Changes in Electrical Perception Threshold Within the First 6 Months After Traumatic Spinal Cord Injury

Hedel, Hubertus J. A. van; Kumru, Hatice; Röhrich, F.; Galen, Sujay

doi:10.1177/1545968311423669

Cited by 13 publications

(12 citation statements)

References 29 publications

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“…Interestingly, those findings were all at or above the LT level according to ISNCSCI, and are for the EPT findings in accordance to other studies. 7,12,22,23 Another discrepancy of segmental epicritic sensation was found below the level of injury according to ISCNSCI. LT revealed impaired response, whereas SWM classified 34.4% dermatomes and EPT classified 22.2% dermatomes as normal.…”

Section: Disparity and Sensitivitymentioning

confidence: 92%

“…This was repeated three times, and the lowest EPT (expressed in mA) of the three measurements was included in the analysis. Van Hedel et al 23 have established the normal values for the electrical perception threshold for each cervical dermatome. In our study, the qualification of normal values was based on the mean value of the upper limits of the 95% CI from the two measurements, which reflects normality according to van Hedel et al 23 In the present study, an impaired EPT value was defined as any value greater than the normative EPT value.…”

Section: Assessmentsmentioning

confidence: 99%

“…Van Hedel et al 23 have established the normal values for the electrical perception threshold for each cervical dermatome. In our study, the qualification of normal values was based on the mean value of the upper limits of the 95% CI from the two measurements, which reflects normality according to van Hedel et al 23 In the present study, an impaired EPT value was defined as any value greater than the normative EPT value. A normal EPT value was defined as any value equal or smaller than the normative EPT value, and the EPT value was considered absent, if the maximum current intensity (threshold at 8.4 mA) was not perceived.…”

Section: Assessmentsmentioning

confidence: 99%

“…7,12,[21][22][23] The EPT is defined as the lowest ascending electrical stimulus intensity expressed in mA at which the patient reports sensation. 6,24 The overall inter-and intra-tester reliabilities of EPT appear to be moderate to good in healthy participants 20,21 and participants with incomplete SCI.…”

Section: Introductionmentioning

confidence: 99%

“…24 However, the ICC varied considerably between individual dermatomes in healthy participants. 23 Therefore, there are different normative values for each dermatome. The EPT can be applied to all sensory dermatomes, and results can be interpreted quickly; however, the method is more time consuming than LT testing.…”

Section: Introductionmentioning

confidence: 99%

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Epicritic Sensation in Cervical Spinal Cord Injury: Diagnostic Gains Beyond Testing Light Touch

Velstra

Bolliger

Baumberger

et al. 2013

Journal of Neurotrauma

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Applied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pathway conveys several large diameter afferent modalities (e.g., sensation of touch, two-point discrimination, and proprioception). Therefore, the objective of this study was to compare the epicritic sensation assessed by LT, Semmes-Weinstein monofilament (SWM), and electrical perception threshold (EPT) across cervical dermatomes (C3-C8) in individuals with cervical SCI. A multicenter cross-sectional study was performed at 6 months after cervical SCI, applying combined measures of LT, SWM, and EPT, bilaterally over predefined key sensory points (C3-C8). A total of 300 left-and right-sided dermatomes were tested for each outcome measure in 25 participants. The percentage agreement between classifications according to LT and SWM/EPT testing for all dermatomes between C3 and C8 ranged from 95.5% to 36.2%. The degree of agreement showed considerably variable coefficients (-0.1kw0.7) for each dermatome between C3 and C8. The additional measurements of epicritic sensation by SWM and EPT increased sensitivity by detecting and quantifying differences in sensory thresholds above, at, and below the LT level of injury. This is relevant for early clinical trials (phase 1/2), in which disclosing any biological activity of an intervention may be revealed by subtle sensory changes that might gain a clinical relevance. AbstractApplied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pathway conveys several large diameter afferent modalities (e.g., sensation of touch, two-point discrimination, and proprioception). Therefore, the objective of this study was to compare the epicritic sensation assessed by LT, Semmes-Weinstein monofilament (SWM), and electrical perception threshold (EPT) across cervical dermatomes (C3-C8) in individuals with cervical SCI. A multicenter cross-sectional study was performed at 6 months after cervical SCI, applying combined measures of LT, SWM, and EPT, bilaterally over predefined key sensory points (C3-C8). A total of 300 left-and right-sided dermatomes were tested for each outcome measure in 25 participants. The percentage agreement between classifications according to LT and SWM/EPT testing for all dermatomes between C3 and C8 ranged from 95.5% to 36.2%. The degree of agreement showed considerably variable j coefficients ( -0.1 ‡ k w £ 0.7) for each dermatome between C3 and C8. The additional measurements of epicritic sensation by SWM and EPT increased sensitivity by detecting and quantifying differences in sensory thresholds above, at, and below the LT...

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Section: Disparity and Sensitivitymentioning

confidence: 92%

Section: Assessmentsmentioning

confidence: 99%