Preliminary data of a neuroselective study of sensory pathways in spinal cord injured (SCI) patients

Introduction/Background Analyze the integrity of sacral area sensory pathways in all its components (Aβ, Aδ and C fibers). We evaluated the relative activation state of each single fiber and correlated these data with the clinical conditions, especially the AIS (American spinal cord injury association Injury Score), to define the grade of SCI completeness. Material and method We examined 25 patients affected by acute post-traumatic SCI and admitted between June 2015 and 2016. Lesion level: 10 quadriplegic (all incomplete) and 15 paraplegic patients (8 complete, 7 incomplete); average age 36.2 y (12–71); time between traumatic event and evaluation  ® ; we analysed the pudendal nerve (Penis Dorsal nerve in male and Superficial Perineal nerve in female). Results In 3 of the 8 AIS A patients we found out a residual activity of sensory fibres (normal activity of C fibres and inactivity of Aβ fibres) showing a discrepancy in AIS score between clinical and instrumental findings (discomplete lesions). Accidentally we found out that this typical sensory fibres activation pattern (observed in 13 of 25 patients) was also associated with non-responder, high-grade neuropathic pain (NRS 8–10/10). Conclusion The presence of a discomplete lesion could lead to a different rehabilitation programme; early identification of patients presenting a typical fibers activation pattern associated with neuropathic pain could give us the opportunity to design a tailored therapy before the onset of chronic pain and overactivities; could the neuromodulation of inactive Aβ fibers be a new therapeutic target?