Evidence map›Paper›PMID 40165994›Full record

ArticleBrain & spine2025

Diagnostic and prognostic value of navigated transcranial magnetic stimulation to assess motor function in patients with acute traumatic spinal cord injury.

Maximilian Schwendner, Marianne Kanaris, Anthony M DiGiorgio, Michael C Huang, Geoffrey T Manley, Phiroz E Tarapore

Abstract read
In one paragraph

Article in Brain & spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maximilian SchwendnerDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany.
Marianne KanarisDepartment of Neurological Surgery, Zuckerberg San Francisco General Hospital, University of California San Francisco, USA.
Anthony M DiGiorgioDepartment of Neurological Surgery, Zuckerberg San Francisco General Hospital, University of California San Francisco, USA.
Michael C HuangDepartment of Neurological Surgery, Zuckerberg San Francisco General Hospital, University of California San Francisco, USA.
Geoffrey T ManleyDepartment of Neurological Surgery, Zuckerberg San Francisco General Hospital, University of California San Francisco, USA.
Phiroz E TaraporeDepartment of Neurological Surgery, Zuckerberg San Francisco General Hospital, University of California San Francisco, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Traumatic spinal cord injuries (SCI) represent a profoundly life-altering diagnosis. Research question: The aim of this study was to evaluate the diagnostic and prognostic value of navigated transcranial magnetic stimulation (nTMS) in assessing motor function in the management of patients with acute SCI. Material and methods: nTMS motor mapping of both upper extremities (UE) and lower extremities (LE) was performed in patients suffering from acute traumatic SCI. Data from intraoperative neuromonitoring (IONM) and patient outcomes, including American Spinal Injury Association Impairment Scale (AISA) scores, were analyzed. Results: The patients had a mean age of 68.9 ± 15.6 years (range: 28-94 years). Preoperatively, 7 patients (35.0%) were classified as AISA A or B, and 13 (65.0%) were classified as AISA C or D. At follow-up, 5 patients (25.0%) had improved.In all patients motor evoked potentials (MEPs) were elicited. MEPs of UE muscles were observed in 38 (61.3%) muscles in IONM and 41 (66.1%) muscles in TMS. MEPs of LE muscles were observed in 5 (19.2%) and 7 (26.9%) muscles, respectively. eCombining the results of IONM and nTMS, a sensitivity of 0.852 and a specificity of 0.889 for motor function of the tested muscle at follow-up was achieved for upper extremity muscles. For lower extremity muscles, a sensitivity of 0.571 and a specificity of 1.00 was achieved. Discussion and conclusion: nTMS in patients with acute SCI provides an objective assessment of motor system integrity. Despite a relatively low sensitivity, potentially due to decreased excitability, this technique exhibited excellent specificity in predicting short-term and long-term motor outcomes.

Indexed as

Intensive careMotor-evoked potentialsnavigated transcranial magnetic stimulationSpinal cord injury

Identifiers

PMID40165994
PMCPMC11957525

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.