title: Time-Dependent Discrepancies between Assessments of Sensory Function after Incomplete Cervical Spinal Cord Injury.
abstract: We recently demonstrated that the electrical perceptual threshold (EPT) examination reveals spared sensory function at lower spinal segments compared with the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination in humans with chronic incomplete cervical spinal cord injury (SCI). Here, we investigated whether discrepancies in sensory function detected by both sensory examinations change over time after SCI. Forty-five participants with acute (<1 year), chronic (≥1-10 years), and extended-chronic (>10 years) incomplete cervical SCI and 30 control subjects were tested on dermatomes C2-T4 bilaterally. EPT values were higher in subjects with acute (2.5 ± 0.8 mA), chronic (2.2 ± 0.7 mA), or extended-chronic (2.8 ± 1.1 mA) SCI compared with controls (1.0 ± 0.1 mA). The EPT examination detected sensory impairments in spinal segments above (2.3 ± 0.9) and below (4.2 ± 2.6) the level detected by the ISNCSCI sensory examination in participants with acute and chronic SCI, respectively. Notably, both examinations detected similar levels of spared sensory function in the extended-chronic phase of SCI (0.8 ± 0.5). A negative correlation was found between differences in EPT and ISNCSCI sensory levels and time post-injury. These observations indicate that discrepancies between EPT and ISNCSCI sensory scores are time-dependent, with the EPT revealing impaired sensory function above, below, or at the same spinal segment as the ISNCSCI examination. We propose that the EPT is a sensitive tool to assess changes in sensory function over time after incomplete cervical SCI.
authors.affiliation: 1 Department of Neurological Surgery, University of Miami , The Miami Project to Cure Paralysis, Miami, Florida.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Macklin
authors.affiliation: 1 Department of Neurological Surgery, University of Miami , The Miami Project to Cure Paralysis, Miami, Florida.
authors.forename: Jihye
authors.initials: J
authors.lastname: Bae
authors.affiliation: 1 Department of Neurological Surgery, University of Miami , The Miami Project to Cure Paralysis, Miami, Florida.
authors.forename: Melanie
authors.initials: M
authors.lastname: Orell
authors.affiliation: 1 Department of Neurological Surgery, University of Miami , The Miami Project to Cure Paralysis, Miami, Florida.
authors.forename: Kim D
authors.initials: KD
authors.lastname: Anderson
authors.affiliation: 2 Division of Brain Sciences, Imperial College , London, United Kingdom .
authors.forename: Peter H
authors.initials: PH
authors.lastname: Ellaway
authors.affiliation: 1 Department of Neurological Surgery, University of Miami , The Miami Project to Cure Paralysis, Miami, Florida.
authors.forename: Monica A
authors.initials: MA
authors.lastname: Perez
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004185:Disability Evaluation; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012677:Sensation; D012684:Sensory Thresholds; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D055815:Young Adult
keywords: American Spinal Injury Association Impairment Scale (AIS); electrical perceptual threshold; light touch; pinprick; tetraplegia