PMID- 34854934 OWN - NLM STAT- MEDLINE DCOM- 20220202 LR - 20220915 IS - 1432-1106 (Electronic) IS - 0014-4819 (Print) IS - 0014-4819 (Linking) VI - 240 IP - 1 DP - 2022 Jan TI - Spinal cord imaging markers and recovery of standing with epidural stimulation in individuals with clinically motor complete spinal cord injury. PG - 279-288 LID - 10.1007/s00221-021-06272-9 [doi] AB - Spinal cord epidural stimulation (scES) is an intervention to restore motor function in those with severe spinal cord injury (SCI). Spinal cord lesion characteristics assessed via magnetic resonance imaging (MRI) may contribute to understand motor recovery. This study assessed relationships between standing ability with scES and spared spinal cord tissue characteristics at the lesion site. We hypothesized that the amount of lateral spared cord tissue would be related to independent extension in the ipsilateral lower limb. Eleven individuals with chronic, clinically motor complete SCI underwent spinal cord MRI, and were subsequently implanted with scES. Standing ability and lower limb activation patterns were assessed during an overground standing experiment with scES. This assessment occurred prior to any activity-based intervention with scES. Lesion hyperintensity was segmented from T2 axial images, and template-based analysis was used to estimate spared tissue in anterior, posterior, right, and left spinal cord regions. Regression analysis was used to assess relationships between imaging and standing outcomes. Total volume of spared tissue was related to left (p = 0.007), right (p = 0.005), and bilateral (p = 0.011) lower limb extension. Spared tissue in the left cord region was related to left lower limb extension (p = 0.019). A positive trend (p = 0.138) was also observed between right spared cord tissue and right lower limb extension. In this study, MRI measures of spared spinal cord tissue were significantly related to standing outcomes with scES. These preliminary results warrant future investigation of roles of supraspinal input and MRI-detected spared spinal cord tissue on lower limb motor responsiveness to scES. CI - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Smith, Andrew C AU - Smith AC AD - Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado School of Medicine, Aurora, CO, USA. FAU - Angeli, Claudia A AU - Angeli CA AD - Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA. AD - Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, USA. AD - Department of Bioengineering, University of Louisville, Louisville, KY, USA. FAU - Ugiliweneza, Beatrice AU - Ugiliweneza B AD - Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA. AD - Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. AD - Department of Health Management and Systems Science, University of Louisville, Louisville, KY, USA. FAU - Weber, Kenneth A 2nd AU - Weber KA 2nd AD - Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. FAU - Bert, Robert J AU - Bert RJ AD - Department of Radiology, University of Louisville, Louisville, KY, USA. FAU - Negahdar, Mohammadjavad AU - Negahdar M AD - Department of Radiology, University of Louisville, Louisville, KY, USA. FAU - Mesbah, Samineh AU - Mesbah S AD - Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA. FAU - Boakye, Maxwell AU - Boakye M AD - Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA. AD - Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. FAU - Harkema, Susan J AU - Harkema SJ AD - Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA. AD - Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY, USA. AD - Department of Bioengineering, University of Louisville, Louisville, KY, USA. AD - Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. FAU - Rejc, Enrico AU - Rejc E AUID- ORCID: 0000-0001-9368-2220 AD - Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA. enrico.rejc@louisville.edu. AD - Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. enrico.rejc@louisville.edu. LA - eng GR - K12 HD055931/HD/NICHD NIH HHS/United States GR - R03 HD094577/HD/NICHD NIH HHS/United States PT - Journal Article DEP - 20211202 PL - Germany TA - Exp Brain Res JT - Experimental brain research JID - 0043312 SB - IM MH - Epidural Space/diagnostic imaging MH - Humans MH - Spinal Cord/diagnostic imaging MH - *Spinal Cord Injuries/diagnostic imaging/therapy MH - *Spinal Cord Stimulation MH - Standing Position PMC - PMC9469645 MID - NIHMS1835080 OTO - NOTNLM OT - Epidural stimulation OT - Spinal cord MRI OT - Spinal cord injury OT - Spinal cord lesion OT - Standing COIS- Conflict of interest The authors declare no competing interests. EDAT- 2021/12/03 06:00 MHDA- 2022/02/03 06:00 PMCR- 2022/09/13 CRDT- 2021/12/02 12:22 PHST- 2021/07/10 00:00 [received] PHST- 2021/10/20 00:00 [accepted] PHST- 2021/12/03 06:00 [pubmed] PHST- 2022/02/03 06:00 [medline] PHST- 2021/12/02 12:22 [entrez] PHST- 2022/09/13 00:00 [pmc-release] AID - 10.1007/s00221-021-06272-9 [pii] AID - 10.1007/s00221-021-06272-9 [doi] PST - ppublish SO - Exp Brain Res. 2022 Jan;240(1):279-288. doi: 10.1007/s00221-021-06272-9. Epub 2021 Dec 2.