Annals of Rehabilitation Medicine

"Central cord syndrome"

Original Article

Repetitive Transcranial Magnetic Stimulation Enhances Recovery in Central Cord Syndrome Patients: Hana Choi, Kyung Cheon Seo, Tae Uk Kim, Seong Jae Lee, Jung Keun Hyun; Ann Rehabil Med 2019;43(1):62-73. Published online February 28, 2019; DOI: https://doi.org/10.5535/arm.2019.43.1.62

Abstract
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Objective
To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on neurological and functional recovery in patients with central cord syndrome (CCS) involving the upper extremities between the treated and non-treated sides of the treated group and whether the outcomes are comparable to that of the untreated control group.
Methods
Nineteen CCS patients were treated with high-frequency (20 Hz) rTMS over the motor cortex for 5 days. The stimulation side was randomly selected, and all the subjects received conventional occupational therapy during the rTMS-treatment period. Twenty CCS patients who did not receive rTMS were considered as controls. Clinical assessments, including those by the International Standard for Neurological Classification of Spinal Cord Injury, the Jebsen-Taylor Hand Function Test, and the O'Connor Finger Dexterity Test were performed initially and followed up for 1 month after rTMS treatment or 5 weeks after initial assessments.
Results
The motor scores for upper extremities were increased and the number of improved cases was greater for the treated side in rTMS-treated patients than for the non-treated side in rTMS-treated patients or controls. The improved cases for writing time and score measured on the Jebsen-Taylor Hand Function Test were also significantly greater in number on the rTMS-treated side compared with the non-treated side and controls. There were no adverse effects during rTMS therapy or the follow-up period.
Conclusion
The results of the application of high-frequency rTMS treatment to CCS patients suggest that rTMS can enhance the motor recovery and functional fine motor task performance of the upper extremities in such individuals.

Citations

Citations to this article as recorded by

Therapeutic efficacy of repetitive transcranial magnetic stimulation on gait and limb balance function in patients with lower limb dysfunction post-cerebral infarction: a systematic review and meta-analysis
De-mei Jia, Xuan Li, Bin-cang Zhang, Bing-ran Zhang, Qiu-juan Zhang, Ming-wei Liu, Lin-ming Zhang
BMC Neurology.2025;[Epub] CrossRef
Stimulation Parameters Used During Repetitive Transcranial Magnetic Stimulation for Motor Recovery and Corticospinal Excitability Modulation in SCI: A Scoping Review
Nabila Brihmat, Didier Allexandre, Soha Saleh, Jian Zhong, Guang H. Yue, Gail F. Forrest
Frontiers in Human Neuroscience.2022;[Epub] CrossRef
rTMS induces analgesia and modulates neuroinflammation and neuroplasticity in neuropathic pain model rats
Roberta Ströher Toledo, Dirson João Stein, Paulo Roberto Stefani Sanches, Lisiane Santos da Silva, Helouise Richardt Medeiros, Felipe Fregni, Wolnei Caumo, Iraci L.S. Torres
Brain Research.2021; 1762: 147427. CrossRef
Research on Assisting Clinicians to Operate rTMS Precisely Based on the Coil Magnetic Field Spatial Distribution With Magnetic Resonance Imaging Navigation
Shijun Li, Yi Wang, ShengJie Li, Yanwei Lv, Lei Zhang, Jun Zou, Lin Ma
Frontiers in Neuroscience.2019;[Epub] CrossRef
Effects of Combined Upper Limb Robotic Therapy in Patients With Tetraplegic Spinal Cord Injury
Joo Hwan Jung, Hye Jin Lee, Duk Youn Cho, Jung-Eun Lim, Bum Suk Lee, Seung Hyun Kwon, Hae Young Kim, Su Jeong Lee
Annals of Rehabilitation Medicine.2019; 43(4): 445. CrossRef

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Case Report

A Case of Central Cord Syndrome Related Status Epilepticus - A Case Report -: Soyoung Lee, Jee-eun Lee, Shimo Yang, Hyukwon Chang; Ann Rehabil Med 2011;35(4):574-578. Published online August 31, 2011; DOI: https://doi.org/10.5535/arm.2011.35.4.574

Abstract
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Central cord syndrome (CCS) is extremely rare as a direct consequence of generalized epileptic seizure. CCS is associated with hyperextension of the spinal cord and has characteristic radiologic findings including posterior ligamentous injury and prevertebral hyperintensity following magnetic resonance imaging (MRI). We experienced the case of a 25-year-old man who suffered CCS after status epilepticus. Cervical spinal MRI revealed high signal intensity at the C1 level but with no signal or structural changes in other sites. After rehabilitation management, the patient significantly improved on the ASIA (American Spinal Injury Association) motor scale and bladder function. We proposed that epilepsy related CCS may be caused by muscle contractions during generalized seizure, which can induce traction injury of the spinal cord or relative narrowing of spinal canal via transient herniated nucleus pulposus or transient subluxation of vertebra. We also suggest CCS without radiologic findings of trauma has good prognosis compared with other CCS.

Citations

Citations to this article as recorded by

Central cord syndrome: Mechanisms, clinical presentation, and management strategies
Antoinette J. Charles, Kristina Andrade, Edwin Owolo, Connor Barrett, Emily Luo, Ikechukwu C. Amakiri, C. Rory Goodwin, Melissa M. Erickson
Seminars in Spine Surgery.2024; 36(2): 101101. CrossRef
Spinal cord injury and its underlying mechanism in rats with temporal lobe epilepsy
Jinjie Liu, Zanhua Liu, Guoliang Liu, Kai Gao, Hengjie Zhou, Yongbo Zhao, Hong Wang, Lin Zhang, Sibo Liu
Experimental and Therapeutic Medicine.2020;[Epub] CrossRef
Central Cord Syndrome in a 7-Year-Old Boy Secondary to Standing High Jump
Sang Ku Jung, Hyung Jin Shin, Hui Dong Kang, Se Hyun Oh
Pediatric Emergency Care.2014; 30(9): 640. CrossRef

52,761 View
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Original Articles

Central Cord Syndrome Developed in Patients with Ossification of the Posterior Longitudinal Ligament: Clinical Features and Functional Outcomes.: Jung, Se Hee , Bang, Moon Suk , Lee, Kun Jai , Kim, Don Kyu , Han, Tai Ryoon; J Korean Acad Rehabil Med 2005;29(6):591-597.

Abstract
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Objective
Ossification of the posterior longitudinal ligament (OPLL) is a degenerative disorder of the spine which is related to cervical compressive myelopathy. We studied patients with central cord syndrome (CCS) to explore the implication of OPLL on clinical features and functional outcomes of CCS. Method: A retrospective study was conducted on 26 patients with CCS between 1998 and 2003. Demographic characteristics, mechanisms of injury, neurological impairments, main functional outcomes, and complications were identified. Clinical features and outcomes were compared between OPLL and non-OPLL group. Results: Twenty patients with CCS had OPLL (12/17 with traumatic and 8/9 with non-traumatic CCS). The initial ASIAObjective: Ossification of the posterior longitudinal ligament (OPLL) is a degenerative disorder of the spine which is related to cervical compressive myelopathy. We studied patients with central cord syndrome (CCS) to explore the implication of OPLL on clinical features and functional outcomes of CCS. Method: A retrospective study was conducted on 26 patients with CCS between 1998 and 2003. Demographic characteristics, mechanisms of injury, neurological impairments, main functional outcomes, and complications were identified. Clinical features and outcomes were compared between OPLL and non-OPLL group. Results: Twenty patients with CCS had OPLL (12/17 with traumatic and 8/9 with non-traumatic CCS). The initial ASIAmotor score of OPLL and non-OPLL patients was 67.8 and 65.3 and, at discharge, 82.8 and 78.5. There were no significant differences in gait, bladder management, length of stay, discharge disposition, and major complications between OPLL and non-OPLL group. Among OPLL patients, non- traumatic CCS patients showed higher ASIA motor score at discharge and had a tendency of better functional outcome than traumatic CCS patients. Conclusion: OPLL was commonly observed in CCS patients. Mechanism of injury rather than the presence of OPLL was a significant determinant of clinical features or functional outcomes of CCS. (J Korean Acad Rehab Med 2005; 29: 591-597)

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Functional Recovery of Patients with Traumatic Central Cord Syndrome.: Lim, Seong Hoon , Ko, Young Jin , Shin, Ji Nam , Kang, Sae Yoon , Moon, Seungguk , Kim, Jong Hyun; J Korean Acad Rehabil Med 2002;26(3):285-291.

Abstract
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Objective: The aim of this study was to identify factors influencing the degree of neurological injury, show the natural course of recovery, and evaluate the relationship between degree of neurological injury and functional recovery from traumatic central cord syndrome.

Method: We reviewed 15 patients retrospectively and investigated their demographic and treatment data. Initial ASIA motor scales and functional recovery at 4 weeks and 8 weeks after injury were analyzed.

Results: The age of patients showed significant correlation with degree of neurological injury (r=⁣0.55145, p＜0.05) while mechanism of injury, surgical intervention and gender difference showed no correlation. Only 2 patients (13.3%) ambulated independently at initial period but subsequently 13 patients (86.7%) at 8 weeks. The number of patients who independently voided increased from 2 (13.3%) to 11 (73.3%) during the 8 weeks. Early ASIA motor score differed significantly according to the degree of functional recovery of bladder and ambulation in 4 weeks, 8 weeks after injury (p＜0.05).

Conclusion: Only the age of patients related to the initial neurologic severity. Most patients regained their bladder and ambulatory functions considerably within 8 weeks, and the degree of early neurological injury by ASIA motor scale reflected the degree of functional recovery in 4 and 8 weeks after injury. (J Korean Acad Rehab Med 2002; 26: 285-291)