Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients
BackgroundFunctional changes after spinal cord injury (SCI) are related to changes in cortical plasticity. These changes can be measured with electroencephalography (EEG) and has potential to be used as a clinical biomarker.MethodIn this longitudinal study participants underwent a total of 30 sessio...
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2021.548558/full |
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| author | Marcel Simis Deniz Doruk Camsari Deniz Doruk Camsari Marta Imamura Thais Raquel Martins Filippo Daniel Rubio De Souza Linamara Rizzo Battistella Felipe Fregni |
| author_facet | Marcel Simis Deniz Doruk Camsari Deniz Doruk Camsari Marta Imamura Thais Raquel Martins Filippo Daniel Rubio De Souza Linamara Rizzo Battistella Felipe Fregni |
| author_sort | Marcel Simis |
| collection | DOAJ |
| description | BackgroundFunctional changes after spinal cord injury (SCI) are related to changes in cortical plasticity. These changes can be measured with electroencephalography (EEG) and has potential to be used as a clinical biomarker.MethodIn this longitudinal study participants underwent a total of 30 sessions of robotic-assisted gait training (RAGT) over a course of 6 weeks. The duration of each session was 30 min. Resting state EEG was recorded before and after 30-session rehabilitation therapy. To measure gait, we used the Walking Index for Spinal Cord Injury Scale, 10-Meter- Walking Test, Timed-Up-and-Go, and 6-Min-Walking Test. Balance was measured using Berg Balance Scale.ResultsFifteen participants with incomplete SCI who had AIS C or D injuries based on American Spinal Cord Injury Association Impairment Scale classification were included in this study. Mean age was 35.7 years (range 17–51) and the mean time since injury was 17.08 (range 4–37) months. All participants showed clinical improvement with the rehabilitation program. EEG data revealed that high beta EEG activity in the central area had a negative correlation with gait (p = 0.049; β coefficient: −0.351; and adj-R2: 0.23) and balance (p = 0.043; β coefficient: −0.158; and adj-R2:0.24) measured at baseline, in a way that greater high beta EEG power was related to worse clinical function at baseline. Moreover, improvement in gait and balance had negative correlations with the change in alpha/theta ratio in the parietal area (Gait: p = 0.049; β coefficient: −0.351; adj-R2: 0.23; Balance: p = 0.043; β coefficient: −0.158; and adj-R2: 0.24).ConclusionIn SCI, functional impairment and subsequent improvement following rehabilitation therapy with RAGT correlated with the change in cortical activity measured by EEG. Our results suggest that EEG alpha/theta ratio may be a potential surrogate marker of functional improvement during rehabilitation. Future studies are necessary to improve and validate these findings as a neurophysiological biomarker for SCI rehabilitation. |
| first_indexed | 2024-12-20T03:11:45Z |
| format | Article |
| id | doaj.art-03f4bb2d5feb44a58122dc75317f51a1 |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-12-20T03:11:45Z |
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| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-03f4bb2d5feb44a58122dc75317f51a12022-12-21T19:55:27ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612021-04-011510.3389/fnhum.2021.548558548558Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury PatientsMarcel Simis0Deniz Doruk Camsari1Deniz Doruk Camsari2Marta Imamura3Thais Raquel Martins Filippo4Daniel Rubio De Souza5Linamara Rizzo Battistella6Felipe Fregni7Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United StatesNeuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United StatesHospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilUniversidade Paulista and Universidade Nove de Julho, São Paulo, BrazilHospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilHospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilNeuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United StatesBackgroundFunctional changes after spinal cord injury (SCI) are related to changes in cortical plasticity. These changes can be measured with electroencephalography (EEG) and has potential to be used as a clinical biomarker.MethodIn this longitudinal study participants underwent a total of 30 sessions of robotic-assisted gait training (RAGT) over a course of 6 weeks. The duration of each session was 30 min. Resting state EEG was recorded before and after 30-session rehabilitation therapy. To measure gait, we used the Walking Index for Spinal Cord Injury Scale, 10-Meter- Walking Test, Timed-Up-and-Go, and 6-Min-Walking Test. Balance was measured using Berg Balance Scale.ResultsFifteen participants with incomplete SCI who had AIS C or D injuries based on American Spinal Cord Injury Association Impairment Scale classification were included in this study. Mean age was 35.7 years (range 17–51) and the mean time since injury was 17.08 (range 4–37) months. All participants showed clinical improvement with the rehabilitation program. EEG data revealed that high beta EEG activity in the central area had a negative correlation with gait (p = 0.049; β coefficient: −0.351; and adj-R2: 0.23) and balance (p = 0.043; β coefficient: −0.158; and adj-R2:0.24) measured at baseline, in a way that greater high beta EEG power was related to worse clinical function at baseline. Moreover, improvement in gait and balance had negative correlations with the change in alpha/theta ratio in the parietal area (Gait: p = 0.049; β coefficient: −0.351; adj-R2: 0.23; Balance: p = 0.043; β coefficient: −0.158; and adj-R2: 0.24).ConclusionIn SCI, functional impairment and subsequent improvement following rehabilitation therapy with RAGT correlated with the change in cortical activity measured by EEG. Our results suggest that EEG alpha/theta ratio may be a potential surrogate marker of functional improvement during rehabilitation. Future studies are necessary to improve and validate these findings as a neurophysiological biomarker for SCI rehabilitation.https://www.frontiersin.org/articles/10.3389/fnhum.2021.548558/fullspinal cord injuryelectroencephalographyrehabilitationbiomarkersneuroplasticity |
| spellingShingle | Marcel Simis Deniz Doruk Camsari Deniz Doruk Camsari Marta Imamura Thais Raquel Martins Filippo Daniel Rubio De Souza Linamara Rizzo Battistella Felipe Fregni Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients Frontiers in Human Neuroscience spinal cord injury electroencephalography rehabilitation biomarkers neuroplasticity |
| title | Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients |
| title_full | Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients |
| title_fullStr | Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients |
| title_full_unstemmed | Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients |
| title_short | Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients |
| title_sort | electroencephalography as a biomarker for functional recovery in spinal cord injury patients |
| topic | spinal cord injury electroencephalography rehabilitation biomarkers neuroplasticity |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2021.548558/full |
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