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a Division of
Neuroscience and Psychological Medicine, Imperial College School of
Medicine, Charing Cross Hospital, Fulham Palace Road, London, UK, b National Spinal Injuries
Centre, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
Correspondence to: Dr Nick J Davey, Department of Sensorimotor Systems, Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. Telephone 0044 181 846 7284; fax 0044 181 846 7338; email n.davey{at}cxwms.ac.uk
Received 8 July 1997 and in revised form 14 October 1997;
Accepted 25 November
1997
OBJECTIVE
To
investigate changes in electromyographic (EMG) responses to
transcranial magnetic stimulation (TMS) of the motor cortex after
incomplete spinal cord injury in humans.
METHODSA group of 10 patients with incomplete spinal cord injury (motor level C3-C8) was
compared with a group of 10 healthy control subjects. Surface EMG
recordings were made from the thenar muscles. TMS was applied with a 9 cm circular stimulating coil centred over the vertex. The EMG responses
to up to 50 magnetic stimuli were rectified and averaged.
RESULTSThresholds for
compound motor evoked potentials (cMEPs) and suppression of voluntary
contraction (SVC) elicited by TMS were higher (p<0.05) in the patient
group. Latency of cMEPs was longer (p<0.05) in the patient group in
both relaxed (controls 21.3 (SEM 0.5) ms; patients 27.7 (SEM 1.3) ms)
and voluntarily contracted (controls 19.8 (SEM 0.5) ms; patients 27.6 (SEM 1.3) ms) muscles. The latency of SVC
was longer (p<0.05) in the patients (51.8 (SEM 1.8) ms) than in the controls (33.4 (SEM 1.9) ms). The latency difference
(SVC
cMEP) was longer in the patients (25.3 (SEM 2.4) ms) than in the controls (13.4 (SEM 1.6) ms).
CONCLUSIONThe longer
latency difference between cMEPs and SVC in the patients may reflect a
weak or absent early component of cortical inhibition. Such a change
may contribute to the restoration of useful motor function after
incomplete spinal cord injury.
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