Spinal cord imaging markers and recovery of standing with epidural stimulation in individuals with clinically motor complete spinal cord injury

Exp Brain Res, 2022 · DOI: 10.1007/s00221-021-06272-9 · Published: January 1, 2022

Simple Explanation

This study investigates the relationship between spinal cord tissue characteristics, as seen on MRI, and the ability to stand with epidural stimulation (scES) in individuals with motor complete spinal cord injury (SCI). Researchers hypothesized that the amount of spared tissue in the spinal cord would correlate with the ability to extend the lower limbs independently. The study found that the amount of spared spinal cord tissue was indeed related to the ability to stand with scES, suggesting that even small amounts of spared tissue can contribute to motor recovery.

Study Duration

Not specified

Participants

Eleven individuals with chronic, clinically motor complete SCI

Evidence Level

Not specified

Key Findings

1
Total volume of spared tissue was related to left, right, and bilateral lower limb extension.
2
Spared tissue in the left cord region was related to left lower limb extension.
3
Standing ability was not found to be related with the two features characterizing the scES paddle electrode position with respect to the lumbosacral spinal cord

Research Summary

This study investigated the relationship between spared spinal cord tissue, as measured by MRI, and standing ability with spinal cord epidural stimulation (scES) in individuals with clinically motor complete spinal cord injury (SCI). The key finding was that the amount of spared spinal cord tissue was significantly related to standing outcomes with scES, specifically the ability to extend the lower limbs. These results suggest that even limited spared fibers in the spinal cord can contribute to motor recovery with scES, warranting further investigation into the role of supraspinal input and spared tissue.

Practical Implications

Personalized Therapy

MRI measures of spared spinal cord tissue may help predict responsiveness to scES and tailor therapeutic interventions.

Targeted Interventions

Focusing on interventions that promote the use of spared neural pathways may enhance motor recovery.

Improved Understanding of SCI

Further research can clarify the mechanisms by which spared tissue contributes to motor function with scES.

Study Limitations

1
Routine clinical MRIs of modest resolution
2
Manual nature of lesion and spinal cord segmentation
3
Future research is warranted and underway to expand the number of participants and collect high-resolution MRI across the lesion site

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