Team of health professionals from the Hospital for paraplegics in Toledo.
A group of researchers from Toledo Paraplegic Hospital has proposed a new scale which measures in a more comprehensive and precise way the neurological evolution after spinal cord injury. The study, published in the journal Journal of Neurotrauma, it serves to personalize rehabilitation therapy, see how it works over time and observe how the patient evolves.
The new scale called ‘Integrated Neurological Change Score’ (INCS), adds a more global and precise vision of the scale that is currently used throughout the world to measure the evolution of spinal cord damage.
To this end, the research group, led by Angel Arevaloa neuroscientist at the Neuroinflammation Laboratory of the National Hospital for Paraplegics, a center dependent on the Castilla-La Mancha Health Service, has had the participation of the world’s leading experts in the field of spinal cord injury, who have confirmed how clinical judgment on how much has improved or worsened a patient is better adjusted to INCS than to the scores provided by the standard procedure currently used internationally.
How is evolution studied after spinal cord injury?
The most widely used procedure to assess the extent of spinal cord injury routinely performed in all specialized centers around the world, consists of a neurological examination known by its acronym in English as Isncsciwhich would translate to International Standards for the Neurological Classification of Spinal Cord Injury. The general image that is obtained of the neurological state of the patient allows us to personalize the rehabilitation therapy. A process that lays the foundations for carrying out a Personalized medicine
In this way, through this means the gross sensitivity (pain, temperature, among others), fine sensitivity, motor skills of the upper extremities and motor skills of the lower extremities.
At this point, as Arévalo points out, “from these four evaluations, four different scores are obtained for sensitivity and motor skills and the level of injury is determined, which is the most caudal segment of the spinal cord, the lowest, in which sensation is preserved and there are useful, antigravity muscular movements. This exploration requires training of the evaluator so that the result is the same, regardless of the professional who performs it or the place where it is done”.
Thus, the group of researchers from the Hospital for Paraplegics in Toledo stresses that “what we have done is integrate into a single value, INCS, changes in the four sensitivity and motor scores. An analogy that can describe what we have done is that, with INCS, instead of seeing the traces we see the whole picture.”
It should be noted that, as Arévalo has pointed out, “it must be explained that the majority of patients experience changes in neurological function. Above all, in the first months after injury, although most of the time these changes do not have an impact on activities of daily living. But prognostic biomarkers of neurological recovery can be inferred from these changes, as we are interested in, which is useful in itself and, furthermore, can lay the foundations for the development of Personalized medicine in spinal cord injury”.
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