State-of-the-Art Diagnostic Methods to Diagnose Equine Spinal Disorders, With Special Reference to Transcranial Magnetic Stimulation and Transcranial Electrical Stimulation.
Authors: Journée Sanne L, de Meeus d'Argenteuil Constance, De Maré Lorie, Boshuizen Berit, Vanderperren Katrien, Journée Louis H, de Bruijn Marco, Bergmann Wilhelmina, Delesalle Cathérine
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Spinal cord dysfunction remains prevalent in equine practice, yet pinpointing lesion location has proven diagnostically elusive because conventional imaging techniques provide anatomical but not functional information about neuronal pathways. Journée and colleagues reviewed contemporary diagnostic approaches for equine spinal disorders, with particular emphasis on transcranial magnetic stimulation (TMS) and the emerging technique of transcranial electrical stimulation (TES)—both non-invasive methods that assess corticospinal tract integrity by inducing and recording muscular responses through scalp-applied magnetic or electrical fields. Whilst TMS activates the motor cortex indirectly, TES bypasses cortical stimulation to directly activate corticospinal and extrapyramidal axons, offering superior functional specificity; crucially, evidence from human medicine indicates both techniques remain largely unaffected by sedation or anaesthesia, allowing reliable assessment during routine equine procedures. For farriers, veterinarians, and rehabilitation specialists, these electrophysiological methods could substantially improve diagnostic accuracy in cases of suspected spinal cord disease by differentiating functional deficits from imaging artefacts, ultimately enabling more targeted and evidence-based therapeutic interventions. The incorporation of TMS and particularly TES into equine practice represents a meaningful shift towards functional neurological assessment that complements rather than replaces traditional imaging.
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Practical Takeaways
- •TMS and TES offer functional neurological diagnostic information that imaging alone cannot provide, helping identify the site of spinal lesions in horses with equivocal clinical signs
- •These techniques can be performed safely under sedation or anesthesia, making them practical for routine equine clinical use
- •TES may offer advantages over TMS by directly stimulating motor pathways, potentially improving diagnostic accuracy for corticospinal and spinal cord disorders
Key Findings
- •TMS and TES are non-invasive brain stimulation techniques that can assess functional integrity of spinal motor tracts and nerve conduction pathways in horses
- •Unlike TMS, TES predominantly activates corticospinal and extrapyramidal axons directly rather than motor cortex, potentially offering greater diagnostic specificity
- •TMS and TES recordings are minimally affected by sedation or anesthesia in human medicine, enabling reliable assessment of functional neurological status in equine patients