Prevalence of discomplete sensorimotor spinal cord injury as evidenced by neurophysiological methods: A cross-sectional study.
Carl Wahlgren, Richard Levi, Salvador Amezcua and 2 others
PMID 33284352WHAT IT FOUND
Some people with clinically complete spinal cord injury had neurophysiological signs of possible remaining sensorimotor connections.
The estimate was 17 to 52 percent of 23, depending on criteria. This is not evidence that treatment works.
Key findings
01Signs of possible remaining sensorimotor connectivity were found in 4 of 23 participants by strict criteria, 9 of 23 by liberal criteria, and 12 of 23 when subjective sensations were included.
02No lower-limb responses were found on sensory evoked potential testing or on brain stimulation of motor pathways.
03Subjective sensations during testing were reported by 10 of 23 participants, even though clinical sensory scores in the corresponding areas were 0.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 23 people were studied at one hospital, so these prevalence estimates are narrow. The estimate changed from 17% to 39% to 52% depending on how strict the definition was, so the result is not one fixed number. The study was not blinded or randomized, and one test was done by two examiners. Some participants did not receive every test: four lacked ulnar nerve testing, three right legs could not be tested, and four did not receive spinal stimulation. The study did not include sensory fMRI, a method recent studies indicate may be sensitive for detecting remaining connections. It measured possible residual connections, not movement, daily function, or response to treatment, and the pain and spasticity comparison may have been too small to detect a difference.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 17 to 52 percent as evidence that a treatment works. The study measured possible residual connections, not movement or treatment benefit, and no intervention was tested.