Abstract: Medical imaging allows for the visualization of spinal cord compression sites; however, it is impossible to assess the impact of visible stenotic sites on neuronal functioning, which is crucial information to formulate a correct prognosis and install targeted therapy. It is hypothesized that with the transcranial electrical stimulation (TES) technique, neurological impairment can be reliably diagnosed. Unassigned: To evaluate the ability of the TES technique to assess neuronal functional integrity in ataxic horses by recording TES-induced muscular evoked potentials (MEPs) in three different muscles and to structurally involve multiple ancillary diagnostic techniques, such as clinical neurological examination, plain radiography (RX) with ratio assessment, contrast myelography, and post-mortem gross and histopathological examination. Unassigned: Nine ataxic horses, showing combined fore and hindlimb ataxia (grades 2-4), were involved, together with 12 healthy horses. TES-induced MEPs were recorded bilaterally at the level of the trapezius (TR), the extensor carpi radialis (ECR), and tibialis cranialis (TC) muscles. Two Board-certified radiologists evaluated intra- and inter-sagittal diameter ratios on RX, reductions of dorsal contrast columns, and dural diameters (range skull-T1). Post-mortem gross pathological and segmental histopathological examination was also performed by a Board-certified pathologist. Unassigned: TES-MEP latencies were significantly prolonged in both ECR and TC in all ataxic horses as opposed to the healthy horses. The TR showed a mixed pattern of normal and prolonged latency times. TES-MEP amplitudes were the least discriminative between healthy and ataxic horses. Youden's cutoff latencies for ataxic horses were 24.6 ms for the ECR and 45.5 ms for the TC (sensitivity and specificity of 100%). For healthy horses, maximum latency values were 22 and 37 ms, respectively. RX revealed spinal cord compression in 8 out of 9 involved ataxic horses with positive predictive values of 0-100%. All ataxic horses showed multi-segmental Wallerian degeneration. All pathological changes recorded in the white matter of the spinal cord were widely dispersed across all cervical segments, whereas gray matter damage was more localized at the specific segmental level. Unassigned: TES-MEP latencies are highly sensitive to detect impairment of spinal cord motor functions for mild-to-severe ataxia (grades 2-4).
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The research paper examines the use of transcranial electrical stimulation (TES) to measure neuronal functional integrity in horses with ataxia. The study found that the TES technique with muscular evoked potentials (MEPs) recording was able to distinguish healthy horses from ataxic horses and thus can be used as an effective diagnostic tool for spinal cord impairments.
Methodology
The researchers used nine ataxic horses and twelve healthy horses for the study.
TES-induced MEPs were recorded in three different muscles: trapezius (TR), extensor carpi radialis (ECR), and tibialis cranialis (TC).
Two certified radiologists evaluated intra- and inter-sagittal diameter ratios using plain radiography (RX).
They also checked reductions of dorsal contrast columns and dural diameters from the skull to T1 vertebra.
Post-mortem gross pathological and segmental histopathological examination was also conducted by a certified pathologist.
Findings
TES-MEP latencies, or the delay before occurrence of a response, were significantly prolonged in both ECR and TC muscles in all ataxic horses compared to healthy horses. The TR muscle showed a mixed pattern of normal and prolonged latency times.
TES-MEP amplitudes, or the size of a response, were not as useful in differentiating between ataxic and healthy horses.
Youden’s cutoff latencies for ataxic horses were 24.6 ms for the ECR and 45.5 ms for the TC, with a sensitivity and specificity rate of 100%. For healthy horses, the maximum latency values were shorter, at 22 and 37 ms respectively.
Plain Radiography (RX) revealed spinal cord compression in 8 out of 9 involved ataxic horses. The positive predictive values varied from 0-100%.
All ataxic horses showed multi-segmental Wallerian degeneration, a form of nerve degeneration resulting from damage to the neuron.
Pathological changes in the white matter of the spinal cord were widely present across all cervical segments. Damage to the gray matter was more localized at the specific segmental level.
Conclusions
The researchers concluded that TES-MEP latencies are a sensitive measure to detect impairment of spinal cord motor functions in horses exhibiting mild to severe ataxia.
TES-MEP can therefore be utilized effectively as a diagnostic tool for ataxic conditions in horses.
Cite This Article
APA
Journée SL, Journée HL, Bergmann W, Chantziaras I, Vanderperren K, Raes E, Reed SM, de Bruijn CM, Berends HI, Delesalle CJG.
(2024).
Evaluation of the diagnostic value of transcranial electrical stimulation (TES) to assess neuronal functional integrity in horses.
Front Neurosci, 18, 1342803.
https://doi.org/10.3389/fnins.2024.1342803
Department of Translational Physiology, Infectiology and Public Health, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Journée, Henricus Louis
Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Orthopedics, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
Department of Orthopedics, Amsterdam University Medical Center, Amsterdam, Netherlands.
Bergmann, Wilhelmina
Department of Biomolecular Health Sciences, Division of Pathology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands.
Chantziaras, Ilias
Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Vanderperren, Katrien
Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Raes, Els
Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Reed, Stephen Michael
Rood and Riddle Equine Hospital, Lexington, KY, United States.
Maxwell H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, United States.
de Bruijn, Cornelis Marinus
Wolvega Equine Clinic, Oldeholtpade, Netherlands.
Berends, Hanneke Irene
Department of Orthopedics, Amsterdam University Medical Center, Amsterdam, Netherlands.
Delesalle, Cathérine John Ghislaine
Department of Translational Physiology, Infectiology and Public Health, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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