Reynolds Center for
Spinal Stimulation, Kessler Foundation, West Orange, New Jersey, USA; Kessler
Institute for Rehabilitation, West Orange, New Jersey, USA; Kessler Foundation,
West Orange, New Jersey, USA.
(7)Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio,
USA; Department of Physical Medicine and Rehabilitation, MetroHealth Center for
Rehabilitation Research, OH, USA; Institute for Functional Restoration, Case
Western Reserve University, Cleveland, OH, USA.
(8)Department of Physical Medicine and Rehabilitation, MetroHealth Center for
Rehabilitation Research, OH, USA; Institute for Functional Restoration, Case
Western Reserve University, Cleveland, OH, USA.
(9)Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio,
USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve
University School of Medicine, Cleveland OH, USA.
(10)Department of Quantitative Health Sciences, Cleveland Clinic Foundation, OH,
USA.
(11)Department of Neuroscience, School of Medicine, University of Texas
RioGrande Valley, RioGrande Valley, TX, USA.
(12)Department of Biomedical Engineering, Lerner Research Institute, Cleveland
Clinic Foundation, OH, USA; Department of Physical Medicine and Rehabilitation,
Neurological Institute, Cleveland Clinic Foundation, OH, USA; Cleveland Clinic
Rehabilitation Hospitals, Cleveland, OH, USA. Electronic address:
.
OBJECTIVE: Corticospinal inhibitory mechanisms are relevant to functional
recovery but remain poorly understood after spinal cord injury (SCI).
Post-injury characteristics of contralateral silent period (CSP), a measure of
corticospinal inhibition evaluated using transcranial magnetic stimulation
(TMS), is inconsistent in literature. We envisioned that investigating CSP
across muscles with varying degrees of weakness may be a reasonable approach to
resolve inconsistencies and elucidate the relevance of corticospinal inhibition
for upper extremity function following SCI.
METHODS: We studied 27 adults with chronic C1-C8 SCI (age 48.8 ± 16.1 years, 3
females) and 16 able-bodied participants (age 33.2 ± 11.8 years, 9 females). CSP
characteristics were assessed across biceps (muscle power = 3-5) and triceps
(muscle power = 1-3) representing stronger and weaker muscles, respectively. We
assessed functional abilities using the Capabilities of the Upper Extremity Test
(CUE-T).
RESULTS: Participants with chronic SCI had prolonged CSPs for biceps but delayed
and diminished CSPs for triceps compared to able-bodied participants.
Early-onset CSPs for biceps and longer, deeper CSPs for triceps correlated with
better CUE-T scores.
CONCLUSIONS: Corticospinal inhibition is pronounced for stronger biceps but
diminished for weaker triceps muscle in SCI indicating innervation relative to
the level of injury matters in the study of CSP.
SIGNIFICANCE: Nevertheless, corticospinal inhibition or CSP holds relevance for
upper extremity function following SCI.
Copyright © 2024 International Federation of Clinical Neurophysiology. Published
by Elsevier B.V. All rights reserved.
DOI: 10.1016/j.clinph.2024.02.026
PMID: 38520799 [Indexed for MEDLINE]
Conflict of interest statement: Conflicts of Interest The authors report no
potential conflict of interests.