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Grassner L, Garcia-Ovejero D, Mach O, et al. A NEW SCORE BASED ON THE INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY FOR INTEGRATIVE EVALUATION OF CHANGES IN SENSORIMOTOR FUNCTIONS. J Neurotrauma. 2021;doi: 10.1089/neu.2021.0368.
Grassner, L., Garcia-Ovejero, D., Mach, O., Lopez-Dolado, E., Vargas-Vaquero, E., Alcobendas, M., Esclarin, A., Sanktjohanser, L., Wutte, C., Becker, J., Lener, S., Hartmann, S., Girod, P. P., Koegl, N., Griessenauer, C., Papadopoulos, M. C., Geisler, F., Thomé, C., Molina-Holgado, E., Vidal, J., Curt, A., Scivoletto, G., Guest, J., Maier, D., Weidner, N., Rupp, R., Kramer, J. L. K., & Arevalo-Martin, A. (2021). A NEW SCORE BASED ON THE INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY FOR INTEGRATIVE EVALUATION OF CHANGES IN SENSORIMOTOR FUNCTIONS. Journal of neurotrauma, . https://doi.org/10.1089/neu.2021.0368
Grassner, Lukas, et al. "A NEW SCORE BASED ON THE INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY FOR INTEGRATIVE EVALUATION OF CHANGES IN SENSORIMOTOR FUNCTIONS." Journal of neurotrauma vol. (2021). doi: https://doi.org/10.1089/neu.2021.0368
Grassner L, Garcia-Ovejero D, Mach O, Lopez-Dolado E, Vargas-Vaquero E, Alcobendas M, Esclarin A, Sanktjohanser L, Wutte C, Becker J, Lener S, Hartmann S, Girod PP, Koegl N, Griessenauer C, Papadopoulos MC, Geisler F, Thomé C, Molina-Holgado E, Vidal J, Curt A, Scivoletto G, Guest J, Maier D, Weidner N, Rupp R, Kramer JLK, Arevalo-Martin A. A NEW SCORE BASED ON THE INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY FOR INTEGRATIVE EVALUATION OF CHANGES IN SENSORIMOTOR FUNCTIONS. J Neurotrauma. 2021 Dec 23; doi: 10.1089/neu.2021.0368. Epub 2021 Dec 23. PMID: 34937399.
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J Neurotrauma. 2021 Dec 23; doi: 10.1089/neu.2021.0368. Epub 2021 Dec 23.

A NEW SCORE BASED ON THE INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY FOR INTEGRATIVE EVALUATION OF CHANGES IN SENSORIMOTOR FUNCTIONS.

Journal of neurotrauma

Lukas Grassner, Daniel Garcia-Ovejero, Orpheus Mach, Elisa Lopez-Dolado, Eduardo Vargas-Vaquero, Monica Alcobendas, Ana Esclarin, Ludwig Sanktjohanser, Christof Wutte, Johannes Becker, Sara Lener, Sebastian Hartmann, Pierre-Pascal Girod, Nikolaus Koegl, Christoph Griessenauer, Marios C Papadopoulos, Fred Geisler, Claudius Thomé, Eduardo Molina-Holgado, Joan Vidal, Armin Curt, Giorgio Scivoletto, James Guest, Doris Maier, Norbert Weidner, Rüdiger Rupp, John L K Kramer, Angel Arevalo-Martin

Affiliations

  1. Innsbruck Medical University Department of Neurology and Neurosurgery, 417777, Innsbruck, Tirol, Austria.
  2. Paracelsus Medical University Salzburg, 31507, Institute of Molecular Regenerative Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Salzburg, Austria; [email protected].
  3. Hospital Nacional de Parapléjicos, SESCAM, Laboratorio de Neuroinflamación, Finca La Peraleda, Toledo, Spain, 45071; [email protected].
  4. Trauma Center Murnau, Center for Spinal Cord Injuries, Prof.-Kuentscher-Str. 8, Murnau, Germany, 82418; [email protected].
  5. Hospital Nacional de Paraplejicos, Physical Medicine and Rehabilitation, Toledo, Spain; [email protected].
  6. Hospital Nacional de Paraplejicos, Sexual Medicine Unit, Toledo, Spain; [email protected].
  7. Hospital Nacional de Paraplejicos, Physical Medicine and Rehabilitation, Toledo, Spain; [email protected].
  8. HOSPITAL NACIONAL DE PARAPLEJICOS, Physical Medicine and Rehabilitation, Finca de la Peraleda S/N, Toledo, Toledo, Spain, 45007.
  9. Fund; [email protected].
  10. Trauma Center Murnau, Center for Spinal Cord Injuries, Murnau, Germany; [email protected].
  11. Trauma Center Murnau, Center for Spinal Cord Injuries, Murnau, Germany; [email protected].
  12. Trauma Center Murnau, Center for Spinal Cord Injuries, Murnau, Germany; [email protected].
  13. Innsbruck Medical University Department of Neurology and Neurosurgery, 417777, Innsbruck, Tirol, Austria; [email protected].
  14. Innsbruck Medical University Department of Neurology and Neurosurgery, 417777, Innsbruck, Tirol, Austria; [email protected].
  15. Innsbruck Medical University Department of Neurology and Neurosurgery, 417777, Innsbruck, Tirol, Austria; [email protected].
  16. Innsbruck Medical University Department of Neurology and Neurosurgery, 417777, Innsbruck, Tirol, Austria; [email protected].
  17. Geisinger Health System, 2780, Neurosurgery, Danville, Pennsylvania, United States.
  18. Harvard Medical School, 1811, Neurological Surgery, Boston, Massachusetts, United States; [email protected].
  19. St George's University of London, Academic Neurosurgery Unit, St George's, University of London, 1.122 Jenner Wing, Cranmer Terrace, London, United Kingdom of Great Britain and Northern Ireland, SW17 0RE; [email protected].
  20. University of Saskatchewan College of Medicine, 12371, Saskatoon, Saskatchewan, Canada; [email protected].
  21. Medical University Innsbruck, Dept. of Neurosurgery, Anichstr. 35, Innsbruck, Austria, 6020; [email protected].
  22. Hospital Nacional de Parapléjicos, SESCAM, Laboratorio de Neuroinflamación, Finca La Peraleda s/n, Toledo, Spain, 45071; [email protected].
  23. Institut Guttmann, 83068, Badalona, Catalunya, Spain; [email protected].
  24. University Hospital Balgrist, Spinal Cord Injury Center, Forchstrasse, Zurich, Switzerland, 8008; [email protected].
  25. IRCCS Fondazioen S. Lucia, Spinal Cord Unit, via Ardeatina 306, Rome, Italy, 00179; [email protected].
  26. University of Miami, Neurological Surgery, 1095 NW 14th Terrace, Miami, Florida, United States, 33136; [email protected].
  27. Trauma Center Murnau, Center for Spinal Cord Injuries, Murnau, Germany; [email protected].
  28. University Hospital Heidelberg, Spinal Cord Injury Center, Schlierbacher Landstr, Heidelberg, Germany, 69118; [email protected].
  29. University Hospital Heidelberg, Spinal Cord Injury Center, Schlierbacher Landstr. 200a, Heidelberg, BW, Germany, 69118; [email protected].
  30. University of British Columbia International Collaboration on Repair Discoveries, 507272, Vancouver, British Columbia, Canada; [email protected].
  31. Hospital Nacional de Paraplejicos, Laboratory of Neuroinflammation, Finca la Peraleda, s/n, Toledo, Spain, 45071; [email protected].

PMID: 34937399 DOI: 10.1089/neu.2021.0368

Abstract

Sensorimotor function of patients with spinal cord injury (SCI) is commonly assessed according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). From the ISNCSCI segmental motor and sensory assessments, upper and lower extremity motor scores (UEMS and LEMS), sum scores of pin prick (PP) and light touch (LT) sensation, the neurological level of injury (NLI) and the classification of lesion severity according to the American Spinal Injury Association Impairment Scale (AIS) grade are derived. Changes of these parameters over time are widely used to evaluate neurological recovery. However, evaluating recovery based on a single ISNCSCI scoring or classification variable may misestimate overall recovery. Here, we propose an Integrated Neurological Change Score (INCS) based on the combination of normalized changes between two-time points of UEMS, LEMS, and total PP and LT scores. To assess the agreement of INCS with clinical judgement of meaningfulness of neurological changes, changes of ISNCSCI variables between two time-points of 88 patients from an independent cohort were rated by 20 clinical experts according to a 5-categories Likert Scale. As for individual ISNCSCI variables, neurological change measured by INCS is associated to severity (AIS grade), age and time since injury, but INCS better reflects clinical judgment about meaningfulness of neurological changes than individual ISNCSCI variables. In addition, INCS is related with changes in functional independence measured by the Spinal Cord Independence Measure (SCIM) in patients with tetraplegia. INCS may be a useful measure of overall neurological change in clinical studies.

Keywords: ASSESSMENT TOOLS; LOCOMOTOR FUNCTION; OUTCOME MEASURES; SENSORY FUNCTION; spinal cord injury

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