caa a22 4500 44583496X CHVBK 20180317145327.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00586-010-1627-z doi (NATIONALLICENCE)springer-10.1007/s00586-010-1627-z The cutaneous silent period is preserved in cervical radiculopathy: significance for the diagnosis of cervical myelopathy [Elektronische Daten] [A. Leis, Markus Kofler, Ivana Stetkarova, Dobrivoje Stokic] Electromyographic (EMG) activity from voluntarily contracting hand muscles undergoes transient suppression following nociceptive fingertip stimulation. This suppression is mediated by a spinal inhibitory reflex designated the cutaneous silent period (CSP). The CSP is abolished or altered in a variety of myelopathic conditions. However, before the CSP can gain acceptance as an aid in the diagnosis of myelopathy, the contribution of non-myelopathic conditions that can interrupt the afferent pathways responsible for the CSP needs to be considered. Accordingly, we examined the effect of radiculopathy on the CSP. Nociceptive stimulation was applied to thumb (C6 dermatome), middle (C7) and little (C8) fingers of 23 patients with cervical radiculopathy. Four or more CSP responses were recorded in abductor pollicis brevis muscle following digital stimulation. The patients had C6 (n=10), C7 (n=7), or C8 (n=6) radiculopathy documented by EMG. A complete CSP was elicited in 21 of 23 patients with comparable latencies and durations irrespective of digit stimulated. We conclude that the CSP is preserved in radiculopathy, probably because afferent impulses are carried by smaller, slower conducting ‘injury-resistant' A-delta fibers. These results provide important missing evidence that ensures specificity of CSP alterations in the diagnosis of cervical myelopathy. The finding that the CSP is spared in radiculopathy should open the door for investigators and clinicians to adopt this simple spinal inhibitory reflex as a physiologic aid in the diagnosis of spinal cord dysfunction. Springer-Verlag, 2010 Spinal reflex nationallicence A-delta fibers nationallicence Cutaneous silent period nationallicence Cervical radiculopathy nationallicence Leis A. Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, 39216, Jackson, MS, USA aut Kofler Markus Department of Neurology, Hochzirl Hospital, Zirl, Austria aut Stetkarova Ivana Department of Neurology, Na Homolce Hospital, Prague, Czech Republic aut Stokic Dobrivoje Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, 39216, Jackson, MS, USA aut European Spine Journal Springer-Verlag 20/2(2011-02-01), 236-239 0940-6719 20:2<236 2011 20 586 https://doi.org/10.1007/s00586-010-1627-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1627-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leis A. Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, 39216, Jackson, MS, USA aut NATIONALLICENCE 700 1- Kofler Markus Department of Neurology, Hochzirl Hospital, Zirl, Austria aut NATIONALLICENCE 700 1- Stetkarova Ivana Department of Neurology, Na Homolce Hospital, Prague, Czech Republic aut NATIONALLICENCE 700 1- Stokic Dobrivoje Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, 39216, Jackson, MS, USA aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/2(2011-02-01), 236-239 0940-6719 20:2<236 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer