ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
TMS-Indexed neurophysiological signatures of neural compensation in spinal cord injury: associations with injury level, motor function, and affective modulation.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSpinal cord injury (SCI) impairs motor, autonomic, and sensory functions from nerve damage. Transcranial Magnetic Stimulation (TMS) enables non-invasive assessment of cortical excitability, essential for understanding neuroplasticity and its role in motor and cognitive recovery in SCI patients.
objectiveTo identify associations between sociodemographic and clinical factors predicting corticospinal excitability in SCI patients.
methodsWe analyzed 102 individuals from the DEFINE cohort using cross-sectional analysis and linear and logistic regression models. TMS metrics were primary outcomes.
resultsAge correlated positively with Motor Threshold (MT) (β = 0.29, p < 0.001), and non-white participants had higher MT than white participants (β = 4.79, p = 0.028). Thoracic and lumbar lesions were negatively associated with MT (β = -9.34, p < 0.001; β = -13.13, p < 0.001). Thoracic and lumbar lesions increased the odds of Motor Evoked Potentials (MEP) above the median by 62.2% (OR = 1.62, p < 0.001) and 54% (OR = 1.54, p = 0.011), respectively. Higher hand strength was linked to lower Intracortical Inhibition (ICI) (β = -0.0062, p = 0.023), while anxiety increased ICI (β = 0.0311, p = 0.003). Females had higher Intracortical Facilitation (ICF) than males (β = 0.14, p = 0.033), and lumbar lesions increased ICF compared to cervical (β = 0.147, p = 0.026).
conclusionCortical excitability in subjects with SCI is influenced by age, race, lesion level, and psychological factors. The observed associations in motor threshold, theta activity, and lesion level underscore the need for personalized rehabilitation strategies.
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