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Abstract Details

Untreated Moderate-to-severe Sleep Apnea Is Associated with More Severe Spasticity in Individuals Living with Spinal Cord Injury: A Cross-sectional Prospective Study.
Neuro-rehabilitation
P7 - Poster Session 7 (11:45 AM-12:45 PM)
11-013
To study the potential association between the severity of spasticity and the degree of sleep-related breathing disorders (SRBDs) in individuals living with subacute/chronic spinal cord injury (SCI). 
SCI has been linked to increased frequencies of SRBDs (up to 50% after paraplegia, up to 90% following tetraplegia) and spasticity (up to 60% after tetraplegia). 
This cross-sectional prospective study examined the potential association between moderate-to-severe SRBD and more severe spasticity among adults with subacute/chronic (≥1 month since SCI), cervical/high-thoracic, complete/incomplete SCI. The diagnosis of SRBD was established using a home-based sleep apnea test that quantifies the apnea-hypopnea index (AHI). Spasticity was assessed using the modified Ashworth scale (MAS), and adjusted MAS based on the use of antispasmodic drugs. C-reactive protein (CRP) level was also measured.
By September/2023, we recruited 57 individuals (17 females, 40 males; ages: 20-84 years, mean age: 67.4 years) with motor complete (n=20) or incomplete SCI at cervical (n=48) or thoracic levels. Time from SCI onset varied from 1 month to 52 years (mean time: 34.4 months). Mean AHI was 19.2 events/hour (range: 0.8-66.2 events/hour). Total MAS varied from 0-12 (mean MAS: 5.3); adjusted MAS varied from 0-12 (mean adjusted-MAS: 5.5). A higher total MAS was associated with a greater AHI (P=0.0458, Rsqr=0.0701); there was also an association between a higher adjusted MAS and a greater AHI (P=0.0434, Rsqr=0.0721). Moreover, individuals with no/mild SRBD had less severe spasticity (lower adjusted MAS) than individuals with moderate-to-severe SRBD (P=0.0149). CRP levels varied from 0.5-101.2 mg/L; there were no significant differences between individuals with no/mild SRBDs and individuals with moderate-to-severe SRBDs regarding their CRP levels (P=0.9498).
Our preliminary results suggest that more severe SRBD is associated with a greater degree of spasticity following SCI. Treatment of SRBDs may have the potential to be a novel treatment target for managing spasticity in SCI.
Authors/Disclosures
Julio C. Furlan, MD, PhD, MBA, MSc, FAAN (Lyndhurst Centre, Toronto Rehabilitation Institute; University of Toronto)
PRESENTER 		The institution of Dr. Furlan has received research support from Wings for Life Spinal Cord Research Foundation. The institution of Dr. Furlan has received research support from Craig H Neilsen Foundation. The institution of Dr. Furlan has received research support from Ontario Neurotrauma Foundation. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from J P Bickell Foundation. The institution of Dr. Furlan has received research support from Praxis Spinal Cord Institute. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from CRANIA. The institution of Dr. Furlan has received research support from Craig H Neilsen Foundation. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from Tanenbaum Institute for Science in Sport. .
Eldon Loh No disclosure on file
Mark I. Boulos, MD, FRCPC, CSCN(EEG), MSc (Sunnybrook Health Sciences Centre) Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Precision AQ. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sleep Medicine (journal). The institution of Dr. Boulos has received research support from Canadian Institutes of Health Research. The institution of Dr. Boulos has received research support from Slamen-Fast New Initiatives in Neurology Award. The institution of Dr. Boulos has received research support from Green Mountain . The institution of Dr. Boulos has received research support from RLS Foundation. The institution of Dr. Boulos has received research support from Temerty Centre for AI Research and 好色先生 in Medicine (T-CAIREM). The institution of Dr. Boulos has received research support from Heart & Stroke Foundation of Canada. The institution of Dr. Boulos has received research support from Alternative Funding Plan from the Academic Health Sciences Centres of Ontario. The institution of Dr. Boulos has received research support from StrokeCog. The institution of Dr. Boulos has received research support from McLaughlin Centre for Molecular Medicine . Dr. Boulos has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with Jazz Pharmaceuticals.