Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
Spinal Cord. 2019 Nov;57(11):909-923. doi: 10.1038/s41393-019-0331-z. Epub 2019 Jul 23.
Narrative review.
To discuss how electrophysiology may contribute to future clinical trials in spinal cord injury (SCI) in terms of: (1) improvement of SCI diagnosis, patient stratification and determination of exclusion criteria; (2) the assessment of adverse events; and (3) detection of therapeutic effects following an intervention.
An international expert panel for electrophysiological measures in SCI searched and discussed the literature focused on the topic.
Electrophysiology represents a valid method to detect, track, and quantify readouts of nerve functions including signal conduction, e.g., evoked potentials testing long spinal tracts, and neural processing, e.g., reflex testing. Furthermore, electrophysiological measures can predict functional outcomes and thereby guide rehabilitation programs and therapeutic interventions for clinical studies.
Objective and quantitative measures of sensory, motor, and autonomic function based on electrophysiological techniques are promising tools to inform and improve future SCI trials. Complementing clinical outcome measures, electrophysiological recordings can improve the SCI diagnosis and patient stratification, as well as the detection of both beneficial and adverse events. Specifically composed electrophysiological measures can be used to characterize the topography and completeness of SCI and reveal neuronal integrity below the lesion, a prerequisite for the success of any interventional trial. Further validation of electrophysiological tools with regard to their validity, reliability, and sensitivity are needed in order to become routinely applied in clinical SCI trials.
叙述性评论。
讨论电生理学如何在以下方面为脊髓损伤 (SCI) 的未来临床试验做出贡献：(1) 改善 SCI 诊断、患者分层和排除标准的确定；(2) 评估不良事件；(3) 检测干预后的治疗效果。
一个针对 SCI 电生理测量的国际专家小组搜索并讨论了该主题的文献。
电生理学是一种有效的方法，可以检测、跟踪和量化神经功能的读数，包括信号传导，例如，诱发电位测试长脊髓束，以及神经处理，例如，反射测试。此外，电生理测量可以预测功能结果，从而指导康复计划和治疗干预的临床试验。
基于电生理技术的感觉、运动和自主功能的客观和定量测量是告知和改善未来 SCI 试验的有前途的工具。补充临床结果测量，电生理记录可以改善 SCI 诊断和患者分层，以及有益和不良事件的检测。专门组成的电生理测量可以用于描述 SCI 的地形和完整性，并揭示损伤以下的神经元完整性，这是任何介入试验成功的前提。为了在临床 SCI 试验中常规应用，需要进一步验证电生理工具的有效性、可靠性和敏感性。
