@article{ref1,
title="A new score based on the international standards for neurological classification of spinal cord injury for integrative evaluation of changes in sensorimotor functions",
journal="Journal of neurotrauma",
year="2021",
author="Grassner, Lukas and Garcia-Ovejero, Daniel and Mach, Orpheus and Lopez-Dolado, Elisa and Vargas-Vaquero, Eduardo and Alcobendas, Monica and Esclarin, Ana and Sanktjohanser, Ludwig and Wutte, Christof and Becker, Johannes and Lener, Sara and Hartmann, Sebastian and Girod, Pierre-Pascal and Koegl, Nikolaus and Griessenauer, Christoph and Papadopoulos, Marios C. and Geisler, Fred and Thomé, Claudius and Molina-Holgado, Eduardo and Vidal, Joan and Curt, Armin and Scivoletto, Giorgio and Guest, James and Maier, Doris and Weidner, Norbert and Rupp, Rüdiger and Kramer, John L. K. and Arevalo-Martin, Angel",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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.<p /> <p>Language: en</p>",
language="en",
issn="0897-7151",
doi="10.1089/neu.2021.0368",
url="http://dx.doi.org/10.1089/neu.2021.0368"
}