Objective: To investigate the adaptational changes in excitability of spinal neuronal circuits below the level of lesion from spinal shock to spasticity in patients with spinal cord injury (SCI).
Methods: More than 6 months after an acute SCI, clinical follow-up examinations were paralleled by electrophysiologic recordings with tibial nerve stimulation (M-wave, F-wave, H-reflex, and flexor reflex).
Results: During spinal shock, the loss of tendon tap reflexes and flaccid muscle tone were associated with low persistence of F-waves and loss of flexor reflexes, whereas H-reflexes were already elicitable. During the transition to spasticity, the reappearance of tendon tap reflexes and muscle tone and the occurrence of spasms was associated with the recovery of F-waves and flexor reflex excitability, whereas the H-to-M ratio remained about stable over months. At later stages (2 to 6 months after SCI) when clinical signs of spasticity became established, the electrophysiologic measures showed little change. In paraplegic patients, in contrast to tetraplegic patients, M-wave and flexor reflex amplitudes even decreased.
Conclusions: The late decrease in M-wave and flexor reflex amplitude in paraplegic patients suggests a secondary impairment/degeneration of premotoneuronal circuits and of motoneurons. The divergent course of clinical signs of spasticity and their probable neuronal correlates indicates the occurrence of non-neuronal changes contributing to spasticity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1212/wnl.54.8.1574 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between prophylactic intermittent non-invasive positive pressure ventilation and incidence of pneumonia in patients with cervical spinal cord injury: a retrospective single-center cohort study.
Trauma Surg Acute Care Open
January 2025
Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan.
Background: Patients with cervical spinal cord injuries (CSCIs) have a high incidence of respiratory complications. The effectiveness of non-invasive positive pressure ventilation (NPPV) in preventing respiratory complications such as pneumonia in acute CSCIs remains unclear. We evaluated whether intermittent NPPV (iNPPV) could prevent pneumonia in patients with acute CSCIs.
View Article and Find Full Text PDFPrognostic analysis of acute type A aortic dissection after different surgical interventions: a cohort study.
J Thorac Dis
December 2024
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Background: Acute type A aortic dissection (ATAAD) requires emergency surgery, but the choice of primary surgery remains controversial. It is believed that simple ascending aorta replacement may lead to higher postoperative survival rate, while the Sun procedure [frozen elephant trunk (FET) + total arch replacement (TAR)] performed in the first stage may obtain better long-term results. The study aimed to compare the outcome of ATAAD patients who underwent the Sun procedure with those without TAR + FET.
View Article and Find Full Text PDFMorphological Patterns of Spinal Degeneration and Trauma in a Nigerian Population: a Retrospective Radio-Anatomic Study.
World Neurosurg
January 2025
Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa. Electronic address:
Background: Understanding the morphological patterns of degenerative and traumatic spinal conditions is essential for precise diagnosis and management plans. This study evaluates the sequence of structural changes in degenerative spinal disorder patients' disco-vertebral unit and the traumatic spinal injury patterns in a northwestern Nigerian population.
Methods: A hospital-based retrospective study reviewed radiologic images of 307 patients with spinal degeneration (n=269) and trauma (n=38) at two tertiary hospitals in Northwest Nigeria.
Size effect-based improved antioxidant activity of selenium nanoparticles regulating Anti-PI3K-mTOR and Ras-MEK pathways for treating spinal cord injury to avoid hormone shock-induced immunosuppression.
J Nanobiotechnology
January 2025
Department of Orthopedics, Zhuhai Medical College (Zhuhai People's Hospital), State Key Laboratory of Bioactive Molecules and Druggability Assessment, College of Chemistry and Materials Science, Jinan University, Zhuhai, 519000, China.
Spinal cord injury (SCI) is a critical condition affecting the central nervous system that often has permanent and debilitating consequences, including secondary injuries. Oxidative damage and inflammation are critical factors in secondary pathological processes. Selenium nanoparticles have demonstrated significant antioxidative and anti-inflammatory properties via a non-immunosuppressive pathway; however, their clinical application has been limited by their inadequate stability and functionality to cross the blood-spinal cord barrier (BSCB).
View Article and Find Full Text PDFA Rare Case of Spinal Hypertrophic Pachymeningitis That Caused Tetraplegia After Myelography.
Cureus
December 2024
Department of Orthopaedics, Tokyo Metropolitan Bokutoh Hospital, Tokyo, JPN.
Hypertrophic pachymeningitis (HP) is a rare inflammatory disease that causes the thickening of the dura mater. Its etiology is mainly classified as idiopathic or secondary, and autoimmune disease is one of the main causes of secondary HP. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and IgG4-related disease are common among autoimmune diseases.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!