Supraspinal and Afferent Signaling Facilitate Spinal Sensorimotor Network Excitability After Discomplete Spinal Cord Injury: A Case Report

• Published in: Frontiers in neuroscience Vol. 14; p. 552
• Main Authors: Militskova, Alena, Mukhametova, Elvira, Fatykhova, Elsa, Sharifullin, Safar, Cuellar, Carlos A., Calvert, Jonathan S., Grahn, Peter J., Baltina, Tatiana, Lavrov, Igor
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Research Foundation 22.06.2020; Frontiers Media S.A
• Subjects: AIS-A; Body weight; Case reports; discomplete spinal cord injury; Electrical stimuli; Excitability; Magnetic resonance imaging; Motor evoked potentials; Muscles; Neuroscience; Paralysis; Rehabilitation; Sensorimotor system; Sensory neurons; Spinal cord injuries; spinal cord injury; spinal cord stimulation; Spine; sub-lesional spinal circuitry; Surgery; Ultrasonic imaging; Vertebrae; spinal cord injury; sub-lesional spinal circuitry; AIS-A; spinal cord stimulation; discomplete spinal cord injury
• ISSN: 1662-453X; 1662-4548; 1662-453X
• DOI: 10.3389/fnins.2020.00552

In this study, we evaluated the role of residual supraspinal and afferent signaling and their convergence on the sublesional spinal network in subject diagnosed with complete paralysis (AIS-A). A combination of electrophysiologic techniques with positional changes and subject-driven reinforcement maneuvers was implemented in this study. Electrical stimulation was applied transcutaneously at the T9-L2 vertebra levels and the spinal cord motor evoked potentials (SEMP) were recorded from leg muscles. To test the influence of positional changes, the subject was placed in (i) supine, (ii) upright with partial body weight bearing and (iii) vertically suspended without body weight bearing positions. Increase in amplitude of SEMP was observed during transition from supine to upright position, supporting the role of sensory input in lumbosacral network excitability. Additionally, amplitudes of SEMP were facilitated during reinforcement maneuvers, indicating a supralesional influence on sub-lesional network. After initial assessment, subject underwent rehabilitation therapy with following electrophysiological testing that reviled facilitation of SEMP. These results demonstrate that combination of electrophysiological techniques with positional and reinforcement maneuvers can add to the diagnostics of discomplete SCI. These findings also support an idea that integration of supraspinal and afferent information on sub-lesional circuitry plays a critical role in facilitation of spinal sensorimotor network in discomplete SCI.