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. 2016 Jan 7:2:15018.
doi: 10.1038/scsandc.2015.18. eCollection 2016.

Motor evoked potential and voluntary EMG activity after olfactory mucosal autograft transplantation in a case of chronic, complete spinal cord injury: case report

Koichi Iwatsuki  1 , Fumihiro Tajima  2 , Yoshiyuki Sankai  3 , Yu-Ichiro Ohnishi  1 , Takeshi Nakamura  2 , Masahiro Ishihara  1 , Koichi Hosomi  1 , Koshi Ninomiya  1 , Takashi Moriwaki  1 , Toshiki Yoshimine  1
Affiliations

Motor evoked potential and voluntary EMG activity after olfactory mucosal autograft transplantation in a case of chronic, complete spinal cord injury: case report

Koichi Iwatsuki et al. Spinal Cord Ser Cases. .

Erratum in

Abstract

The efficacy of olfactory mucosal autografts (OMAs) for chronic spinal cord injury (SCI) has been reported, but there is no report documenting electrophysiological conductivity via the emergence of motor evoked potentials (MEPs). We report the case of a 39-year-old man with chronic, complete SCI at T8, who exhibited MEPs after OMA transplantation, and, with intensive rehabilitation, was ultimately able to ambulate with short leg braces and Lofstrand crutches. The initial injury occurred in a motor vehicle accident in November 1999 and resulted in a complete loss of sensorimotor function below T8. OMA transplantation to the injury site was performed in March 2010 in combination with intensive pre- and postoperative rehabilitation. The patient exhibited voluntary electromyograph (EMG) activity and MEPs at 96 and 144 weeks after transplantation and he was was ambulatory with short leg braces and Lofstrand crutches at 144 weeks after transplantation. We were able to elicit MEPs after OMA with intensive rehabilitation. To our knowledge, this is the first report of recovery of electrophysiological conductivity in the spinal cord after any type of treatment for chronic, complete SCI.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging (MRI). (a) T1-weighted sagittal image before transplantation shows atrophic change of the thoracic spinal cord. (b) T2-weighted sagittal image before transplantation shows an intramedullary high-intensity area. MRI at 48 weeks after transplantation shows fairly complete filling of cavities with heterogeneous intensity on T1- (c) and T2-weighted (d) images. (e) Gadolinium-enhanced images also show heterogeneous enhancement of the grafts. No evidence of neoplastic tissue overgrowth was observed during the initial follow-up period.
Figure 2
Figure 2
ASIA motor scores (lower extremity). The patient’s score improved from 0 to 2 by week 24, 0 to 4 by weak 48 and 0 to 6 by weak 144, respectively.
Figure 3
Figure 3
Upper: we did not detect EMG signals in the leg during walking at 48 weeks after OMA transplantation. Lower: we detected EMG signals in the leg during walking at 96 and 144 weeks after OMA transplantation. EMG signals at 144 weeks after OMA transplantation are shown.
Figure 4
Figure 4
This image represents the motor evoked potential that was elicited in response to bifocal transcranial magnetic stimulation of the rectus femoris muscles.
See this image and copyright information in PMC

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