Simple methods of examination in paraplegia: I. the spoon test

Bors, Ernest

doi:10.1038/sc.1964.4

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…Of the non- painful tactile phantoms, 4 were evoked by contact in RZ (2͞12 subjects, 16%). This incidence of tactile RPS is in agreement with the only prior study (to our knowledge) that has examined tactile RPS after SCI (34), which reported RPS in 12% of SCI subjects.…”

Section: Resultssupporting

confidence: 91%

“…In a pattern analogous to the RPS evoked by tactile contact in Subject 1, Bors (34) observed RZ on the chest with RPS in the upper leg or sacral region in three of six SCI subjects with RZ. Similarly, in a subject with T8-level complete SCI, electrical stimulation of regions of the ventral thalamus that had receptive fields on the chest evoked sensations in the upper thigh region (57).…”

Section: Previous Studies Of Perceptual and Cortical Reorganization Amentioning

confidence: 80%

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Referred phantom sensations and cortical reorganization after spinal cord injury in humans

Moore

Stern

Dunbar

et al. 2000

Proc. Natl. Acad. Sci. U.S.A.

121

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To test the hypothesis that cortical remapping supports phantom sensations, we examined referred phantom sensations and cortical activation in humans after spinal-cord injury (SCI) at the thoracic level (T3-T12). Of 12 SCI subjects, 9 reported phantom sensations, and 2 reported referred phantom sensations. In both of these subjects, referred phantom sensations were evoked by contact in reference zones (RZ) that were not adjacent in the periphery and were not predicted to be adjacent in the postcentral gyrus (PoCG), suggesting that representations separated by centimeters of cortical space were simultaneously engaged. This finding was supported by functional MRI (fMRI). In a subject with a T6-level complete SCI, contact in RZ on the left or right forearm projected referred phantom sensations to the ipsilateral chest. During fMRI, contact in either forearm RZ evoked activity in the central PoCG (the position of the forearm representation) and the medial PoCG (the position of the chest representation) with >1.6 cm of nonresponsive cortex intervening. In contrast, stimulation in non-RZ forearm and palm regions in this subject and in lesion-matched SCI subjects evoked central but not medial PoCG activation. Our findings support a relation between PoCG activation and the percept of referred phantom sensations. These results, however, present an alternative to somatotopic cortical reorganization, namely, cortical plasticity expressed in coactivation of nonadjacent representations. The observed pattern suggests that somatotopic subcortical remapping, projected to the cortex, can support perceptual and cortical reorganization after deafferentation in humans.A variety of types of deafferentation evoke reorganization of somatosensory maps within the central nervous system (CNS). Rapid reorganization, occurring within minutes after deafferentation, has been observed in the mammalian brainstem, thalamus, and cortex (1-3). This process likely depends on the disinhibition or facilitation of existing divergent subthreshold inputs and may be a general feature of neural coding (4, 5). Long-term deafferentation in monkeys, assessed months to years after sensory loss, induces more extensive remapping (6-10) and is associated with anatomic changes within the CNS. These changes include the sprouting of new connections into deafferented territory [spinal cord and dorsal column nuclei (11, 12); areas 3b and 1 (13)] and transneuronal atrophy in deafferented structures (14,15). The most extensive cortical reorganization, spanning over a centimeter within the cortex, has been observed after the combination of long-term recovery and CNS lesions (9,14,16). Typically, studies of deafferentation-driven plasticity in the cortex have emphasized the takeover of deafferented representations by the expansion of inputs from adjacent representations, a somatotopic pattern of reorganization (6-10).After deafferentation, patients often feel a vivid percept of the deafferented region, a phenomenon referred to as a phantom sensation (17,18). In a subset...

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Section: Resultssupporting

confidence: 91%

Section: Previous Studies Of Perceptual and Cortical Reorganization Amentioning

confidence: 80%

Referred phantom sensations and cortical reorganization after spinal cord injury in humans

Moore

Stern

Dunbar

et al. 2000

Proc. Natl. Acad. Sci. U.S.A.

121

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show abstract

“…The spoon test qualitatively evaluates the smoothness with which the convex side of a spoon slides over moist skin. It does not require any pharmacological stimulation of the sweat glands and is extremely easy-to-perform [58]. Its major limitation is the lack of quantitative assessment as the results depend on the investigator's perception of the spoon sliding.…”

Section: Non-axon-reflex-based Sudomotor Testsmentioning

confidence: 99%

Assessment of cutaneous axon-reflex responses to evaluate functional integrity of autonomic small nerve fibers

et al. 2020

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Cutaneous autonomic small nerve fibers encompass unmyelinated C-fibers and thinly myelinated Aδ-fibers, which innervate dermal vessels (vasomotor fibers), sweat glands (sudomotor fibers), and hair follicles (pilomotor fibers). Analysis of their integrity can capture early pathology in autonomic neuropathies such as diabetic autonomic neuropathy or peripheral nerve inflammation due to infectious and autoimmune diseases. Furthermore, intraneural deposition of alpha-synuclein in synucleinopathies such as Parkinson's disease can lead to small fiber damage. Research indicated that detection and quantitative analysis of small fiber pathology might facilitate early diagnosis and initiation of treatment. While autonomic neuropathies show substantial etiopathogenetic heterogeneity, they have in common impaired functional integrity of small nerve fibers. This impairment can be evaluated by quantitative analysis of axonal responses to iontophoretic application of adrenergic or cholinergic agonists to the skin. The axon-reflex can be elicited in cholinergic sudomotor fibers to induce sweating and in cholinergic vasomotor fibers to induce vasodilation. Currently, only few techniques are available to quantify axon-reflex responses, the majority of which is limited by technical demands or lack of validated analysis protocols. Function of vasomotor small fibers can be analyzed using laser Doppler flowmetry, laser Doppler imaging, and laser speckle contrast imaging. Sudomotor function can be assessed using quantitative sudomotor axon-reflex test, silicone imprints, and quantitative direct and indirect testing of sudomotor function. More recent advancements include analysis of piloerection (goose bumps) following stimulation of adrenergic small fibers using pilomotor axon-reflex test. We provide a review of the current literature on axon-reflex tests in cutaneous autonomic small fibers.

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Die Bedeutung der Druckmessung der hinteren Harnröhre bei neurogener Detrusor-Blasenhals-Dysfunktion und Hyperreflexie

Schurch¹,

Rossier²

1997

Neurogene Blasenfunktionsstörung Neurogene Sexualstörung

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Simple methods of examination in paraplegia: I. the spoon test

Cited by 7 publications

References 10 publications

Referred phantom sensations and cortical reorganization after spinal cord injury in humans

Referred phantom sensations and cortical reorganization after spinal cord injury in humans

Assessment of cutaneous axon-reflex responses to evaluate functional integrity of autonomic small nerve fibers

Die Bedeutung der Druckmessung der hinteren Harnröhre bei neurogener Detrusor-Blasenhals-Dysfunktion und Hyperreflexie

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