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Use of the Audiospinal Response to Test for Completeness of Spinal Cord InjuryDepartment of Neurology, School of Medicine, University of California, Los Angeles, California
Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
School of Medicine, University of California, Los Angeles, California In this pilot study of patients with spinal cord injury (SCI), the audiospinal response (ASR), mediated by bilateral reticulospinal tracts, was assessed as a test for residual descending synaptic activity on cervical and lumbar motor pools. The Hoffman's reflex (H-reflex) from the flexor carpi radialis (FCR) and the soleus muscles was conditioned by an auditory stimulus. Facilitation of the Hmax amplitude was found in eleven control subjects. In three patients with a clinically complete mid-thoracic SCI, the FCR, but not the soleus H-reflex, was facilitated. One of two patients with a motor complete, sensory incomplete mid-thoracic lesion showed facilitation of the ASR at the soleus. Two patients with incomplete cervical lesions had facilitation of both H-reflexes. Since motor pool excitability may be high below a lesion, auditory conditioning of a sub-maximal H-reflex was used to reveal facilitation when Hmax was equivocally modulated by a sound burst. The ASR might serve as an adjunct to assessments for residual supraspinal influences in patients who meet clinical criteria for a complete motor spinal cord lesion.
Key Words: Rehabilitation • Spinal cord injury • H-reflex • Motor control • Electrodiagnosis.
Neurorehabilitation and Neural Repair, Vol. 8, No. 4,
187-191 (1994) |
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