Functional outcome following spinal cord injury: Significance of motor-evoked potentials and ASIA scores

被引:134
作者
Curt, A [1 ]
Keck, ME [1 ]
Dietz, V [1 ]
机构
[1] Univ Hosp Balgrist, Swiss Parapleg Ctr, CH-8008 Zurich, Switzerland
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 1998年 / 79卷 / 01期
关键词
D O I
10.1016/S0003-9993(98)90213-1
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: Prediction of outcome of ambulatory capacity and hand function in tetraplegic patients with spinal cord injury (SCI) using neurologic examination, according to the protocol of the American Spinal Injury Association (ASIA) and motor-evoked potentials (MEP). Design: Correlation study on a prospective cohort. Setting: SCI center, university hospital. Patients: Thirty-six patients with acute and 34 with chronic SCI. Outcome Measures: (1) ASIA motor and sensory scores, (2) MEP recordings of upper and lower limb muscles, and (3) outcome of ambulatory capacity and hand function. Results: In acute and chronic SCI, both the initial ASIA scores and the MEP recordings were significantly related (p < .0001) to the outcome of ambulatory capacity and hand function. In tetraplegic patients, the MEP of the abductor digiti minimi muscle (Spearman correlation coefficient, .75; p < .0001) and the ASIA motor score for the upper limbs (Spearman correlation coefficient, .83; p < .0001) were most related to the outcome of hand function. Ambulatory capacity could be predicted by the ASIA motor score of the lower limbs (Spearman correlation coefficient, .78: p < .0001) and by MEP recordings of the leg muscles (Spearman correlation coefficient, .77; p < .0001). In patients with acute SCI, for the period 6 months posttrauma, the ASIA motor score increased significantly (ANOVA, p < .05), whereas the ASIA sensory scores and MEP recordings were unchanged (ANOVA, p > 0.1). Conclusion: Both ASIA scores and MEP recordings are similarly related to the outcome of ambulatory capacity and hand function in patients with SCI. MEP recordings are of additional value to the clinical examination in uncooperative or incomprehensive patients, The combination of clinical examination and MEP recordings allows differentiation between the recovery of motor function (hand function, ambulatory capacity) and that of impulse transmission of descending motor tracts. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
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页码:81 / 86
页数:6
相关论文
共 39 条
[1]  
BARKER AT, 1985, LANCET, V1, P1106
[2]   MULTIMODAL ELECTROPHYSIOLOGICAL STUDIES INCLUDING MOTOR EVOKED-POTENTIALS IN PATIENTS WITH LOCKED-IN-SYNDROME - REPORT OF 6 PATIENTS [J].
BASSETTI, C ;
MATHIS, J ;
HESS, CW .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1994, 57 (11) :1403-1406
[3]   SPINAL-CORD INFARCTION - MRI AND MEP FINDINGS IN 3 CASES [J].
BERLIT, P ;
KLOTZSCH, G ;
ROTHER, J ;
ASSMUS, HP ;
DAFFERTSHOFER, M ;
SCHWARTZ, A .
JOURNAL OF SPINAL DISORDERS, 1992, 5 (02) :212-216
[4]   CHANGES IN CORTICOSPINAL FACILITATION OF LOWER-LIMB SPINAL MOTOR NEURONS AFTER SPINAL-CORD LESIONS [J].
BROUWER, B ;
BUGARESTI, J ;
ASHBY, P .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1992, 55 (01) :20-24
[5]   CENTRAL MOTOR CONDUCTION TIME TO UPPER AND LOWER-LIMBS IN CERVICAL CORD LESIONS [J].
BRUNHOLZL, C ;
CLAUS, D .
ARCHIVES OF NEUROLOGY, 1994, 51 (03) :245-249
[6]   Magnetic transcranial stimulation in acute stroke: Early excitation threshold and functional prognosis [J].
Catano, A ;
Houa, M ;
Caroyer, JM ;
Ducarne, H ;
Noel, P .
ELECTROMYOGRAPHY AND MOTOR CONTROL-ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY, 1996, 101 (03) :233-239
[7]   ESTIMATE OF MOTOR CONDUCTION IN HUMAN SPINAL-CORD - SLOWED CONDUCTION IN SPINAL-CORD INJURY [J].
CHANG, CW ;
LIEN, IN .
MUSCLE & NERVE, 1991, 14 (10) :990-996
[8]   SOMATOSENSORY EVOKED-POTENTIALS AND NEUROLOGICAL GRADES AS PREDICTORS OF OUTCOME IN ACUTE SPINAL-CORD INJURY [J].
CHEN, L ;
HOULDEN, DA ;
ROWED, DW .
JOURNAL OF NEUROSURGERY, 1990, 72 (04) :600-609
[9]   PROGNOSTIC VALUE OF CORTICAL MAGNETIC STIMULATION IN SPINAL-CORD INJURY [J].
CLARKE, CE ;
MODARRESSADEGHI, H ;
TWOMEY, JA ;
BURT, AA .
PARAPLEGIA, 1994, 32 (08) :554-560
[10]   SPINAL-CORD INJURY - PROGNOSIS FOR AMBULATION BASED ON QUADRICEPS RECOVERY [J].
CROZIER, KS ;
CHENG, LL ;
GRAZIANI, V ;
ZORN, G ;
HERBISON, G ;
DITUNNO, JF .
PARAPLEGIA, 1992, 30 (11) :762-767