M Liechti1, R Müller, T Lam, A Curt. 1. Balgrist University Hospital, Spinal Cord Injury Center, Forchstrasse 340, 8008 Zurich, Switzerland.
Abstract
OBJECTIVE: Postural instability limits ambulatory capacity in patients with spinal cord injury (SCI). Galvanic vestibular stimulation (GVS) was used to investigate the integrity of vestibulospinal pathways and related changes in postural responses in SCI. METHODS: Binaural bipolar galvanic stimuli of 400 ms duration and 3 mA intensity were applied in 8 motor incomplete SCI and 8 control subjects who stood facing towards the left. EMG responses were recorded from the right soleus muscle and the trajectory of the centre of pressure (CoP) was measured with a force plate. RESULTS: There was no difference in excitability and amplitude of the responses between the groups. However, the latency and duration of the medium latency EMG response and all CoP responses were significantly longer in the SCI group. Additionally, postural stability was reduced in the SCI group, as shown by a greater tendency to fall due to GVS. CONCLUSIONS: Despite early EMG responses proving the basic connectivity of the direct vestibulospinal pathways, the delayed GVS responses suggest a vestibulospinal deficit in the SCI subjects. SIGNIFICANCE: GVS can be applied in incomplete SCI to supplement the neurological examination by revealing changes in vestibulospinal responses and impairment of postural stability.
OBJECTIVE: Postural instability limits ambulatory capacity in patients with spinal cord injury (SCI). Galvanic vestibular stimulation (GVS) was used to investigate the integrity of vestibulospinal pathways and related changes in postural responses in SCI. METHODS:Binaural bipolar galvanic stimuli of 400 ms duration and 3 mA intensity were applied in 8 motor incomplete SCI and 8 control subjects who stood facing towards the left. EMG responses were recorded from the right soleus muscle and the trajectory of the centre of pressure (CoP) was measured with a force plate. RESULTS: There was no difference in excitability and amplitude of the responses between the groups. However, the latency and duration of the medium latency EMG response and all CoP responses were significantly longer in the SCI group. Additionally, postural stability was reduced in the SCI group, as shown by a greater tendency to fall due to GVS. CONCLUSIONS: Despite early EMG responses proving the basic connectivity of the direct vestibulospinal pathways, the delayed GVS responses suggest a vestibulospinal deficit in the SCI subjects. SIGNIFICANCE: GVS can be applied in incomplete SCI to supplement the neurological examination by revealing changes in vestibulospinal responses and impairment of postural stability.
Authors: Marc Bolliger; Andrew R Blight; Edelle C Field-Fote; Kristin Musselman; Serge Rossignol; Dorothy Barthélemy; Laurent Bouyer; Milos R Popovic; Jan M Schwab; Michael L Boninger; Keith E Tansey; Giorgio Scivoletto; Naomi Kleitman; Linda A T Jones; Dany H Gagnon; Sylvie Nadeau; Dirk Haupt; Lea Awai; Chris S Easthope; Björn Zörner; Ruediger Rupp; Dan Lammertse; Armin Curt; John Steeves Journal: Spinal Cord Date: 2018-04-27 Impact factor: 2.772