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1

Spinal Injuries in Children  

PubMed Central

About 5% of spinal injuries occur in children – however the consequences to the society are devastating, all the more so because the cervical spine is more commonly affected. Anatomical differences with adults along with the inherent elasticity of the pediatric spine, makes these injuries a biomechanically separate entity. Hence clinical manifestations are unique, one of which is the Spinal Cord Injury Without Radiological Abnormality. With the advent of high quality MRI and CT scan along with digital X-ray, it is now possible to exactly delineate the anatomical location, geometrical configuration, and the pathological extent of the injury. This has improved the management strategies of these unfortunate children and the role of surgical stabilization in unstable injuries can be more sharply defined. However these patients should be followed up diligently because of the recognized long term complications of spinal deformity and syringomyelia. PMID:22855681

Basu, Saumyajit

2012-01-01

2

Attitudes Towards Individuals with Spinal Cord Injuries  

ERIC Educational Resources Information Center

This paper will shed light on the lives of persons with spinal cord injuries by revealing the literature on spinal cord injuries that focuses on research that can shed light on attitudes towards persons with spinal cord injuries. The background literature related to incidences, the definition of spinal cord injury, and vocational opportunities are…

Conway, Cassandra Sligh D.; Gooden, Randy; Nowell, Jennifer; Wilson, Navodda

2010-01-01

3

Adjustment to Spinal Cord Injury  

MedlinePLUS

... to adjusting to spinal cord injury is personal motivation . Individuals who are newly injured are often motivated ... to find purpose in your life and the motivation to achieve your goals. It may help to ...

4

Depression and Spinal Cord Injury  

MedlinePLUS

... colleagues, with an educational grant from Pfizer Inc. University of Washington-operated SCI Clinics: Harborview Medical Center ... Spinal Cord Injury Clinic nurses: 206-744-5862 University of Washington Medical Center Rehabilitation Medicine Clinic 1959 ...

5

Spinal Injury Rehabilitation in Singapore.  

ERIC Educational Resources Information Center

This study reviewed 231 cases of spinal cord injury treated in Singapore. Data on demographic characteristics, common causes (mostly falls and traffic accidents), types of spinal damage, and outcomes are reported. Following rehabilitation, 68 patients were able to ambulate independently and 45 patients achieved independence in activities of daily…

Yen, H. L.; Chua, K.; Chan, W.

1998-01-01

6

Hyponatraemia after acute spinal injury.  

PubMed

Of 134 patients admitted to the Midlands Centre for Spinal Injuries within 2 days of the spinal injury during 1991-1992, 25 developed hyponatraemia in the acute phase. Hyponatraemia was most common among patients with complete tetraplegia (45 per cent) and these patients tended to be younger as well as have more severe and prolonged hyponatraemia. Overhydration is a common cause of hyponatraemia in this group of patients and should be avoided. PMID:8288360

Biyani, A; Inman, C G; el Masry, W S

1993-12-01

7

Aging with Spinal Cord Injury: Selected Topics  

Microsoft Academic Search

Spinal cord injury is a complex condition with many chal- lenging issues and co-morbid conditions. Aging with spinal cord injury adds to the complexity and can threaten the individual's independence. Some common medical complications associated with spinal cord injury and the effects of aging will be highlighted, to include the genitourinary system, the musculoskeletal system and pain, and the skin,

Deborah G. Stewart

8

Spinal Cord Injury in Youth  

Microsoft Academic Search

To identify special characteristics of the pediatric spinal cord-injured (SCI) population, we analyzed a database of 1,770 traumatic SCI patients; 88 (5%) fell into the two pediatric subgroups: 0-12 years (n = 26) and 13-15 years (n = 62) at time of injury. Differences between age groups were identified with regard to demographics, neurologic characteristics, associated injuries and complications, and

David F. Apple; Carol A. Anson; John D. Hunter; R. Bryan Bell

1995-01-01

9

Pregnancy following spinal cord injury.  

PubMed Central

Each year about 2,000 women of childbearing age in the United States have a spinal cord injury. Only a few mostly anecdotal reports describe pregnancy after such an injury. In a retrospective study of 16 women with a spinal cord injury, half of whom have a complete injury and about half quadriplegia, 25 pregnancies occurred, with 21 carried to full term. The women delayed pregnancy an average of 6.5 years after their injury, with an average age at first pregnancy of 26.8 years. Cesarean section was necessary in 4 patients because of inadequate progress of labor. In 5 deliveries an episiotomy and local anesthesia were required, 7 required epidural anesthesia, including all cesarean sections, and 10 did not require anesthesia. Several complications have been identified in the antepartum, intrapartum, and postpartum periods including autonomic hyperreflexia, premature labor, pressure sores, urinary tract infections, abnormal presentation, and failure to progress. Ultrasonography and amniocentesis were used selectively. Women with spinal cord injuries can have healthy children, although there are significant risks and these women have special needs. PMID:1866960

Cross, L. L.; Meythaler, J. M.; Tuel, S. M.; Cross, A. L.

1991-01-01

10

Spinal Cord Injury  

MedlinePLUS Videos and Cool Tools

... which could involve surgery. Secondly, the patient receives steroid medication as soon as possible after the injury. Recent studies show that steroids may help to improve neurological function. Rehabilitation As ...

11

Spinal Cord Injury (SCI)  

MedlinePLUS

... SCI in the United States. 2,14 Annually, 15 to 40 new cases per million people—or 12,000 to 20, ... injury patients. 1,2,8,9,11,14,15 Most new SCI cases occur in persons younger than 30 years old; ...

12

Pain Management Following Spinal Cord Injury  

MedlinePLUS

... SCI Care Center Spinal Cord Injury InfoSheet 10 Level - Consumer Pain Management following Spinal Cord Injury coming from somewhere other ... abdomen (stomach area) either above or below the level of injury. The pain is described as burning, ... Pain management usually includes treatment with medications, modified ...

13

Therapeutic approaches for spinal cord injury  

PubMed Central

This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a “disease that should not be treated.” Over the last two decades, several studies have been performed to obtain more effective treatments for spinal cord injury. Most of these studies approach a patient with acute spinal cord injury in one of four manners: corrective surgery or a physical, biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life. PMID:23070351

Cristante, Alexandre Fogaca; de Barros Filho, Tarcisio Eloy Pessoa; Marcon, Raphael Martus; Letaif, Olavo Biraghi; da Rocha, Ivan Dias

2012-01-01

14

Testosterone Plus Finasteride Treatment After Spinal Cord Injury  

ClinicalTrials.gov

Spinal Cord Injury; Spinal Cord Injuries; Trauma, Nervous System; Wounds and Injuries; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Gonadal Disorders; Endocrine System Diseases; Hypogonadism; Genital Diseases, Male

2014-09-22

15

Regional Spinal Cord Injury Rehabilitation Center.  

National Technical Information Service (NTIS)

The report consists of two basic parts. The first part deals with the findings and accomplishments which took place during this three-year period. The second part is a description of the spinal injury rehabilitation process, considering the Spinal Injury ...

E. S. Stauffer, N. E. Wilcox, V. L. Nickel, E. R. Erickson

1972-01-01

16

Causes of Spinal Cord Injury  

PubMed Central

Background: Knowledge of the causes of spinal cord injury (SCI) and associated factors is critical in the development of successful prevention programs. Objective: This study analyzed data from the National SCI Database (NSCID) and National Shriners SCI Database (NSSCID) in the United States to examine specific etiologies of SCI by age, sex, race, ethnicity, day and month of injury, and neurologic outcomes. Methods: NSCID and NSSCID participants who had a traumatic SCI from 2005 to 2011 with known etiology were included in the analyses (N=7,834). Thirty-seven causes of injury documented in the databases were stratified by personal characteristics using descriptive analysis. Results: The most common causes of SCI were automobile crashes (31.5%) and falls (25.3%), followed by gunshot wounds (10.4%), motorcycle crashes (6.8%), diving incidents (4.7%), and medical/surgical complications (4.3%), which collectively accounted for 83.1% of total SCIs since 2005. Automobile crashes were the leading cause of SCI until age 45 years, whereas falls were the leading cause after age 45 years. Gunshot wounds, motorcycle crashes, and diving caused more SCIs in males than females. The major difference among race/ethnicity was in the proportion of gunshot wounds. More SCIs occurred during the weekends and warmer months, which seemed to parallel the increase of motorcycle- and diving-related SCIs. Level and completeness of injury are also associated with etiology of injury. Conclusions: The present findings suggest that prevention strategies should be tailored to the targeted population and major causes to have a meaningful impact on reducing the incidence of SCI. PMID:23678280

2013-01-01

17

Nanomedicine for treating spinal cord injury.  

PubMed

Spinal cord injury results in significant mortality and morbidity, lifestyle changes, and difficult rehabilitation. Treatment of spinal cord injury is challenging because the spinal cord is both complex to treat acutely and difficult to regenerate. Nanomaterials can be used to provide effective treatments; their unique properties can facilitate drug delivery to the injury site, enact as neuroprotective agents, or provide platforms to stimulate regrowth of damaged tissues. We review recent uses of nanomaterials including nanowires, micelles, nanoparticles, liposomes, and carbon-based nanomaterials for neuroprotection in the acute phase. We also review the design and neural regenerative application of electrospun scaffolds, conduits, and self-assembling peptide scaffolds. PMID:23945984

Tyler, Jacqueline Y; Xu, Xiao-Ming; Cheng, Ji-Xin

2013-10-01

18

Antioxidant Therapies for Acute Spinal Cord Injury  

Microsoft Academic Search

Summary  One of the most investigated molecular mechanisms involved in the secondary pathophysiology of acute spinal cord injury (SCI)\\u000a is free radical-induced, iron-catalyzed lipid peroxidation (LP) and protein oxidative\\/nitrative damage to spinal neurons,\\u000a glia, and microvascular cells. The reactive nitrogen species peroxynitrite and its highly reactive free radicals are key initiators\\u000a of LP and protein nitration in the injured spinal cord,

Edward D. Hall

2011-01-01

19

Omental transposition in chronic spinal cord injury  

Microsoft Academic Search

The results of omental transposition in chronic spinal cord injury have been reported in 160 patients operated upon in the United States, Great Britain, China, Japan, India and Mexico, with detailed outcomes reported in few studies. Recovery of function to a greater degree than expected by natural history has been reported. In this series, 15 patients with chronic traumatic spinal

G L Clifton; W H Donovan; M M Dimitrijevic; S J Allen; A Ku; J R Potts; F G Moody; C Boake; A M Sherwood; J V Edwards

1996-01-01

20

Intractable Pruritus After Traumatic Spinal Cord Injury  

PubMed Central

Background: This report describes a young woman with incomplete traumatic cervical spinal cord injury and intractable pruritus involving her dorsal forearm. Method: Case report. Findings: Anatomic distribution of the pruritus corresponded to the dermatomal distribution of her level of spinal cord injury and vertebral fusion. Symptoms were attributed to the spinal cord injury and possible cervical root injury. Pruritus was refractory to all treatments, including topical lidocaine, gabapentin, transcutaneous electrical nerve stimulation, intravenous Bier block, stellate ganglion block, and acupuncture. Conclusions: Further understanding of neuropathic pruritus is needed. Diagnostic workup of intractable pruritus should include advanced imaging to detect ongoing nerve root compression. If diagnostic studies suggest radiculopathy, epidural steroid injection should be considered. Because the autonomic nervous system may be involved in complex chronic pain or pruritic syndromes, sympatholysis via such techniques as stellate ganglion block might be effective. PMID:19777867

Crane, Deborah A; Jaffee, Kenneth M; Kundu, Anjana

2009-01-01

21

What Are the Treatments for Spinal Cord Injury (SCI)?  

MedlinePLUS

... Resources and Publications What are the treatments for spinal cord injury (SCI)? Skip sharing on social media links Share ... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved May 22, 2012, from ...

22

Neurotrophic factors in spinal cord injury.  

PubMed

A major challenge in repairing the injured spinal cord is to assure survival of damaged cells and to encourage regrowth of severed axons. Because neurotrophins are known to affect these processes during development, many experimental approaches to improving function of the injured spinal cord have made use of these agents, particularly Brain derived neurotrophic factor (BDNF) and Neurotrophin-3 (NT-3). More recently, neurotrophins have also been shown to affect the physiology of cells and synapses in the spinal cord. The effect of neurotrophins on circuit performance adds an important dimension to their consideration as agents for repairing the injured spinal cord. In this chapter we discuss the role of neurotrophins in promoting recovery after spinal cord injury from both a structural and functional perspective. PMID:24668482

Boyce, Vanessa S; Mendell, Lorne M

2014-01-01

23

Supernumerary phantom limbs in spinal cord injury  

Microsoft Academic Search

Study design and objectives:Case report and review of supernumerary phantom limbs in patients suffering from spinal cord injury (SCI).Setting:SCI rehabilitation centre.Case report:After a ski accident, a 71-year-old man suffered an incomplete SCI (level C3; AIS C, central cord syndrome), with a C3\\/C4 dislocation fracture. From the first week after injury, he experienced a phantom duplication of both upper limbs that

A Curt; C Ngo Yengue; L M Hilti; P Brugger

2011-01-01

24

Vocational outcome following spinal cord injury  

Microsoft Academic Search

Study Design: Non-experimental (ex post facto) survey research design involving the use of a fixed alternative format questionnaire. Objectives: To investigate variables influencing vocational outcome, to identify barriers to gaining and sustaining employment and to identify the effects of variables on the type of work engaged in following spinal cord injury. The two sets of independent variables considered were, individual

L Conroy; K McKenna

1999-01-01

25

Vulnerable Groups Living with Spinal Cord Injury  

PubMed Central

There is considerable variation in rehabilitation outcomes within the population of spinal cord–injured individuals across racial and socioeconomic groups. This suggests that the long-term health following spinal cord injury (SCI) is determined, at least in part, by group differences in exposure to advantages and disadvantages among persons living in the community. This article conceptualizes the nature of vulnerability and how increased vulnerability leads to disparities in SCI outcomes. Demographic, socioeconomic, and geographic determinants of adverse outcomes among vulnerable groups are discussed. Finally, a research model that outlines potential processes that elicit vulnerability following SCI and clinical implications is reviewed. PMID:23966760

Fyffe, Denise C.; Botticello, Amanda L.; Myaskovsky, Larissa

2013-01-01

26

What Is Spinal Cord Injury?  

MedlinePLUS

... which are in the neck. There are 12 thoracic vertebrae (T1 through T12), which are located in ... motor function below the damaged area on the spine. There are many degrees of incomplete injury. 1 ...

27

Gene therapy approaches for spinal cord injury  

NASA Astrophysics Data System (ADS)

As the biomedical engineering field expands, combination technologies are demonstrating enormous potential for treating human disease. In particular, intersections between the rapidly developing fields of gene therapy and tissue engineering hold promise to achieve tissue regeneration. Nonviral gene therapy uses plasmid DNA to deliver therapeutic proteins in vivo for extended periods of time. Tissue engineering employs biomedical materials, such as polymers, to support the regrowth of injured tissue. In this thesis, a combination strategy to deliver genes and drugs in a polymeric scaffold was applied to a spinal cord injury model. In order to develop a platform technology to treat spinal cord injury, several nonviral gene delivery systems and polymeric scaffolds were evaluated in vitro and in vivo. Nonviral vector trafficking was evaluated in primary neuronal culture to develop an understanding of the barriers to gene transfer in neurons and their supporting glia. Although the most efficient gene carrier in vitro differed from the optimal gene carrier in vivo, confocal and electron microscopy of these nonviral vectors provided insights into the interaction of these vectors with the nucleus. A novel pathway for delivering nanoparticles into the nuclei of neurons and Schwann cells via vesicle trafficking was observed in this study. Reporter gene expression levels were evaluated after direct and remote delivery to the spinal cord, and the optimal nonviral vector, dose, and delivery strategy were applied to deliver the gene encoding the basic fibroblast growth factor (bFGF) to the spinal cord. An injectable and biocompatible gel, composed of the amphiphillic polymer poly(ethylene glycol)-poly(epsilon-caprolactone)-poly(ethylene glycol) (PEG-PCL-PEG) was evaluated as a drug and gene delivery system in vitro, and combined with the optimized nonviral gene delivery system to treat spinal cord injury. Plasmid DNA encoding the bFGF gene and the therapeutic NEP1--40 peptide were incorporated in the PEG-PCL-PEG gel and injected into a lesion transecting the main dorsomedial and minor ventral medial corticospinal tract (CST). The degree of collateralization of the transected CST was quantified as an indicator of the regenerative potential of these treatments. At one month post-injury, we observed the robust rostral collateralization of the CST tract in response to the bFGF plasmid-loaded gel. In conclusion, we hope that this platform technology can be applied to the sustained local delivery of other proteins for the treatment of spinal cord injury.

Bright, Corinne

28

Anesthetic Management of Chronic Spinal Cord Injury  

Microsoft Academic Search

\\u000a As longevity increases for patients with spinal cord injuries (SCI), operative procedures are often necessary to further rehabilitation,\\u000a control pain, evaluate urinary dysfunction, maintain skin integrity and reverse further neurologic degeneration. Increasingly,\\u000a SCI women are completing pregnancies. Considerations for anesthetic management of patients with chronic SCI include avoiding\\u000a autonomic hyperreflexia and hyperkalemia-related to succinylcholine, preventing exacerbations of pulmonary dysfunction and

Patricia H. Petrozza

29

Oligodendrocyte Fate after Spinal Cord Injury  

Microsoft Academic Search

Summary  Oligodendrocytes (OLs) are particularly susceptible to the toxicity of the acute lesion environment after spinal cord injury\\u000a (SCI). They undergo both necrosis and apoptosis acutely, with apoptosis continuing at chronic time points. Loss of OLs causes\\u000a demyelination and impairs axon function and survival. In parallel, a rapid and protracted OL progenitor cell proliferative\\u000a response occurs, especially at the lesion borders.

Akshata Almad; F. Rezan Sahinkaya; Dana M. McTigue

2011-01-01

30

Epidemiologic Change of Patients With Spinal Cord Injury  

PubMed Central

Objective To evaluate the epidemiologic change of patients with spinal cord injury who were admitted to a Rehabilitation Hospital, Yonsei University College of Medicine, during 1987-1996 and 2004-2008. Methods Medical records of 629 patients with spinal cord injury admitted to the Rehabilitation Hospital, Yonsei University College of Medicine, from 2004 to 2008 were collected and reviewed retrospectively. Results The male-to-female ratio decreased to 2.86:1, the mean age at injury increased, nontraumatic etiology increased, traffic accident remained to be the most common in traumatic spinal cord injury, and falling increased significantly. Tumor was the most common etiology in nontraumatic spinal cord injury, tetraplegia and incomplete injuries occurred more than paraplegia and complete injuries, indwelling catheter was the most common voiding method, and the duration of hospitalization decreased. Conclusion Many trends changed in epidemiology of spinal cord injury. PMID:23525183

Shin, Ji Cheol; Yu, Su Jin; Yang, Hea Eun; Yoon, Seo Yeon

2013-01-01

31

Adult Stem Cell Application in Spinal Cord Injury  

Microsoft Academic Search

The mechanical force incurred by spinal cord injury results in degenerative neural tissue damage beyond the site of initial injury. By nature, the central nervous system (CNS) does not regenerate itself. Cell therapy, in particular, stem cell implantation has become a possible solution for spinal cord injury. Embryonic stem cells and fetal stem cells are the forefathers of the field

Sherri S. Schultz

2005-01-01

32

Dual diagnosis: traumatic brain injury with spinal cord injury.  

PubMed

Spinal cord injury (SCI) patients should be assessed for a co-occurring traumatic brain injury (TBI) on admission to a rehabilitation program. Incidence of a dual diagnosis may approach 60% with certain risk factors. Diagnosis of mild-moderate severity TBIs may be missed during acute care hospitalizations of SCI. Neuropsychological symptoms of a missed TBI diagnosis may be perceived during rehabilitation as noncompliance, inability to learn, maladaptive reactions to SCI, and poor motivation. There are life-threatening and quality-of-life-threatening complications of TBI that also may be missed if a dual diagnosis is not made. PMID:25064795

Kushner, David S; Alvarez, Gemayaret

2014-08-01

33

Corticospinal reorganization after spinal cord injury  

PubMed Central

The corticospinal tract (CST) is a major descending pathway contributing to the control of voluntary movement in mammals. During the last decades anatomical and electrophysiological studies have demonstrated significant reorganization in the CST after spinal cord injury (SCI) in animals and humans. In animal models of SCI, anatomical evidence showed corticospinal sprouts rostral and caudal to the lesion and their integration into intraspinal axonal circuits. Electrophysiological data suggested that indirect connections from the primary motor cortex to forelimb motoneurons, via brainstem nuclei and spinal cord interneurons, or direct connections from slow uninjured corticospinal axons, might contribute to the control of movement after a CST injury. In humans with SCI, post mortem spinal cord tissue revealed anatomical changes in the CST some of which were similar but others markedly different from those found in animal models of SCI. Human electrophysiological studies have provided ample evidence for corticospinal reorganization after SCI that may contribute to functional recovery. Together these studies have revealed a large plastic capacity of the CST after SCI. There is also a limited understanding of the relationship between anatomical and electrophysiological changes in the CST and control of movement after SCI. Increasing our knowledge of the role of CST plasticity in functional restoration after SCI may support the development of more effective repair strategies. PMID:22586214

Oudega, Martin; Perez, Monica A

2012-01-01

34

Employment after spinal cord injury: an analysis of cases from the model spinal cord injury systems  

Microsoft Academic Search

Objective: To describe the relationship of multiple biographic, injury-related, and educational factors with employment outcomes after spinal cord injury (SCI).Design: Cross-sectional.Setting: Data were collected through 18 model SCI systems, a nationwide network of hospitals that treat approximately 14% of all SCIs in the United States.Participants: A total of 3,756 persons with traumatic SCI who completed the Form II data collection

J Stuart Krause; Donald Kewman; Michael J. De Vivo; Frederick Maynard; Jennifer Coker; Mary Joan Roach; Stanley Ducharme

1999-01-01

35

Functional electrical stimulation and spinal cord injury.  

PubMed

Spinal cord injuries (SCI) can disrupt communications between the brain and the body, resulting in loss of control over otherwise intact neuromuscular systems. Functional electrical stimulation (FES) of the central and peripheral nervous system can use these intact neuromuscular systems to provide therapeutic exercise options to allow functional restoration and to manage medical complications following SCI. The use of FES for the restoration of muscular and organ functions may significantly decrease the morbidity and mortality following SCI. Many FES devices are commercially available and should be considered as part of the lifelong rehabilitation care plan for all eligible persons with SCI. PMID:25064792

Ho, Chester H; Triolo, Ronald J; Elias, Anastasia L; Kilgore, Kevin L; DiMarco, Anthony F; Bogie, Kath; Vette, Albert H; Audu, Musa L; Kobetic, Rudi; Chang, Sarah R; Chan, K Ming; Dukelow, Sean; Bourbeau, Dennis J; Brose, Steven W; Gustafson, Kenneth J; Kiss, Zelma H T; Mushahwar, Vivian K

2014-08-01

36

Functional Electrical Stimulation in Spinal Cord Injury:  

PubMed Central

This article outlines steps to practical application of functional electrical stimulation (FES) within activity-based restorative therapy (ABRT). Drawing from current evidence, specific applications of FES intended to help restore function lost to spinal cord injury and associated neurologic disease are discussed. The medical and therapeutic indications, precautions, and contraindications are reviewed to help participants with appropriate patient selection, treatment planning, and assessment. Also included are the physiological implications of FES and alterable parameters, including dosing and timing, for a desired response. Finally, approaches to improve cortical representation and motor learning and to transition emerging movement into functional tasks are reviewed. PMID:23459150

Martin, Rebecca; Sadowsky, Cristina; Obst, Kimberly; Meyer, Brooke; McDonald, John

2012-01-01

37

Spinal cord injuries in children and adolescents.  

PubMed

This chapter provides an overview of spinal cord injuries (SCI) in children and adolescents, including epidemiology, medical and musculoskeletal complications, rehabilitation and psychosocial aspects. Males are more commonly affected than females during adolescence; however, as the age at injury decreases, the preponderance of males becomes less marked, and by 3 years of age the number of females with SCIs equals that of males. The neurologic level and degree of completeness varies with age; among children injured prior to 12 years of age approximately two-thirds are paraplegic and approximately two-thirds have complete lesions. Among adolescents, approximately 50% have paraplegia and 55% have complete lesions. Management of pediatric-onset SCI should be family centered and developmentally based, responsive to the dynamic changes that occur during growth and development. Distinctive anatomical and physiological features of children and adolescents, along with growth and development, are responsible for unique manifestations and complications of pediatric SCI. SCI without radiological abnormalities (SCIWORA), birth injuries, lap-belt injuries, upper cervical injuries, and the delayed onset of neurological deficits are relatively unique to pediatric SCI. Children who sustain their SCI before puberty experience a higher incidence of musculoskeletal complications, such as scoliosis and hip dislocation. PMID:23098710

Vogel, Lawrence C; Betz, Randall R; Mulcahey, M J

2012-01-01

38

Accelerating locomotor recovery after incomplete spinal injury.  

PubMed

A traumatic spinal injury can destroy cells, irreparably damage axons, and trigger a cascade of biochemical responses that increase the extent of injury. Although damaged central nervous system axons do not regrow well naturally, the distributed nature of the nervous system and its capacity to adapt provide opportunities for recovery of function. It is apparent that activity-dependent plasticity plays a role in this recovery and that the endogenous response to injury heightens the capacity for recovery for at least several weeks postinjury. To restore locomotor function, researchers have investigated the use of treadmill-based training, robots, and electrical stimulation to tap into adaptive activity-dependent processes. The current challenge is to maximize the degree of functional recovery. This manuscript reviews the endogenous neural system response to injury, and reviews data and presents novel analyses of these from a rat model of contusion injury that demonstrates how a targeted intervention can accelerate recovery, presumably by engaging processes that underlie activity-dependent plasticity. PMID:23531014

Hillen, Brian K; Abbas, James J; Jung, Ranu

2013-03-01

39

Sexual health after spinal cord injury: A longitudinal study  

Microsoft Academic Search

Fisher TL, Laud PW, Byfield MG, Brown TT, Hayat MJ, Fiedler IG. Sexual health after spinal cord injury: a longitudinal study. Arch Phys Med Rehabil 2002;83:1043-51. Objectives: To clarify sexuality issues after spinal cord injury (SCI) and to identify the appropriate timing of sexual health interventions. Design: Longitudinal analysis of the survey responses of persons with SCI at 4 intervals

Thomas L. Fisher; Prakash W. Laud; Margaret G. Byfield; Traci T. Brown; Matthew J. Hayat; Irma G. Fiedler

2002-01-01

40

Classification of chronic pain associated with spinal cord injuries  

Microsoft Academic Search

Cardenas DD, Turner JA, Warms CA, Marshall HM. Classification of chronic pain associated with spinal cord injuries. Arch Phys Med Rehabil 2002;83:1708-14. Objectives: To determine interrater reliability of a classification system for chronic pain in persons with spinal cord injury (SCI) and to determine the frequency and characteristics of various pain types as categorized by this system. Design: Independent categorization

Diana D. Cardenas; Judith A. Turner; Catherine A. Warms; Helen M. Marshall

2002-01-01

41

Cellular/Molecular Enhanced Oligodendrocyte Survival after Spinal Cord Injury  

E-print Network

Cellular/Molecular Enhanced Oligodendrocyte Survival after Spinal Cord Injury in Bax-Deficient Mice Medical School, Boston, Massachusetts 02115 Mechanisms of oligodendrocyte death after spinal cord injury Bax (Bax / ). In the lateral white-matter tracts, substantial oligodendrocyte death was evident

Steinbach, Joe Henry

42

Long-Term Renal Function After Spinal Cord Injury.  

National Technical Information Service (NTIS)

This research project investigated the long-term effects of spinal cord injury and neurogenic bladder dysfunctional on renal function in patients who are ten years or more post-spinal cord injury. It is important to understand the natural history of those...

K. B. Waites

1995-01-01

43

A 10-year review of sports-related spinal injuries  

Microsoft Academic Search

Introduction  The incidence of traumatic spinal cord injury varies in different countries from 2.5 to 57.8 per million per annum, with sport\\u000a accounting for 8–12.7% of these injuries. Spinal injuries associated with recreational sport often result in long-term permanent\\u000a disability in otherwise active individuals.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  The aetiology, pattern and mechanism of the 196 sports-related spinal injuries treated in the National

S. Boran; B. Lenehan; D. McCormack; A. Poynton

44

Spinal cord transplants enhance the recovery of locomotor function after spinal cord injury at birth  

Microsoft Academic Search

Fetal spinal cord transplants placed into the site of a neonatal spinal cord lesion alter the response of immature CNS neurons to injury. The transplants prevent the retrograde cell death of immature axotomized neurons and support the growth of axons into and through the site of injury. In the present experiments we used a battery of locomotor tasks to determine

E. Kunkel-Bagden; B. S. Bregman

1990-01-01

45

Blood-spinal cord barrier after spinal cord injury: Relation to revascularization and wound healing  

Microsoft Academic Search

Spinal cord injury produces prominent disruption of the blood-spinal cord barrier. We have defined the blood- spinal cord barrier breakdown to the protein luciferase (61 kDa) in the acutely injured murine spinal cord and during revascularization. We show that newly formed and regenerating blood vessels that have abnormal perme- ability exhibit differential expression of the glucose-1 transporter (Glut-1), and that

William D. Whetstone; Jung-Yu C. Hsu; Manuel Eisenberg; Zena Werb; Linda J. Noble-Haeusslein

2003-01-01

46

Subacute combined degeneration mimicking traumatic spinal cord injury.  

PubMed

Subacute combined degeneration (SCD) of the spinal cord is the most common neurologic manifestation of vitamin B12 (cobalamin) deficiency and is usually secondary to autoimmune gastritis, but may also be seen in malnutrition syndromes such as chronic alcoholism, strict vegetarianism, gastrectomy, and also in nitrous oxide abuse. Although traumatic spinal cord injury is routinely encountered in the medical examiner's office, medical causes of spinal cord abnormalities such as SCD should be considered in the appropriate clinical setting. We report a case of alcohol-associated SCD mimicking traumatic spinal cord injury. PMID:19237854

Paul, Ian; Reichard, R Ross

2009-03-01

47

Cardiovascular disease and spinal cord injury  

PubMed Central

Objective: To evaluate the association between cardiovascular disease (CVD) and spinal cord injury (SCI) in a large representative sample. Methods: Data were compiled from more than 60,000 individuals from the 2010 cycle of the cross-sectional Canadian Community Health Survey (CCHS). Multivariable logistic regression analysis was conducted to examine this relationship, adjusting for confounders and using probability weighting to account for the CCHS sampling method. Results: After adjusting for age and sex, SCI was associated with a significant increased odds of heart disease (adjusted odds ratio [OR] = 2.72, 95% confidence interval [CI] 1.94–3.82) and stroke (adjusted OR = 3.72, 95% CI 2.22–6.23). Conclusions: These remarkably heightened odds highlight the exigent need for targeted interventions and prevention strategies addressing modifiable risk factors for CVD in individuals with SCI. PMID:23884034

Noonan, Vanessa K.; Krassioukov, Andrei; Borisoff, Jaimie

2013-01-01

48

Race-Ethnicity, Education, and Employment after Spinal Cord Injury  

ERIC Educational Resources Information Center

The objective of this article was to identify the relationship between race-ethnicity and employment after spinal cord injury (SCI), while evaluating interrelationships with gender, injury severity, and education. The authors used a cohort design using the most current status from a post-injury interview from the National SCI Statistical Center.…

Krause, James S.; Saunders, Lee; Staten, David

2010-01-01

49

Advances in Imaging of Vertebral and Spinal Cord Injury  

PubMed Central

Background/Objectives: Imaging technology is an important part of the diagnosis and management of spinal trauma. Indications and findings in post-traumatic imaging of the vertebral column and spinal cord are reviewed. Methods: An extensive literature review was performed on the imaging of vertebral and spinal cord injury. Relevant images from a Level I trauma center were included as examples. Results: Imaging plays an important role in the evaluation of acute and chronic spinal injury. Spinal cord and soft-tissue injuries are best evaluated by magnetic resonance imaging (MRI), whereas spinal fractures are better characterized by computed tomography (CT). Vascular injuries can be evaluated using CT or MR angiography. Conclusions: Imaging using CT and MRI is essential in the management of spinal cord injuries, both in the acute and in the chronic settings. MRI shows the status of ligamentous integrity and visualizes internal derangement of the spinal cord. Vascular compromise can be diagnosed by MR and CT angiography. Plain radiography now has a more limited, adjunctive role, and the need for higher risk myelography has been minimized. PMID:20486529

Goldberg, Andrew L; Kershah, Sharif M

2010-01-01

50

Arylsulfatase B Improves Locomotor Function after Mouse Spinal Cord Injury  

PubMed Central

Bacterial chondroitinase ABC (ChaseABC) has been used to remove the inhibitory chondroitin sulfate chains from chondroitin sulfate proteoglycans to improve regeneration after rodent spinal cord injury. We hypothesized that the mammalian enzyme arylsulfatase B (ARSB) would also enhance recovery after mouse spinal cord injury. Application of the mammalian enzyme would be an attractive alternative to ChaseABC because of its more robust chemical stability and reduced immunogenicity. A one-time injection of human ARSB into injured mouse spinal cord eliminated immunoreactivity for chondroitin sulfates within five days, and up to 9 weeks after injury. After a moderate spinal cord injury, we observed improvements of locomotor recovery assessed by the Basso Mouse Scale (BMS) in ARSB treated mice, compared to the buffer-treated control group, at 6 weeks after injection. After a severe spinal cord injury, mice injected with equivalent units of ARSB or ChaseABC improved similarly and both groups achieved significantly more locomotor recovery than the buffer-treated control mice. Serotonin and tyrosine hydroxylase immunoreactive axons were more extensively present in mouse spinal cords treated with ARSB and ChaseABC, and the immunoreactive axons penetrated further beyond the injury site in ARSB or ChaseABC treated mice than in control mice. These results indicate that mammalian ARSB improves functional recovery after CNS injury. The structural/molecular mechanisms underlying the observed functional improvement remain to be elucidated. PMID:23520469

Yoo, Myungsik; Khaled, Muntasir; Gibbs, Kurt M.; Kim, Jonghun; Kowalewski, Bjorn; Dierks, Thomas; Schachner, Melitta

2013-01-01

51

Experiences of Living with Pain after a Spinal Cord Injury.  

National Technical Information Service (NTIS)

Persistent chronic pain is prevalent after a spinal cord injury (SCI), with about two-thirds of persons with SCI reporting persistent pain despite available treatments. There is a risk for a significant psychosocial impact and a substantially reduced qual...

E. G. Widerstrom-Noga

2013-01-01

52

Spinal cord injury I: A synopsis of the basic science  

PubMed Central

Substantial knowledge has been gained in the pathological findings following naturally occurring spinal cord injury (SCI) in dogs and cats. The molecular mechanisms involved in failure of neural regeneration within the central nervous system, potential therapeutics including cellular transplantation therapy, neural plasticity, and prognostic indicators of recovery from SCI have been studied. This 2-part review summarizes 1) basic science perspectives regarding treating and curing spinal cord injury, 2) recent studies that shed light on prognosis and recovery from SCI, 3) current thinking regarding standards of care for dogs with SCI, 4) experimental approaches in the laboratory setting, and 5) current clinical trials being conducted in veterinary medicine. Part I presents timely information on the pathophysiology of spinal cord injury, challenges associated with promoting regeneration of neurons of the central nervous system, and experimental approaches aimed at developing treatments for spinal cord injury. PMID:20676289

Webb, Aubrey A.; Ngan, Sybil; Fowler, J. David

2010-01-01

53

[Local spinal cord glucose utilization and extracellular potassium activity changes after spinal cord injury in rats].  

PubMed

Spinal microenvironment and metabolic alterations after experimental contusional injury of the spinal cord were evaluated in the same Wistar rats. Severe spinal cord injury was made under light GOF anesthesia with a 10 g weight drop onto the exposed Th-8 spinal cord from a 10 cm height and then halothane was ceased. The author studied extracellular potassium activity ([K+]e) and DC potential for 2 hours after paraplegic spinal cord injury in conscious rats. Furthermore, at 2 hours after cord injury, local spinal cord glucose utilization (1-SCGU) was measured with quantitative autoradiographic 2-[14C] deoxy-glucose method (Sokoloff et al.). [K+]e in injured spinal cords was 59 +/- 5 (mean +/- S.E.M.) mEq at 10 min after injury and was cleared with an exponential half-life of 1 hour. At 2 hours after injury [K+]e was still high with a value of 16 +/- 1 mEq compared with 4 mEq of control animals. DC potential changes was a mirror image of that of [K+]e. DC potential changed by a mean of 10.7 mV positively from 10 min. to 2 hours after injury. 1-SCGU at the impact site was extremely low in both white and gray matters. At 6mm rostral from the impact center 1-SCGU was remarkably reduced in the gray matter, and in the lateral white matter. But at 3 mm rostral 1-SCGU was well preserved. And at 20 mm rostral there was no difference in 1-SCGU with control animals. Massive potassium efflux from the injured spinal cord to the adjacent spinal segment was clarified at this experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1888573

Murai, H; Itoh, C; Wagai, N; Nakamura, T; Yamaura, A; Makino, H

1991-04-01

54

National survey of spinal injuries in hockey players.  

PubMed Central

There has been an alarming increase in the number of spinal injuries in hockey players. Between 1976 and 1983, 42 were reported to the Committee on Prevention of Spinal Injuries due to Hockey. The median age of the injured players was 17 years. Of the 42 players 28 had spinal cord injuries, and 17 of them had complete paralysis below the vertebral level of the injury. Strikes from behind and collisions with the boards were common mechanisms of injury. Many of the players had suffered a burst fracture of the cervical spine following a blow to the top of the helmet when the neck was slightly flexed. The committee studied a number of possible etiologic factors and made several recommendations regarding prevention. League officials, coaches, players and equipment manufacturers can all play a role in prevention. Images Fig. 1 Fig. 2 PMID:6704840

Tator, C. H.; Edmonds, V. E.

1984-01-01

55

Spinal Injury: Regeneration, Recovery, and a Possible New Approach  

SciTech Connect

Spinal injury is most frequent in young healthy men, desperate to walk. Most treatments have focused on regeneration of the injured axons, but no one has as yet achieved success with this approach. However, in the lamprey, a primitive fish with a spinal cord having all the critical features of the human spinal cored, spinal injury is followed by complete regeneration of injured axons. Additionally, the animal recovers the ability to swim, and in many, the swimming is normal. Unfortunately, in most others, it is highly abnormal. This talk will review evidence from the abnormal regeneration, why it bespeaks difficulties heretofore not considered, and suggest an alternate approach for the near future. In so doing, the speaker will introduce the normal function of the spinal cord, what happens in normal and abnormal regeneration, and the new techniques that employ methods from neuromorphic engineering, a synthesis of neuroscience and engineering to engineer smart devices.

Cohen, Avis (U of Maryland, Dept of Biology) [U of Maryland, Dept of Biology

2009-02-04

56

New rehabilitation interventions in spinal cord injury.  

PubMed

Progress in the care of people with spinal cord injury (SCI) spans every aspect, from research in neuroregeneration to pharmacologic interventions. This article focuses on advances in rehabilitation interventions, which have employed bioengineering, computerization, and advanced therapeutic techniques. These interventions are being applied to functional deficits of the bladder, bowel, upper extremities, and respiratory system, as well as to improvements in ambulation and mobility. Functional electrical stimulation (FES) is being used to augment the function of the lower extremities, the upper extremities (Freehand System), and the bowel and bladder (Vocare System). Tendon transfer is a reconstructive technique used to improve upper extremity function; it is sometimes combined with FES. Body weight-supported treadmill training is being used to improve ambulation in people with incomplete SCI, and advances in wheelchair technology are expanding options for mobility. Cushion design and pressure mapping are modalities being used to reduce the high risk for pressure ulcers in the SCI population. Research on shoulder stressors is being applied to transfer techniques, exercise regimens, adaptive equipment and wheelchair mechanics to minimize shoulder pain, another common complication. The effectiveness of rehabilitation interventions needs to be documented by evidence-based research. Researchers are focusing on the identification of outcomes measures that will form the basis for established standards of care for individuals with SCI. Perhaps the combination of conventional and newer therapies may enhance neurological recovery. Well-designed studies are needed before we can make this determination. PMID:15484665

Kirshblum, Steven

2004-01-01

57

The Relationship between Productivity and Adjustment Following Spinal Cord Injury.  

ERIC Educational Resources Information Center

Examined adjustment and productivity of persons (N=344) with spinal cord injuries. Found 45 percent of subjects gainfully employed, 14 percent engaged in unpaid productive activities, 41 percent not engaged in any productive activities. Employed subjects had best overall adjustment. Injury level was not related to level of productive activity,…

Krause, James S.

1990-01-01

58

Sexual issues of women with spinal cord injuries  

Microsoft Academic Search

The need for research addressing problems unique to women with spinal cord injuries is well documented. Consequently, 231 such women, ages 18 to 45, were surveyed. Demographic characteristics and data relating to physician usage, female hygiene, pregnancy, contraception and sexuality were collected.Analysis revealed that 60% of the respondents had post injury amenorrhea; the average time until menses resumption was 5

S W Charlifue; K A Gerhart; R R Menter; G G Whiteneck; M Scott Manley

1992-01-01

59

Trajectories of Resilience, Depression, and Anxiety Following Spinal Cord Injury  

Microsoft Academic Search

Purpose\\/Objective: To investigate longitudinal trajectories of depression and anxiety symptoms following spinal cord injury (SCI) as well as the predictors of those trajectories. Research Method\\/Design: A longitudinal study of 233 participants assessed at 4 time points: within 6 weeks, 3 months, 1 year, and 2 years from the point of injury. Data were analyzed using latent growth mixture modeling to

George A. Bonanno; Paul Kennedy; Isaac R. Galatzer-Levy; Peter Lude; Mangus L. Elfström

2012-01-01

60

Spinal cord injury: inductive lability can enhance and hasten recovery.  

PubMed

In spinal cord injury, recovery of function, if any, confirms the presence of survived neural tissue at the injury site. However, recovery several years after the injury remains unexplained. Body weight bearing locomotor exercises seem to bring these new outcomes. Developing locomotor system and computer simulation studies show that motor learning requires the presence of redundant sets of competing synapses within the spinal cord interneurons. The new exercise regimens have not addressed this essential prerequisite; this could perhaps explain the long delays in recovery. We recommend that inclusion of inductive lability procedure (Krishnan, 1983, 1991, 2003) will help hasten and enhance the recovery. PMID:12775341

Krishnan, R V

2003-06-01

61

Perspectives on the treatment of the longitudinal spinal cord injury.  

PubMed

The current technique for surgical treatment of the longitudinal spinal cord injury has proven to be successful for restoration of some motor function and alleviation of pain. This has been the first step in finding a cure for spinal cord injuries, but so far there are many obstacles still to be overcome. In this particular injury return of function from spinal cord surgery is only partial. Some of the main remaining problems are related to injury-induced neuronal death, direction and specificity of regeneration and muscle, and receptor disintegration from long time denervation. Currently this is a surgical procedure without any adjuvant treatments. In order to gain further functional improvement combinational therapies developed in basic science experiments are essential. PMID:21206763

Carlstedt, Thomas

2010-01-01

62

Nonfatal All-Terrain Vehicle-Related Injuries to Youths Living on Farms in the United States, 2001  

ERIC Educational Resources Information Center

Use of all-terrain vehicles (ATVs) in agriculture appears to be growing. Purpose: To provide estimates of ATV ownership and exposure on US farms and an overview of injuries to youths as a result of ATV use on the farm in 2001. Methods: Analysis of the National Institute for Occupational Safety and Health and US Department of Agriculture 2001…

Goldcamp, E. Michael; Myers, John; Hendricks, Kitty; Layne, Larry; Helmkamp, Jim

2006-01-01

63

Exercise recommendations for individuals with spinal cord injury.  

PubMed

Persons with spinal cord injury (SCI) exhibit deficits in volitional motor control and sensation that limit not only the performance of daily tasks but also the overall activity level of these persons. This population has been characterised as extremely sedentary with an increased incidence of secondary complications including diabetes mellitus, hypertension and atherogenic lipid profiles. As the daily lifestyle of the average person with SCI is without adequate stress for conditioning purposes, structured exercise activities must be added to the regular schedule if the individual is to reduce the likelihood of secondary complications and/or to enhance their physical capacity. The acute exercise responses and the capacity for exercise conditioning are directly related to the level and completeness of the spinal lesion. Appropriate exercise testing and training of persons with SCI should be based on the individual's exercise capacity as determined by accurate assessment of the spinal lesion. The standard means of classification of SCI is by application of the International Standards for Classification of Spinal Cord Injury, written by the Neurological Standards Committee of the American Spinal Injury Association. Individuals with complete spinal injuries at or above the fourth thoracic level generally exhibit dramatically diminished cardiac acceleration with maximal heart rates less than 130 beats/min. The work capacity of these persons will be limited by reductions in cardiac output and circulation to the exercising musculature. Persons with complete spinal lesions below the T(10) level will generally display injuries to the lower motor neurons within the lower extremities and, therefore, will not retain the capacity for neuromuscular activation by means of electrical stimulation. Persons with paraplegia also exhibit reduced exercise capacity and increased heart rate responses (compared with the non-disabled), which have been associated with circulatory limitations within the paralysed tissues. The recommendations for endurance and strength training in persons with SCI do not vary dramatically from the advice offered to the general population. Systems of functional electrical stimulation activate muscular contractions within the paralysed muscles of some persons with SCI. Coordinated patterns of stimulation allows purposeful exercise movements including recumbent cycling, rowing and upright ambulation. Exercise activity in persons with SCI is not without risks, with increased risks related to systemic dysfunction following the spinal injury. These individuals may exhibit an autonomic dysreflexia, significantly reduced bone density below the spinal lesion, joint contractures and/or thermal dysregulation. Persons with SCI can benefit greatly by participation in exercise activities, but those benefits can be enhanced and the relative risks may be reduced with accurate classification of the spinal injury. PMID:15456347

Jacobs, Patrick L; Nash, Mark S

2004-01-01

64

Walking index for spinal cord injury (WISCI): criterion validation  

Microsoft Academic Search

Study design:Retrospective examination.Objectives:To compare the Walking Index for Spinal Cord Injury (WISCI) and current scales for their sensitivity to walking changes in subjects with a spinal cord lesion (SCL) and further validate the WISCI for use in clinical trails.Setting:A large rehabilitation hospital in the center of Italy.Patients and methods:Retrospective review was performed on 284 patient records with an SCL. Measurements

B Morganti; G Scivoletto; P Ditunno; J F Ditunno; M Molinari

2005-01-01

65

Effect of spinal cord injury upon prostate: adenocarcinoma of prostate in a spinal cord injury patient - a case report  

PubMed Central

Introduction Following spinal cord injury, prostate undergoes atrophy probably due to interruption of neuro-hormonal pathways. The incidence of carcinoma of prostate is lower in patients with spinal cord injury above T-10 than in those with lesion below T-10. Case presentation A Caucasian male sustained T-4 paraplegia in 1991 at the age of 59-years. He had long-term indwelling urethral catheter. In May 1995, routine blood test showed prostate-specific antigen to be 17.7 mg/ml. Prostate biopsy revealed moderately differentiated primary adenocarcinoma of prostate; Gleason score was 3+3. Bone scans showed no evidence of metastatic bone disease. Bilateral orchidectomy was performed in September 1995. MRI of pelvis revealed no evidence of spread beyond prostatic capsule. There was no pelvic lymphadenopathy. In October 1996, this patient got chest infection and recovered fully after taking amoxicillin. In February 2001, he developed pneumonia and was prescribed cefuroxime intravenously. In March 2001, cystoscopy and electrohydraulic lithotripsy of vesical calculi were carried out. In August 2001, this patient was admitted to spinal unit for management of pressure sores. He expired on 28 June 2002 in local hospital. Cause of death was recorded as acute ventricular failure, congestive heart failure, chronic respiratory failure and spinal cord injury. Conclusion Although prostate gland undergoes atrophy in men who sustained spinal cord injury in early age, physicians should be vigilant and look for prostatic diseases particularly in men, who have sustained spinal cord injury during later period of life. Patients with cervical and upper dorsal lesions are at risk of developing potentially life-threatening chest complications after major surgical procedures including radical prostatectomy. Therefore, it may be advisable to consider chemoprevention of prostate cancer with Finasteride, especially in men, who sustained cervical and upper dorsal spinal cord injury during later part of their life. PMID:20062548

2009-01-01

66

Detrimental Effects of Uncontrollable Stimulation on Recovery After Spinal Cord Injury  

E-print Network

When a person suffers a spinal cord injury, peripheral damage often accompanies it, such as damage to the legs, for instance. The pain (nociceptive) signals from this peripheral injury are being sent to the damaged spinal cord, but the patient...

Hudson, Kara

2007-07-23

67

Spinal cord injury in an inner city hospital.  

PubMed

During the first six years of existence of the rehabilitation unit in a black inner city major municipal hospital, 53 patients with spinal cord injury were admitted. A retrospective study of these patients sought answers to questions concerning etiology, patient characteristics, services provided and method of delivery, and advantages and disadvantages of rehabilitation in a community hospital. Findings revealed differences in causation of spinal cord injury between women and men and between patients with paraplegia and quadriplegia. tthe male paraplegic patients were the youngest; their life style led to spinal cord injury. Social factors such as inadequate housing, lack of transportation, and insufficient financial resources were deterrents to rehabilitation. An approach that emphasized consideration of all the psychosocial factors was developed. Evaluation and treatment were extended into the community. Lack of peer groups and multiphasic programs were the major disadvantages. PMID:623516

Macauley, C A; Weiss, L

1978-02-01

68

Regional Spinal Cord Blood Flow and Energy Metabolism in Rats after Laminectomy and Acute Compression Injury  

Microsoft Academic Search

Many data are available concerning spinal cord blood flow (SCBF) and metabolism on various models and timing after spinal cord injury, however, detailed information on their exact relationship in the same injury model is lacking. This relationship is a crucial factor in the understanding of the pathophysiology of spinal cord trauma. Rats were subjected to lumbar laminectomy or lumbar spinal

Angelika E. M. Mautes; Helmut Schröck; Amadeo C. Nacimiento; Wulf Paschen

2000-01-01

69

Rodent Models and Behavioral Outcomes of Cervical Spinal Cord Injury  

PubMed Central

Rodent spinal cord injury (SCI) models have been developed to examine functional and physiological deficits after spinal cord injury with the hope that these models will elucidate information about human SCI. Models are needed to examine possible treatments and to understand histopathology after SCI; however, they should be considered carefully and chosen based on the goals of the study being performed. Contusion, compression, transection, and other models exist and have the potential to reveal important information about SCI that may be related to human SCI and the outcomes of treatment and timing of intervention.

Geissler, Sydney A.; Schmidt, Christine E.; Schallert, Timothy

2014-01-01

70

Treadmill step training promotes spinal cord neural plasticity after incomplete spinal cord injury.  

PubMed

A large body of evidence shows that spinal circuits are significantly affected by training, and that intrinsic circuits that drive locomotor tasks are located in lumbosacral spinal segments in rats with complete spinal cord transection. However, after incomplete lesions, the effect of treadmill training has been debated, which is likely because of the difficulty of separating spontaneous stepping from specific training-induced effects. In this study, rats with moderate spinal cord contusion were jected to either step training on a treadmill or used in the model (control) group. The treadmill training began at day 7 post-injury and lasted 20 ± 10 minutes per day, 5 days per week for 10 weeks. The speed of the treadmill was set to 3 m/min and was increased on a daily basis according to the tolerance of each rat. After 3 weeks of step training, the step training group exhibited a sig-nificantly greater improvement in the Basso, Beattie and Bresnahan score than the model group. The expression of growth-associated protein-43 in the spinal cord lesion site and the number of tyrosine hydroxylase-positive ventral neurons in the second lumbar spinal segment were greater in the step training group than in the model group at 11 weeks post-injury, while the levels of brain-derived neurotrophic factor protein in the spinal cord lesion site showed no difference between the two groups. These results suggest that treadmill training significantly improves functional re-covery and neural plasticity after incomplete spinal cord injury. PMID:25206564

Sun, Tiansheng; Ye, Chaoqun; Wu, Jun; Zhang, Zhicheng; Cai, Yanhua; Yue, Feng

2013-09-25

71

Nanotechnology for treatment of stroke and spinal cord injury.  

PubMed

The use of nanotechnology in cell therapy and tissue engineering offers promising future perspectives for brain and spinal cord injury treatment. Stem cells have been shown to selectively target injured brain and spinal cord tissue and improve functional recovery. To allow cell detection, superparamagnetic iron-oxide nanoparticles can be used to label transplanted cells. MRI is then a suitable method for the in vivo tracking of grafted cells in the host organism. CNS, and particularly spinal cord, injury is accompanied by tissue damage and the formation of physical and biochemical barriers that prevent axons from regenerating. One aspect of nanomedicine is the development of biologically compatible nanofiber scaffolds that mimic the structure of the extracellular matrix and can serve as a permissive bridge for axonal regeneration or as a drug-delivery system. The incorporation of biologically active epitopes and/or the utilization of these scaffolds as stem cell carriers may further enhance their therapeutic efficacy. PMID:20025468

Kubinová, Sárka; Syková, Eva

2010-01-01

72

Respiration following Spinal Cord Injury: Evidence for Human Neuroplasticity  

PubMed Central

Respiratory dysfunction is one of the most devastating consequences of cervical spinal cord injury (SCI) with impaired breathing being a leading cause of morbidity and mortality in this population. However, there is mounting experimental and clinical evidence for moderate spontaneous respiratory recovery, or “plasticity”, after some spinal cord injuries. Pre-clinical models of respiratory dysfunction following SCI have demonstrated plasticity at neural and behavioral levels that result in progressive recovery of function. Temporal changes in respiration after human SCI have revealed some functional improvements suggesting plasticity paralleling that seen in experimental models – a concept that has been previously under-appreciated. While the extent of spontaneous recovery remains limited, it is possible that enhancing or facilitating neuroplastic mechanisms may have significant therapeutic potential. The next generation of treatment strategies for SCI and related respiratory dysfunction should aim to optimize these recovery processes of the injured spinal cord for lasting functional restoration. PMID:23891679

Hoh, Daniel J.; Mercier, Lynne M.; Hussey, Shaunn P.; Lane, Michael A.

2013-01-01

73

Men, sport, spinal cord injury, and narratives of hope  

Microsoft Academic Search

Drawing on data from a life history study of a small group of men who have suffered spinal cord injury and become disabled through playing sport, this article explores the meanings of hope in their lives. It focuses upon the life stories of 14, white, predominantly working-class men, aged 26–51. The most common kinds of hope used by the men

Brett Smith; Andrew C. Sparkes

2005-01-01

74

Spinal Cord Injury Therapy through Active Learning Thomas Desautels  

E-print Network

Spinal Cord Injury Therapy through Active Learning Thesis by Thomas Desautels In Partial would particularly like to recognize Jaehoon Choe and Parag Gad, who carried out the animal experiments Koeper, the Burdick group's administrative assistant. Without Maria, we would never get anything done

Winfree, Erik

75

Prostate activity and prostate cancer in spinal cord injury  

Microsoft Academic Search

In addition to androgen, autonomic nerves may be involved in prostatic function. As patients with spinal cord injury (SCI) have impaired innervation of the prostate, the prostate volume and prostate-specific antigen (PSA) level in patients with SCI may be different from those of healthy men. Experiments in rats with SCI indicate that neurogenic factors play an important role in prostate

H B Shim; T Y Jung; J K Lee; J H Ku; JH Ku

2006-01-01

76

Extinction and synesthesia in patients with spinal cord injuries  

Microsoft Academic Search

Extinction and synesthesia were studied in 50 patients with spinal cord injury with various levels and extents. Extinction was found in 20 (40 per cent) and synesthesia in 6 (12 per cent) of the 40 males and 10 females. No correlations were found between either of the two phenomena and parameters of patient's age, lesion's age, lesion's level and extent,

Ernest Bors

1979-01-01

77

Epigenetics of neural repair following spinal cord injury.  

PubMed

Spinal cord injury results from an insult inflicted on the spinal cord that usually encompasses its 4 major functions (motor, sensory, autonomic, and reflex). The type of deficits resulting from spinal cord injury arise from primary insult, but their long-term severity is due to a multitude of pathophysiological processes during the secondary phase of injury. The failure of the mammalian spinal cord to regenerate and repair is often attributed to the very feature that makes the central nervous system special-it becomes so highly specialized to perform higher functions that it cannot effectively reactivate developmental programs to re-build novel circuitry to restore function after injury. Added to this is an extensive gliotic and immune response that is essential for clearance of cellular debris, but also lays down many obstacles that are detrimental to regeneration. Here, we discuss how the mature chromatin state of different central nervous system cells (neural, glial, and immune) may contribute to secondary pathophysiology, and how restoring silenced developmental gene expression by altering histone acetylation could stall secondary damage and contribute to novel approaches to stimulate endogenous repair. PMID:24081781

York, Elisa M; Petit, Audrey; Roskams, A Jane

2013-10-01

78

Quality of Life After Spinal Cord Injury: A Qualitative Study  

Microsoft Academic Search

ABSTRACT. Objective: To describe the subjective quality of life (QOL) of persons with a spinal cord injury (SCI). Study Design: Qualitative analysis of transcribed interviews. Participants: Forty community-dwellers with SCI. Results: Few participants could define QOL, but most could identify indicators of QOL and provided clear ratings of their own QOL. Individuals were grouped into three QOL ratings categories (excellent

Colette Hillebrand Duggan; Marcel Dijkers

2001-01-01

79

Spinal Injuries in the Aquatics Environment, Part I: Prevention.  

ERIC Educational Resources Information Center

Water-related activities are the number one cause of spinal cord injuries resulting from sports and recreation activities. This article discusses principles of safe diving; principles of safe water sliding; ways to reduce springboard diving accidents; factors contributing to springboard diving accidents; and safety recommendations for open water…

Dworkin, Gerald M.

1987-01-01

80

FGF-2-Responsive and Spinal Cord-Resident Cells Improve Locomotor Function after Spinal Cord Injury.  

PubMed

Abstract The adult central nervous system has only a limited capacity for axonal regeneration. In this study, fibroblast growth factor-2 (FGF-2) was injected once into the spinal cord tissue around the injury site immediately after complete spinal cord transection in rats. This treatment markedly improved the locomotor function of the animals. Histological analysis demonstrated that tissue composed of FGF-2-induced fibronectin-positive cells (FIFs) had infiltrated the injury site and filled large cystic cavities, into which numerous axons with growth-associated protein-43 immunoreactivity penetrated. The FIFs could also be cultured from the intact spinal cord tissue, demonstrating that they were resident in the non-injured spinal cord. They had a spindle-shaped morphology and enhanced expression of mRNAs of N-cadherin and neurotrophic factors, suggesting the beneficial properties of the FIFs for axonal regeneration. Thus, these results argue for the continual use of autologous transplantation as a novel and promising cell therapy for the treatment of spinal cord injury. PMID:20199141

Kasai, Masaki; Jikoh, Takahiro; Fukumitsu, Hidefumi; Furukawa, Shoei

2014-09-15

81

Abdominal hollow viscus injuries are associated with spine and neurologic infections after penetrating spinal cord injuries.  

PubMed

Penetrating spinal cord injuries are rare but potentially devastating injuries that are associated with significant morbidity. The objective of this study was to assess the impact of abdominal hollow viscus injuries (HVIs) on neurologic and spinal infectious complications in patients sustaining penetrating spinal cord injuries. We performed a 13-year retrospective review of a Level I trauma center database. Variables analyzed included demographics, injury patterns and severity, spine operations, and outcomes. Spine and neurologic infections (SNIs) were defined as paraspinal or spinal abscess, osteomyelitis, and meningitis. Multivariate analysis was performed to identify factors associated with SNI. Of 137 patients, there were 126 males (92%) with a mean age of 27 ± 10 years. Eight patients (6%) underwent operative stabilization of their spine. Fifteen patients (11%) developed SNI. There was a higher incidence of SNI among patients with abdominal HVI compared with those without (eight [26%] vs six [6%], P < 0.001). On multivariate analysis, after controlling for injury severity, solid abdominal injury and HVI, vascular injury, and spine operation, abdominal HVIs were independently associated with an increased risk for SNI (odds ratio, 6.88; 95% confidence interval, 2.14 to 22.09; P = 0.001). Further studies are required to determine the optimal management strategy to prevent and successfully treat these infections. PMID:25264640

Schwed, Alexander C; Plurad, David S; Bricker, Scott; Neville, Angela; Bongard, Fred; Putnam, Brant; Kim, Dennis Y

2014-10-01

82

Spinal Cord Injury: A Systematic Review of Current Treatment Options  

Microsoft Academic Search

Background  Spinal cord injury (SCI) is a devastating event often resulting in permanent neurologic deficit. Research has revealed an\\u000a understanding of mechanisms that occur after the primary injury and contribute to functional loss. By targeting these secondary\\u000a mechanisms of injury, clinicians may be able to offer improved recovery after SCI.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  In this review, we highlight advances in the field of SCI

David W. Cadotte; Michael G. Fehlings

2011-01-01

83

Induction of Angiopoietin-2 after Spinal Cord Injury  

PubMed Central

Angiopoietin 1 (Ang-1) and angiopoietin 2 (Ang-2) have opposing effects on blood vessels, with Ang-2 being mainly induced during the endothelial barrier breakdown. It is known that spinal cord injury (SCI) induces lasting decreases in Ang-1 levels, underlying endothelial barrier disruption, but the expression of Ang-2 in spinal cord injury has not been studied. We characterized Ang-2 after SCI using a clinically relevant rat model of contusion SCI. We found that SCI induces marked and persistent upregulation of Ang-2 (up to 10 weeks after SCI), which does not reflect well-characterized temporal profile of the blood-spinal cord barrier (BSCB) breakdown after SCI, and thus suggests other role(s) for Ang-2 in injured spinal cords. Furthermore, we also found that higher Ang-2 levels were associated with more successful locomotor recovery after SCI, both in SCI rats with markedly better spontaneous motor recovery, and in SCI rats receiving a neuroprotective pharmacological intervention (amiloride), suggesting a beneficial role for Ang-2 in injured spinal cords. Immunocytochemical analyses revealed that Ang-2 was not induced in endothelial cells, but in perivascular and non-vascular cells labeled with glial fibrillary acidic protein (GFAP) or with chondroitin sulfate proteoglycan (NG2). Therefore, it is unlikely that induction of Ang-2 contributes to vascular dysfunction underlying functional impairment after SCI, but rather that it contributes to the beneficial pro-angiogenic and/or gliogenic processes underlying recovery processes after SCI. PMID:22020092

Lee-Durham, J.C.; Wu, Y.; Mokkapati, V.U.L.; Paulucci-Holthauzen, A.A; Nesic, O.

2012-01-01

84

Assessment of autonomic dysreflexia in patients with spinal cord injury.  

PubMed Central

OBJECTIVES AND METHODS: To assess the impairment of supraspinal control over spinal sympathetic centres and the occurrence of autonomic dysreflexia in patients with spinal cord injury. Autonomic dysreflexia is caused by the disconnection of spinal sympathetic centres from supraspinal control and is characterised by paroxysmal hypertensive episodes caused by non-specific stimuli below the level of the lesion. Therefore, patients with spinal cord injury were examined clinically and by different techniques to assess the occurrence of autonomic dysreflexia and to relate disturbances of the sympathetic nervous system to episodes of autonomic dysreflexia. RESULTS: None of the paraplegic patients, but 59% (13/22) of tetraplegic patients (91% of the complete, 27% of the incomplete patients) presented signs of autonomic dysreflexia during urodynamic examination. Only 62% of the tetraplegic patients complained about symptoms of autonomic dysreflexia. Pathological sympathetic skin responses (SSRs) of the hands were related to signs of autonomic dysreflexia in 93% of cases. No patient with preserved SSR potentials of the hands and feet showed signs of autonomic dysreflexia, either clinically or during urodynamic examination. Ambulatory blood pressure measurements (ABPMs) indicated a loss of circadian blood pressure rhythm (sympathetic control) but preserved heart rate rhythm (parasympathetic regulation) only in patients with complete tetraplegia. Pathological ABPM recordings were seen in 70% of patients with symptoms of autonomic dysreflexia. CONCLUSIONS: The urodynamic examination was more sensitive in indicating signs of autonomic dysreflexia in patients with spinal cord injury, whereas SSR allowed the assessment of the degree of disconnection of the sympathetic spinal centres from supraspinal control. Using ABPM recordings the occurrence of episodes of autonomic dysreflexia over 24 hours and the effectiveness of therapeutical treatment can be assessed. PMID:9153603

Curt, A; Nitsche, B; Rodic, B; Schurch, B; Dietz, V

1997-01-01

85

Effects of injury level and severity on direct costs of care for acute spinal cord injury.  

PubMed

New treatments are being investigated for spinal cord injury (SCI), and any improvement may result in incremental cost savings. The objective of this study was to determine the direct costs of care 2 years after an SCI, stratifying for completeness and level of injury. A retrospective database analysis was carried out using data from the Quebec Trauma Registry, the Quebec Medical Insurance Board, and the Quebec Automobile Insurance Corporation between 1997 and 2007. Excluding individuals sustaining moderate or severe traumatic brain injuries, 481 individuals who sustained an SCI from motor vehicle accidents were identified. Individuals were classified as complete and incomplete in the following categories: C1-C7, C8-T6, T7-L1, L2-S5. Using data from governmental public healthcare organizations makes this study comprehensive. For C1-C7 complete and incomplete spinal cord injuries, the first-year cost was $157?718 and $56?505, respectively (2009 Canadian dollars calculated per patient). Similar differences between complete and incomplete spinal cord injuries were seen for the other groups. Furthermore, for complete injuries, costs were higher for higher levels of injury during both the first and the second year after injury. For incomplete lesions, costs did not differ significantly between groups during the first or the second year. Incomplete spinal cord injuries result in lower healthcare costs compared with complete injuries across all groups during the first 2 years after injury. As less severe levels of injury result in measurably lower costs, the funds spent to reduce the severity or level of SCI could at least partially be recouped through healthcare savings. PMID:25192008

Radhakrishna, Mohan; Makriyianni, Ioli; Marcoux, Judith; Zhang, Xun

2014-12-01

86

Bradykinin antagonist decreases early disruption of the blood–spinal cord barrier after spinal cord injury in mice  

Microsoft Academic Search

Bradykinin is one of the key molecules involved in the disruption of the blood–brain barrier and blood–spinal cord barrier occurring after spinal cord injury (SCI). Previously we have shown a biphasic opening of the blood–spinal cord barrier as well as increased transport of tumor necrosis factor-? (TNF?) after SCI by compression of the lumbar spinal cord in mice. To evaluate

Weihong Pan; Abba J Kastin; Lajos Gera; John M Stewart

2001-01-01

87

Spinal cord injury in Vietnamese combat.  

PubMed

This report deals with the experience gained by observation and treatment of 114 Vietnamese combat injuries from December 1965 to April 1969. The report covers all aspects of rehabilitation, medical, physical and socio-economic. PMID:11438857

Jacobson, S A; Bors, E

2001-06-01

88

DARPA challenge: developing new technologies for brain and spinal injuries  

NASA Astrophysics Data System (ADS)

The repair of traumatic injuries to the central nervous system remains among the most challenging and exciting frontiers in medicine. In both traumatic brain injury and spinal cord injuries, the ultimate goals are to minimize damage and foster recovery. Numerous DARPA initiatives are in progress to meet these goals. The PREventing Violent Explosive Neurologic Trauma program focuses on the characterization of non-penetrating brain injuries resulting from explosive blast, devising predictive models and test platforms, and creating strategies for mitigation and treatment. To this end, animal models of blast induced brain injury are being established, including swine and non-human primates. Assessment of brain injury in blast injured humans will provide invaluable information on brain injury associated motor and cognitive dysfunctions. The Blast Gauge effort provided a device to measure warfighter's blast exposures which will contribute to diagnosing the level of brain injury. The program Cavitation as a Damage Mechanism for Traumatic Brain Injury from Explosive Blast developed mathematical models that predict stresses, strains, and cavitation induced from blast exposures, and is devising mitigation technologies to eliminate injuries resulting from cavitation. The Revolutionizing Prosthetics program is developing an avant-garde prosthetic arm that responds to direct neural control and provides sensory feedback through electrical stimulation. The Reliable Neural-Interface Technology effort will devise technologies to optimally extract information from the nervous system to control next generation prosthetic devices with high fidelity. The emerging knowledge and technologies arising from these DARPA programs will significantly improve the treatment of brain and spinal cord injured patients.

Macedonia, Christian; Zamisch, Monica; Judy, Jack; Ling, Geoffrey

2012-06-01

89

Prophylactic low dose heparin anticoagulant therapy in patients with spinal cord injuries: a retrospective study  

Microsoft Academic Search

A retrospective study was performed of 100 consecutive acute traumatic spinal injury patients with neurological deficit admitted to the Yorkshire regional spinal injuries centre prior to May 1990. Ninety-seven of these patients received prophylactic low dose subcutaneous heparin and 3 patients were excluded because of noted complications. Twenty-six patients developed thromboembolic complications. Apart from the fact that acute spinal cord

J R Kulkarni; A A Burt; A T Tromans; P D L Constable

1992-01-01

90

Perceptions of Gain Following Spinal Cord Injury: A Qualitative Analysis  

PubMed Central

Background: Significant research has focused on psychological difficulties following spinal cord injury (SCI), and there is a small prevalence of individuals who experience distress after injury. However, the converse is that many adjust well to injury and rate their quality of life highly. Despite this, there has been a comparative dearth of research investigating positive psychological outcomes after SCI, perceived by individuals living with this disability. Objective: To explore individuals’ perceptions of gain following the experience of SCI. Methods: Participants, who had sustained an SCI between the ages 16 and 83, responded to an open-ended written question: “What do you think you have gained from the experience of spinal cord injury?” This was administered at 4 time points post injury: 6 weeks, 12 weeks, 1 year, and 2 years. Results: Participants’ responses were analyzed qualitatively using the framework of thematic analysis. Thirteen themes were identified: relationships, appreciation of relationships, perspective and appreciation of life, new goals or priorities, understanding of SCI or disability, appreciation of health or health care, changed personality, opportunity or challenge, knowledge of SCI or body, newly acquired skills, spirituality, acceptance, and nothing. Descriptive statistics were incorporated in the presentation of the data. Conclusions: This study provides evidence that a broad range of positive as well as negative psychological outcomes are possible following SCI. More research is needed to better understand the process through which these outcomes arise and to inform how such outcomes may be communicated to persons experiencing this type of injury. PMID:23960704

2013-01-01

91

Re-expression of Locomotor Function After Partial Spinal Cord Injury  

NSDL National Science Digital Library

After a complete spinal section, quadruped mammals (cats, rats, and mice) can generally regain hindlimb locomotion on a treadmill because the spinal cord below the lesion can express locomotion through a neural circuitry termed the central pattern generator (CPG). In this review, we propose that the spinal CPG also plays a crucial role in the locomotor recovery after incomplete spinal cord injury.

G. Barriere (Universite de Montreal)

2009-04-01

92

Naturally Occurring Disk Herniation in Dogs: An Opportunity for Pre-Clinical Spinal Cord Injury Research  

PubMed Central

Abstract Traumatic spinal cord injuries represent a significant source of morbidity in humans. Despite decades of research using experimental models of spinal cord injury to identify candidate therapeutics, there has been only limited progress toward translating beneficial findings to human spinal cord injury. Thoracolumbar intervertebral disk herniation is a naturally occurring disease that affects dogs and results in compressive/contusive spinal cord injury. Here we discuss aspects of this disease that are analogous to human spinal cord injury, including injury mechanisms, pathology, and metrics for determining outcomes. We address both the strengths and weaknesses of conducting pre-clinical research in these dogs, and include a review of studies that have utilized these animals to assess efficacy of candidate therapeutics. Finally, we consider a two-species approach to pre-clinical data acquisition, beginning with a reproducible model of spinal cord injury in the rodent as a tool for discovery with validation in pet dogs with intervertebral disk herniation. PMID:21438715

Levine, Gwendolyn J.; Porter, Brian F.; Topp, Kimberly; Noble-Haeusslein, Linda J.

2011-01-01

93

Adaptation of motor function after spinal cord injury: novel insights into spinal shock.  

PubMed

The mechanisms underlying spinal shock have not been clearly defined. At present, clinical assessment remains the mainstay to describe progression through spinal shock following traumatic spinal cord injury. However, nerve excitability studies in combination with conventional nerve conduction and clinical assessments have the potential to investigate spinal shock at the level of the peripheral axon. Therefore, peripheral motor axon excitability was prospectively and systematically evaluated in more than 400 studies of 11 patients admitted to hospital after traumatic spinal cord injury, with cord lesions above T9 (nine cervical, two thoracic). Recordings commenced within 15 days of admission from the median nerve to abductor pollicis brevis in the upper limb and the common peroneal nerve to tibialis anterior in both lower limbs, and were continued until patient discharge from hospital. Excitability was assessed using threshold tracking techniques and recordings were compared with data from healthy controls. In addition, concurrent clinical measures of strength, serum electrolytes and nerve conduction were collected. High threshold stimulus-response relationships were apparent from the early phase of spinal shock that coincided with depolarization-like features that reached a peak on Day 16.9 (± 2.7 standard error) for the common peroneal nerve and Day 11.8 (± 2.0 standard error) for the median nerve. Overall, changes in the common peroneal nerve were of greater magnitude than for the median nerve. For both nerves, the most significant changes were in threshold electrotonus, which was 'fanned in', and during the recovery cycle superexcitability was reduced (P < 0.001). However, refractoriness was increased only for the common peroneal nerve (P < 0.05). Changes in the spinal injured cohort could not be explained on the basis of an isolated common peroneal nerve palsy. By the time patients with spinal injury were discharged from hospital between Days 68 and 215, excitability for upper and lower limbs had returned towards normative values, but not for all parameters. Electrolyte levels and results for nerve conduction studies remained within normal limits throughout the period of admission. Contrary to prevailing opinion, these data demonstrate that significant changes in peripheral motor axonal excitability occur early during spinal shock, with subsequent further deterioration in axonal function, before recovery ensues. PMID:20952380

Boland, Robert A; Lin, Cindy S-Y; Engel, Stella; Kiernan, Matthew C

2011-02-01

94

Molecular Imaging in Stem Cell Therapy for Spinal Cord Injury  

PubMed Central

Spinal cord injury (SCI) is a serious disease of the center nervous system (CNS). It is a devastating injury with sudden loss of motor, sensory, and autonomic function distal to the level of trauma and produces great personal and societal costs. Currently, there are no remarkable effective therapies for the treatment of SCI. Compared to traditional treatment methods, stem cell transplantation therapy holds potential for repair and functional plasticity after SCI. However, the mechanism of stem cell therapy for SCI remains largely unknown and obscure partly due to the lack of efficient stem cell trafficking methods. Molecular imaging technology including positron emission tomography (PET), magnetic resonance imaging (MRI), optical imaging (i.e., bioluminescence imaging (BLI)) gives the hope to complete the knowledge concerning basic stem cell biology survival, migration, differentiation, and integration in real time when transplanted into damaged spinal cord. In this paper, we mainly review the molecular imaging technology in stem cell therapy for SCI. PMID:24701583

Tian, Mei; Zhang, Hong

2014-01-01

95

Low-level laser therapy for spinal cord injury in rats: effects of polarization  

E-print Network

The effects of laser polarization on the efficacy of near-infrared low-level laser therapy for spinal cord injury (SCI) are presented. Rat spinal cords were injured with a weight-drop device, and the lesion sites were ...

Ando, Takahiro

96

Development and Treatments of Inflammatory Cells and Cytokines in Spinal Cord Ischemia-Reperfusion Injury  

PubMed Central

During aortic surgery, interruption of spinal cord blood flow might cause spinal cord ischemia-reperfusion injury (IRI). The incidence of spinal cord IRI after aortic surgery is up to 28%, and patients with spinal cord IRI might suffer from postoperative paraplegia or paraparesis. Spinal cord IRI includes two phases. The immediate spinal cord injury is related to acute ischemia. And the delayed spinal cord injury involves both ischemic cellular death and reperfusion injury. Inflammation is a subsequent event of spinal cord ischemia and possibly a major contributor to spinal cord IRI. However, the development of inflammatory mediators is incompletely demonstrated. And treatments available for inflammation in spinal cord IRI are insufficient. Improved understanding about spinal cord IRI and the development of inflammatory cells and cytokines in this process will provide novel therapeutic strategies for spinal cord IRI. Inflammatory cytokines (e.g., TNF-? and IL-1) may play an important role in spinal cord IRI. For treatment of several intractable autoimmune diseases (e.g., rheumatoid arthritis), where inflammatory cytokines are involved in disease progression, anti-inflammatory cytokine antagonist is now available. Hence, there is great potential of anti-inflammatory cytokine antagonist for therapeutic use of spinal cord IRI. We here review the mediators and several possibilities of treatment in spinal cord IRI. PMID:23956505

Zhu, Ping; Li, Jia-xin; Fujino, Masayuki; Zhuang, Jian; Li, Xiao-Kang

2013-01-01

97

Flexion reflex modulation during stepping in human spinal cord injury  

Microsoft Academic Search

The flexion reflex modulation pattern was investigated in nine people with a chronic spinal cord injury during stepping using\\u000a body weight support on a treadmill and manual assistance by therapists. Body weight support was provided by an upper body\\u000a harness and was adjusted for each subject to promote the best stepping pattern with the least manual assistance required by\\u000a the

Maria Knikou; Claudia A. Angeli; Christie K. Ferreira; Susan J. Harkema

2009-01-01

98

Therapeutic approaches for spinal cord injury induced spasticity  

Microsoft Academic Search

Spasticity is evident in both humans and animals following spinal cord injury (SCI) and can contribute to significant functional\\u000a limitation and disruption in quality of life of patients with this disorder. This mini-review describes a number of preclinical\\u000a and clinical studies that promise to improve outcomes for, especially in terms of spasticity and hyper-reflexia, patients\\u000a with SCI. A gold standard

C. C. Yates; K. Garrison; A. Charlesworth; N. B. Reese; E. Garcia-Rill

2010-01-01

99

In Delicate Balance: Stem Cells and Spinal Cord Injury Advocacy  

Microsoft Academic Search

Spinal cord injury (SCI) is a major focus for stem cell therapy (SCT). However, the science of SCT has not been well matched\\u000a with an understanding of perspectives of persons with SCI. The online advocacy community is a key source of health information\\u000a for primary stakeholders and their caregivers. In this study, we sought to characterize the content of SCI

Sara Parke; Judy Illes

2011-01-01

100

Alcohol use and readiness to change after spinal cord injury  

Microsoft Academic Search

Objective: To describe alcohol use and motivation to change drinking among persons with recent spinal cord injury (SCI).Design: SurveySetting: Acute inpatient rehabilitation programPatients: Subjects were 58 patients with recent SCI assessed during inpatient rehabilitation.Main Outcome Measures: Short Michigan Alcoholism Screening Test (SMAST), Readiness to Change questionnaire (RTC), and alcohol use questions.Results: Subjects were on average 39 years old, 88% were

Charles H. Bombardier; Carl T. Rimmele

1998-01-01

101

Spinal cord injury: Present and future therapeutic devices and prostheses  

Microsoft Academic Search

Summary  A range of passive and active devices are under development or are already in clinical use to partially restore function after\\u000a spinal cord injury (SCI). Prosthetic devices to promote host tissue regeneration and plasticity and reconnection are under\\u000a development, comprising bioengineered bridging materials free of cells. Alternatively, artificial electrical stimulation and\\u000a robotic bridges may be used, which is our focus

Simon F. Giszter

2008-01-01

102

Marriage Rates Among Persons With Spinal Cord Injury  

Microsoft Academic Search

Postinjury marriage rates of 6,853 persons enrolled in the National Spinal Cord Injury Statistical Center database between 1973 and 1992 were determined. Only 781 marriages occurred, whereas 1,884 marriages were expected based on 29,660 person-years of follow-up and overall annual marriage rates that were specific for age, gender, and previous marital status. Within the study population, characteristics associated with significantly

Michael J. DeVivo; J. Scott Richards

1996-01-01

103

Spinal cord injury in Italy: A multicenter retrospective study  

Microsoft Academic Search

Celani MG, Spizzichino L, Ricci S, Zampolini M, Franceschini M, Retrospective Study Group on SCI. Spinal cord injury in Italy: a multicenter retrospective study. Arch Phys Med Rehabil 2001;82:589-96. Objective: To investigate certain factors influencing the length of stay (LOS) in a rehabilitation center, the incidence of pressure ulcers, and the neurologic improvement of patients with traumatic (T\\/SCI) and nontraumatic

M. Grazia Celani; Lorenzo Spizzichino; Stefano Ricci; Mauro Zampolini; Marco Franceschini

2001-01-01

104

Psychological resources in spinal cord injury: a systematic literature review  

Microsoft Academic Search

Study design:Systematic literature review.Objectives:The purpose of this study was to gain a systematic overview of the role of psychological resources in the adjustment to spinal cord injury (SCI).Methods:A systematic literature review was performed. The literature search was conducted in the databases Pubmed, PsycINFO, the Social Sciences Citation Index, the Education Resources Information Center, Embase and the Citation Index of Nursing

C Peter; R Müller; A Cieza; S Geyh

2012-01-01

105

Pathological CNS Autoimmune Disease Triggered by Traumatic Spinal Cord Injury: Implications for Autoimmune Vaccine Therapy  

Microsoft Academic Search

Lymphocytes respond to myelin proteins after spinal cord injury (SCI) and may contribute to post-traumatic secondary degen- eration. However, there is increasing evidence that autoreactive T-lymphocytes may also convey neuroprotection and promote functional recovery after CNS injury. To clarify the role of myelin autoreactive lymphocytes after SCI, we performed contusion injuries in the thoracic spinal cord of transgenic (Tg) mice

T. Bucky Jones; D. Michele Basso; Ajeet Sodhi; Jonathan Z. Pan; Ronald P. Hart; Robert C. MacCallum; Sunhee Lee; Caroline C. Whitacre; Phillip G. Popovich

2002-01-01

106

A clinical prediction rule for ambulation outcomes after traumatic spinal cord injury: a longitudinal cohort study  

Microsoft Academic Search

BACKGROUND: Traumatic spinal cord injury is a serious disorder in which early prediction of ambulation is important to counsel patients and to plan rehabilitation. We developed a reliable, validated prediction rule to assess a patient's chances of walking independently after such injury. METHODS: We undertook a longitudinal cohort study of adult patients with traumatic spinal cord injury, with early (within

Joost J van Middendorp; Allard JF Hosman; A Rogier T Donders; Martin H Pouw; John F Ditunno; Armin Curt; Alexander CH Geurts; Hendrik Van de Meent

2011-01-01

107

Posttraumatic Stress Disorder and Major Depression in Veterans With Spinal Cord Injury  

Microsoft Academic Search

Objective: To explore the relationship between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in veterans with spinal cord injury and to compare those results with results found in veterans who had sustained other traumatic injuries. Method: To investigate the relationship between PTSD and MDD in persons with spinal cord injury, the authors examined whether individuals endorsed overlapping items

Rachel L. Goldman; Cynthia L. Radnitz; Robert E. McGrath

2008-01-01

108

Neuroprotective Effects of Sulforaphane after Contusive Spinal Cord Injury  

PubMed Central

Abstract Traumatic spinal cord injury (SCI) leads to oxidative stress, calcium mobilization, glutamate toxicity, the release of proinflammatory factors, and depletion of reduced glutathione (GSH) at the site of injury. Induction of the Keap1/Nrf2/ARE pathway can alleviate neurotoxicity by protecting against GSH depletion, oxidation, intracellular calcium overload, mitochondrial dysfunction, and excitotoxicity. Sulforaphane (SF), an isothiocyanate derived from broccoli, is a potent naturally-occurring inducer of the Keap1/Nrf2/ARE pathway, leading to upregulation of genes encoding cytoprotective proteins such as NAD(P)H: quinone oxidoreductase 1, and GSH-regulatory enzymes. Additionally, SF can attenuate inflammation by inhibiting the nuclear factor-?B (NF-?B) pathway, and the enzymatic activity of the proinflammatory cytokine macrophage inhibitory factor (MIF). Our study examined systemic administration of SF in a rat model of contusion SCI, in an effort to utilize its indirect antioxidant and anti-inflammatory properties to decrease secondary injury. Two doses of SF (10 or 50?mg/kg) were administered at 10?min and 72?h after contusion SCI. SF (50?mg/kg) treatment resulted in both acute and long-term beneficial effects, including upregulation of the phase 2 antioxidant response at the injury site, decreased mRNA levels of inflammatory cytokines (i.e., MMP-9) in the injured spinal cord, inactivation of urinary MIF tautomerase activity, enhanced hindlimb locomotor function, and an increased number of serotonergic axons caudal to the lesion site. These findings demonstrate that SF provides neuroprotective effects in the spinal cord after injury, and could be a candidate for therapy of SCI. PMID:22853439

Benedict, Andrea L.; Mountney, Andrea; Hurtado, Andres; Bryan, Kelley E.; Schnaar, Ronald L.; Dinkova-Kostova, Albena T.

2012-01-01

109

Characterizing phospholipase A2-induced spinal cord injury-a comparison with contusive spinal cord injury in adult rats.  

PubMed

To assess whether phospholipase A2 (PLA2) plays a role in the pathogenesis of spinal cord injury (SCI), we compared lesions either induced by PLA2 alone or by a contusive SCI. At 24-h post-injury, both methods induced a focal hemorrhagic pathology. The PLA2 injury was mainly confined within the ventrolateral white matter, whereas the contusion injury widely affected both the gray and white matter. A prominent difference between the two models was that PLA2 induced a massive demyelination with axons remaining in the lesion area, whereas the contusion injury induced axonal damage and myelin breakdown. At 4 weeks, no cavitation was found within the PLA2 lesion, and numerous axons were myelinated by host-migrated Schwann cells. Among them, 45% of animals had early transcranial magnetic motor-evoked potential (tcMMEP) responses. In contrast, the contusive SCI induced a typical centralized cavity with reactive astrocytes forming a glial border. Only 15% of rats had early tcMMEP responses after the contusion. BBB scores were similarly reduced in both models. Our study indicates that PLA2 may play a unique role in mediating secondary SCI likely by targeting glial cells, particularly those of oligodendrocytes. This lesion model could also be used for studying demyelination and remyelination in the injured spinal cord associated with PLA2-mediated secondary SCI. PMID:23585818

Liu, Nai-Kui; Titsworth, William Lee; Zhang, Yi Ping; Xhafa, Aurela I; Shields, Christopher B; Xu, Xiao-Ming

2011-12-01

110

Two case reports of cervical spinal cord injury in football (soccer) players  

Microsoft Academic Search

Study design: Two case reports of male football players who sustained injury to cervical spinal cord as a direct result of the sport.Objective: To raise the awareness that playing football (soccer), a very popular sport, may cause injury to the cervical spinal cord with dire consequences, albeit rarely.Setting: North West Regional Spinal Injuries Centre, Southport, UK.Case report: We report two

P Silva; S Vaidyanathan; B N Kumar; B M Soni; P Sett

2006-01-01

111

Decorin treatment of spinal cord injury  

PubMed Central

The scarring response after a penetrant central nervous system injury results from the interaction between invading leptominingeal/pericyte-derived fibroblasts and endogenous reactive astrocytes about the wound margin. Extracellular matrix and scar-derived axon growth inhibitory molecules fill the lesion site providing both a physical and chemical barrier to regenerating axons. Decorin, a small leucine-rich chondroitin-dermatan sulphate proteoglycan expressed by neurons and astrocytes in the central nervous system, is both anti-fibrotic and anti-inflammatory and attenuates the formation and partial dissolution of established and chronic scars. Here, we discuss the potential of using Decorin to antagonise scarring in the central nervous system. PMID:25374584

Esmaeili, Maryam; Berry, Martin; Logan, Ann; Ahmed, Zubair

2014-01-01

112

A Case of Spinal Cord Injury  

NSDL National Science Digital Library

“Jason Hendrix,” a 21-year-old student majoring in economics, is injured in a serious motorcycle accident while on spring break in Florida.  Students read the short case scenario, which provides a brief clinical history of the patient and a description of his injury, then answer a set of directed questions designed to probe the students’ knowledge of the anatomy, physiology, and pathology underlying the patient’s condition. The case study has been used in both a sophomore-level course in human anatomy and physiology and a senior-level course in general physiology.

Dean, David F.

2005-01-01

113

Depression, Pain Intensity, and Interference in Acute Spinal Cord Injury  

PubMed Central

Background: The high prevalence of pain and depression in persons with spinal cord injury (SCI) is well known. However the link between pain intensity, interference, and depression, particularly in the acute period of injury, has not received sufficient attention in the literature. Objective: To investigate the relationship of depression, pain intensity, and pain interference in individuals undergoing acute inpatient rehabilitation for traumatic SCI. Methods: Participants completed a survey that included measures of depression (PHQ-9), pain intensity (“right now”), and pain interference (Brief Pain Inventory: general activity, mood, mobility, relations with others, sleep, and enjoyment of life). Demographic and injury characteristics and information about current use of antidepressants and pre-injury binge drinking also were collected. Hierarchical multiple regression was used to test depression models in 3 steps: (1) age, gender, days since injury, injury level, antidepressant use, and pre-injury binge drinking (controlling variables); (2) pain intensity; and (3) pain interference (each tested separately). Results: With one exception, pain interference was the only statistically significant independent variable in each of the final models. Although pain intensity accounted for only 0.2% to 1.2% of the depression variance, pain interference accounted for 13% to 26% of the variance in depression. Conclusion: Our results suggest that pain intensity alone is insufficient for understanding the relationship of pain and depression in acute SCI. Instead, the ways in which pain interferes with daily life appear to have a much greater bearing on depression than pain intensity alone in the acute setting. PMID:24574820

Kalpakjian, Claire Z.

2014-01-01

114

Regional Lidocaine Infusion Reduces Postischemic Spinal Cord Injury in Rabbits  

PubMed Central

Paraplegia secondary to spinal cord ischemia is a devastating complication in operations on the descending and thoracoabdominal aorta. We hypothesized that the tolerance of the spinal cord to an ischemic insult could be improved by means of regional administration of lidocaine. Thirty-one New Zealand white rabbits were anesthetized and spinal cord ischemia was induced by the placement of clamps both below the left renal vein and above the aortic bifurcation. The animals were divided into 5 groups. Aortic occlusion time was 20 minutes in Group 1 and 30 minutes in all other groups. Groups 1 and 2 functioned as controls. Lidocaine (Group 5) or normal saline solution (Group 3) was infused into the isolated aortic segment after cross-clamping. Group 4 animals received 20% mannitol regionally, before and after reperfusion. Postoperatively, rabbits were classified as either neurologically normal or injured (paralyzed or paretic). Among controls, 20 minutes of aortic occlusion did not produce any neurologic deficit (Group 1: 0/4 injured), while 30 minutes of occlusion resulted in more consistent injury (Group 2: 6/8 injured). Animals that received normal saline (Group 3) or mannitol (Group 4) regionally showed 80% neurologic injury (4/5). Animals treated with the regional lidocaine infusion (Group 5) showed much better neurologic outcomes (7/9 normal: 78%). This superiority of Group 5 over Groups 2, 3, and 4 was significant (P < 0.02). We conclude that regional administration of lidocaine reduced neurologic injury secondary to spinal cord ischemia and reperfusion after aortic occlusion in the rabbit model. PMID:11678249

Apaydin, Anil Z.; Buket, Suat

2001-01-01

115

Long-term spinal cord injury increases susceptibility to isometric contraction-induced muscle injury  

Microsoft Academic Search

Complete spinal cord injury (SCI) results in inactivation and unloading of affected skeletal muscles. Unloading causes an increased susceptibility of muscle to contraction-induced injury. This study used magnetic resonance imaging (MRI) to test the hypothesis that isometric contractions would evoke greater muscle damage to the quadriceps femoris muscle (mQF) of SCI subjects than that of able-bodied (AB) controls. MR images

C. Scott Bickel; Jill M. Slade; Gary A. Dudley

2004-01-01

116

Spinal cord stress injury assessment (SCOSIA): clinical applications of mechanical modeling of the spinal cord and brainstem  

NASA Astrophysics Data System (ADS)

Abnormal stretch and strain is a major cause of injury to the spinal cord and brainstem. Such forces can develop from age-related degeneration, congenital malformations, occupational exposure, or trauma such as sporting accidents, whiplash and blast injury. While current imaging technologies provide excellent morphology and anatomy of the spinal cord, there is no validated diagnostic tool to assess mechanical stresses exerted upon the spinal cord and brainstem. Furthermore, there is no current means to correlate these stress patterns with known spinal cord injuries and other clinical metrics such as neurological impairment. We have therefore developed the spinal cord stress injury assessment (SCOSIA) system, which uses imaging and finite element analysis to predict stretch injury. This system was tested on a small cohort of neurosurgery patients. Initial results show that the calculated stress values decreased following surgery, and that this decrease was accompanied by a significant decrease in neurological symptoms. Regression analysis identified modest correlations between stress values and clinical metrics. The strongest correlations were seen with the Brainstem Disability Index (BDI) and the Karnofsky Performance Score (KPS), whereas the weakest correlations were seen with the American Spinal Injury Association (ASIA) scale. SCOSIA therefore shows encouraging initial results and may have wide applicability to trauma and degenerative disease involving the spinal cord and brainstem.

Wong, Kenneth H.; Choi, Jae; Wilson, William; Berry, Joel; Henderson, Fraser C., Sr.

2009-02-01

117

Alteration of capsaicin-induced pulmonary chemoreflex following chronic cervical spinal cord injury.  

E-print Network

??High cervical spinal cord injury usually changes the respiratory pattern, which may influence the pulmonary vagal afferent activity. Previous study revealed that pulmonary chemoreflex cannot… (more)

Chang, Yu-Shuo

2014-01-01

118

Spinal cord injury II: Prognostic indicators, standards of care, and clinical trials  

PubMed Central

This is the second of a 2-part review of spinal cord injury. The focus herein is to highlight recent findings regarding prognostic indicators used for spinal cord injury (SCI) in dogs, promote an awareness of the current recommendations of standard of care for traumatic spinal cord injury in veterinary medicine, and highlight the findings of clinical trials of therapies for spinal cord injury in dogs. This 2-part review provides information that will assist general and specialty veterinary practitioners in evidence-based veterinary medical practice in an area that has become particularly specialized. PMID:20808569

Webb, Aubrey A.; Ngan, Sybil; Fowler, David

2010-01-01

119

An Evaluation of White Matter Injury After Spinal Cord Ischemia in Rats: A Comparison with Gray Matter Injury  

Microsoft Academic Search

We quantitatively assessed both gray and white matter injury after spinal cord ischemia in rats, and the rela- tionship between the magnitude of gray and white matter injury was determined. Twenty-five male rats were anesthetized with isoflurane, and spinal cord ischemia (SCI) was induced by balloon intraaortic oc- clusion combined with hypotension. The animals wererandomlyallocatedtooneofthefollowingthree groups: animals with SCI for

Naoko Kurita; Masahiko Kawaguchi; Toshinori Horiuchi; Satoki Inoue; Takanori Sakamoto; Mitsutoshi Nakamura; Noboru Konishi; Hitoshi Furuya

2005-01-01

120

Neurological recovery distal to the zone of injury in 172 cases of closed, traumatic spinal cord injury  

Microsoft Academic Search

The Southwest Regional System for Treatment of Spinal Cord Injury (Good Samaritan Hospital and St Joseph's Hospital, Phoenix, Arizona) treated 325 cases of traumatic spinal cord injury during the period June 1970 through December 1975. Of these, 172 met the study population criteria of the cases reported by Frankel et al. (1969) in their paper ‘The value of postural reduction

John S Young; Wayne R Dexter

1978-01-01

121

Post-operative spinal epidural hematoma causing American Spinal Injury Association B spinal cord injury in patients with suction wound drains  

PubMed Central

Background Subfascial wound suction drains are commonly used after spinal surgery to decrease the incidence of post-operative hematoma. However, there is a paucity of literature regarding their effectiveness. Objective To report four cases of post-operative spinal epidural hematoma causing massive neurological deficit in patients who had subfascial suction wound drains. Methods During an 8-year period, a retrospective review of 1750 consecutive adult spinal surgery cases was performed to determine the incidence, commonalities, and outcomes of catastrophic neurological deficit caused by post-operative spinal epidural hematoma. Findings Epidural hematoma causing major neurological deficit (American Spinal Injury Association B) was identified in 4 out of 1750 patients (0.23%). All four patients in this series had subfascial wound suction drains placed prophylactically at the conclusion of their initial procedure. Results Three patients developed massive neurological deficits with the drain in place; one patient had the drain removed at 24 hours and subsequently developed neurological symptoms during the following post-operative day. Significant risk factors for the development of hematoma were identified in two of the four patients. Average time to return to the operating room for hematoma evacuation was 6 hours (range 3–12 hours). Neurological status significantly improved in all four patients after hematoma evacuation. Conclusions Post-operative epidural hematoma causing catastrophic neurological deficit is a rare complication after spinal surgery. The presence of suction wound drains does not appear to prevent the occurrence of this devastating complication. PMID:23809591

Chimenti, Peter; Molinari, Robert

2013-01-01

122

Sports and Recreation Are a Rising Cause of Spinal Cord Injury.  

ERIC Educational Resources Information Center

Sports and recreation rose from the third to the second leading cause of spinal injuries treated in two Toronto hospitals between 1948 and 1983. Separate surveys of diving and hockey injuries are also reported. (Author/MT)

Tator, Charles H.; Edmonds, Virginia E.

1986-01-01

123

Tert-butylhydroquinone protects the spinal cord against inflammatory response produced by spinal cord injury.  

PubMed

Antioxidant transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) has been shown in our previous studies to play an important role in protection against spinal cord injury (SCI) induced inflammatory response. The objective of this study was to test whether tert-butylhydroquinone (tBHQ), a novel Nrf2 activator, can protect the spinal cord against SCI-induced inflammatory damage. Adult male Sprague-Dawley rats were subjected to laminectomy at T8-T9 and compression with a vascular clip. Three groups were analyzed: a sham group, a SCI group, and a SCI+rhEPO group (n=16 per group). We measured Nrf2 and nuclear factor kappa B (NF-?B) binding activities by an electrophoretic mobility shift assay (EMSA). We also measured the concentrations of tumor necrosis factor-? (TNF-?), interleukin-1? (IL-1?), and interleukin-6 (IL-6) by an enzyme-linked immunosorbent assay (ELISA); we also measured hindlimb locomotion function by the Basso, Beattie, and Bresnahan (BBB) rating, spinal cord edema by wet/dry weight method, and apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) analysis. The results showed that the induction of the Nrf2 activity by tBHQ markedly decreased NF-?B activation and inflammatory cytokines production in the injured spinal cord. Administration of tBHQ also significantly attenuated SCI induced hindlimb locomotion deficits, spinal cord edema, and apoptosis. To conclude, pre-treatment with tBHQ could attenuate the spinal cord inflammatory response after SCI. PMID:24795053

Jin, Wei; Ni, Hongbin; Hou, Xiaoshan; Ming, Xing; Wang, Jing; Yuan, Baoyu; Zhu, Tiansheng; Jiang, Jian; Wang, Handong; Liang, Weibang

2014-01-01

124

Microglial Activation in Rat Experimental Spinal Cord Injury Model  

PubMed Central

Background: The present study was designed to evaluate the secondary microglial activation processes after spinal cord injury (SCI). Methods: A quantitative histological study was performed to determine ED-1 positive cells, glial cell density, and cavitation size in untreated SCI rats at days 1, 2, and 4, and weeks 1, 2, 3, and 4. Results: The results of glial cell quantification along the 4900-µm long injured spinal cord showed a significant increase in glial cell density percentage at day 2 as compared to other days. Whereas the highest increase in ED-1 immunoreactive cells (monocyte/phagocyte marker in rats) was observed at day 2 (23.15%) post-injury. Evaluation of cavity percentage showed a significant difference between weeks 3 and 4 post-injury groups. Conclusions: This study provides a new insight into the multiphase immune response to SCI, including cellular inflammation, macrophages/microglia activation, glial cell density, and cavitation. Better understanding of the inflammatory processes associated with acute SCI would permit the development of better therapeutic strategies. PMID:23999718

Abdanipour, Alireza; Tiraihi, Taki; Taheri, Taher; Kazemi, Hadi

2013-01-01

125

MR-imaging of chronic spinal cord injury. Association with neurologic function  

Microsoft Academic Search

Twenty-two para- and tetraplegic patients with chronic spinal cord injuries were examined with magnetic resonance imaging (MRI). The clinical course in the entire rehabilitation period was recorded and an attempt was made to associate the functional status of the patients with the morphologic findings on MRI. Small and large spinal cord cysts and syringomyelia, cord atrophy, and spinal stenosis were

Andreas Nidecker; Michel Kocher; Marc Maeder; Othmar Gratzl; Guido A. Zäch; Ulrich F. Benz; Bernhard Burckhardt

1991-01-01

126

Case Study: A Case of Spinal Cord Injury  

NSDL National Science Digital Library

This is a case study for undergraduate students in anatomy, physiology, and/or anatomy and physiology. In particular this case study explores anatomy and physiology associated with spinal cord injury (plegia, neuroanatomy, neurophysiology, dermatome, stretch reflex). Users of the National Center for Case Study Teaching in Science will be required to register (free) to gain access to the answer key (and must be of teaching status to receive the key). Included in the resource are the case overview, objectives, case study, teaching notes and answer key.

David Dean (Spring Hill College Biology)

2005-12-02

127

Psychology treatment time during inpatient spinal cord injury rehabilitation  

PubMed Central

Background Rehabilitation psychologists are integral members of spinal cord injury (SCI) rehabilitation teams. Objective To describe specific information regarding types and intensity of treatments delivered by rehabilitation psychologists to patients with various levels of SCI. Methods Utilizing a taxonomy of psychological interventions as a framework, rehabilitation psychologists documented time spent on specific psychology interventions for each interaction they had with 600 patients with traumatic SCI at 6 inpatient SCI rehabilitation centers. Associations of patient and injury characteristics with time spent on various psychological interventions were examined using ordinary least squares stepwise regression models. Results Psychologists focus the majority of the time they spend with patients with SCI on psychotherapeutic interventions of processing emotions, emotional adjustment, and family coping, while educational efforts focus mostly on coping and adjusting to the new injury. There was wide variation in the amount of time spent on psychotherapeutic and psychoeducational interventions; patient, injury, and clinician characteristics explained little of the variation in time spent. Conclusions Variations observed in psychological treatment delivery mirror real-world human complexity and clinical experience; they are not explained well by patient and injury characteristics and set the stage for future analyses to associate treatments with outcomes. PMID:21675358

Huston, Toby; Gassaway, Julie; Wilson, Catherine; Gordon, Samuel; Koval, Jill; Schwebel, Andrea

2011-01-01

128

Thoracic Rat Spinal Cord Contusion Injury Induces Remote Spinal Gliogenesis but Not Neurogenesis or Gliogenesis in the Brain  

PubMed Central

After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis) in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC) or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn) of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU) to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord) and unaltered in neurogenic regions (dentate gyrus and SVZ) of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement. PMID:25050623

Pfeifer, Kathrin; Kierdorf, Birthe; Sandner, Beatrice; Bogdahn, Ulrich; Blesch, Armin; Winner, Beate; Weidner, Norbert

2014-01-01

129

Thoracic rat spinal cord contusion injury induces remote spinal gliogenesis but not neurogenesis or gliogenesis in the brain.  

PubMed

After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis) in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC) or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn) of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU) to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord) and unaltered in neurogenic regions (dentate gyrus and SVZ) of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement. PMID:25050623

Franz, Steffen; Ciatipis, Mareva; Pfeifer, Kathrin; Kierdorf, Birthe; Sandner, Beatrice; Bogdahn, Ulrich; Blesch, Armin; Winner, Beate; Weidner, Norbert

2014-01-01

130

Reference for the 2011 revision of the international standards for neurological classification of spinal cord injury  

PubMed Central

The latest revision of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) was available in booklet format in June 2011, and is published in this issue of the Journal of Spinal Cord Medicine. The ISNCSCI were initially developed in 1982 to provide guidelines for the consistent classification of the neurological level and extent of the injury to achieve reliable data for clinical care and research studies. This revision was generated from the Standards Committee of the American Spinal Injury Association in collaboration with the International Spinal Cord Society's Education Committee. This article details and explains the updates and serves as a reference for these revisions and clarifications. PMID:22330109

Kirshblum, Steven C.; Waring, William; Biering-Sorensen, Fin; Burns, Stephen P.; Johansen, Mark; Schmidt-Read, Mary; Donovan, William; Graves, Daniel E.; Jha, Amitabh; Jones, Linda; Mulcahey, M. J.; Krassioukov, Andrei

2011-01-01

131

The role of the psychologist in the treatment of spinal cord injury  

Microsoft Academic Search

Advances in the treatment of spinal cord injury have shifted the emphasis from problems of survival to problems of psychological integration into the community. However, the patient's expectations for a fairly normal life are often not realised because of discrimination against disabled persons by able-bodied persons. Therefore, rehabilitation should include psychosocial skills training to teach spinal cord injury persons to

Roberta B Trieschmann

1978-01-01

132

Cardiovascular and endocrine responses during the cold pressor test in subjects with cervical spinal cord injuries  

Microsoft Academic Search

Mizushima T, Tajima F, Okawa H, Umezu Y, Furusawa K, Ogata H. Cardiovascular and endocrine responses during the cold pressor test in subjects with spinal cord injuries. Arch Phys Med Rehabil 2003;84:112-8. Objective: To investigate cardiovascular regulation and endocrine responses during the cold pressor test in patients with chronic spinal cord injury (SCI). Design: Experimental and control study. Setting: University

Takashi Mizushima; Fumihiro Tajima; Hiroyuki Okawa; Yuichi Umezu; Kazunari Furusawa; Hajime Ogata

2003-01-01

133

Theory of Planned Behaviour, Skin Care and Pressure Sores Following Spinal Cord Injury  

Microsoft Academic Search

Objectives: To use the Theory of Planned Behaviour to explore factors associated with performing skin care behaviors and the occurrence of pressure sores in people with spinal cord injury. Design: A within-group cross-sectional design was used to assess 59 people with spinal cord injury living in the community. Of these, 17 participants returned a repeat assessment allowing a longitudinal examination

R. Sheppard; P. Kennedy; C. A. Mackey

2006-01-01

134

Chronic spinal cord injury: management of patients in acute hospital settings  

Microsoft Academic Search

Spinal cord injury (SCI) is a lifelong condition affecting over 40,000 people in the UK. When an individual with established SCI is admitted to hospital for a procedure or because of illness, hospital teams need to manage both the acute condition and the spinal cord injury. These guidelines aim to assist in their assessment and management to avoid the common

Angela Gall; Lynne Turner; Stokes FRCP

2008-01-01

135

Ischemic Preconditioning Protects against Spinal Cord Ischemia-Reperfusion Injury in Rabbits by Attenuating Blood Spinal Cord Barrier Disruption  

PubMed Central

Ischemic preconditioning has been reported to protect against spinal cord ischemia-reperfusion (I-R) injury, but the underlying mechanisms are not fully understood. To investigate this, Japanese white rabbits underwent I-R (30 min aortic occlusion followed by reperfusion), ischemic preconditioning (three cycles of 5 min aortic occlusion plus 5 min reperfusion) followed by I-R, or sham surgery. At 4 and 24 h following reperfusion, neurological function was assessed using Tarlov scores, blood spinal cord barrier permeability was measured by Evan’s Blue extravasation, spinal cord edema was evaluated using the wet-dry method, and spinal cord expression of zonula occluden-1 (ZO-1), matrix metalloproteinase-9 (MMP-9), and tumor necrosis factor-? (TNF-?) were measured by Western blot and a real-time polymerase chain reaction. ZO-1 was also assessed using immunofluorescence. Spinal cord I-R injury reduced neurologic scores, and ischemic preconditioning treatment ameliorated this effect. Ischemic preconditioning inhibited I-R-induced increases in blood spinal cord barrier permeability and water content, increased ZO-1 mRNA and protein expression, and reduced MMP-9 and TNF-? mRNA and protein expression. These findings suggest that ischemic preconditioning attenuates the increase in blood spinal cord barrier permeability due to spinal cord I-R injury by preservation of tight junction protein ZO-1 and reducing MMP-9 and TNF-? expression. PMID:23685868

Fang, Bo; Li, Xiao-Man; Sun, Xi-Jia; Bao, Na-Ren; Ren, Xiao-Yan; Lv, Huang-Wei; Ma, Hong

2013-01-01

136

OPERANT CONDITIONING OF A SPINAL REFLEX CAN IMPROVE LOCOMOTION AFTER SPINAL CORD INJURY IN HUMANS  

PubMed Central

Operant conditioning protocols can modify the activity of specific spinal cord pathways and can thereby affect behaviors that use these pathways. To explore the therapeutic application of these protocols, we studied the impact of down-conditioning the soleus H-reflex in people with impaired locomotion caused by chronic incomplete spinal cord injury. After a baseline period in which soleus H-reflex size was measured and locomotion was assessed, subjects completed either 30 H-reflex down-conditioning sessions (DC subjects) or 30 sessions in which the H-reflex was simply measured (Unconditioned (UC) subjects), and locomotion was reassessed. Over the 30 sessions, the soleus H-reflex decreased in two-thirds of the DC subjects (a success rate similar to that in normal subjects) and remained smaller several months later. In these subjects, locomotion became faster and more symmetrical, and the modulation of EMG activity across the step-cycle increased bilaterally. Furthermore, beginning about halfway through the conditioning sessions, all of these subjects commented spontaneously that they were walking faster and farther in their daily lives, and several noted less clonus, easier stepping, and/or other improvements. The H-reflex did not decrease in the other DC subjects or in any of the UC subjects; and their locomotion did not improve. These results suggest that reflex conditioning protocols can enhance recovery of function after incomplete spinal cord injuries and possibly in other disorders as well. Because they are able to target specific spinal pathways, these protocols could be designed to address each individual’s particular deficits, and might thereby complement other rehabilitation methods. PMID:23392666

Thompson, Aiko K.; Pomerantz, Ferne; Wolpaw, Jonathan R.

2013-01-01

137

Characterization of Vascular Disruption and Blood-Spinal Cord Barrier Permeability following Traumatic Spinal Cord Injury  

PubMed Central

Abstract Significant vascular changes occur subsequent to spinal cord injury (SCI), which contribute to progressive pathophysiology. In the present study, we used female Wistar rats (300–350?g) and a 35-g clip-compression injury at T6 to T7 to characterize the spatial and temporal vascular changes that ensue post-SCI. Before sacrifice, animals were injected with vascular tracing dyes (2% Evans Blue (EB) or fluorescein isothiocyanate/Lycopersicon esculentum agglutinin [FITC-LEA]) to assess blood–spinal cord barrier (BSCB) integrity or vascular architecture, respectively. Spectrophotometry of EB tissue showed maximal BSCB disruption at 24?h postinjury, with significant disruption observed until 5 days postinjury (p<0.01). FITC-LEA-identified functional vasculature was dramatically reduced by 24?h. Similarly, RECA-1 immunohistochemistry showed a significant decrease in the number of vessels at 24?h postinjury, compared to uninjured animals (p<0.01), with slight increases in endogenous revascularization by 10 days postinjury. White versus gray matter (GM) quantification showed that GM vessels are more susceptible to SCI. Finally, we observed an endogenous angiogenic response between 3 and 7 days postinjury: maximal endothelial cell proliferation was observed at day 5. These data indicate that BSCB disruption and endogenous revascularization occur at specific time points after injury, which may be important for developing effective therapeutic interventions for SCI. PMID:24237182

Figley, Sarah A.; Khosravi, Ramak; Legasto, Jean M.; Tseng, Yun-Fan

2014-01-01

138

The impact of spinal cord injury on breathing during sleep  

PubMed Central

The prevalence of sleep disordered breathing (SDB) following spinal cord injury (SCI) is considerably greater than in the general population. While the literature on this topic is still relatively small, and in some cases contradictory, a few general conclusions can be drawn. First, while both central and obstructive sleep apnea (OSA) has been reported after SCI, OSA appears to be more common. Second, SDB after SCI likely reflects a complex interplay between multiple factors including body mass, lung volume, autonomic function, sleep position, and respiratory neuroplasticity. It is not yet possible to pinpoint a “primary factor” which will predispose an individual with SCI to SDB, and the underlying mechanisms may change during progression from acute to chronic injury. Given the prevalence and potential health implications of SDB in the SCI population, we suggest that additional studies aimed at defining the underlying mechanisms are warranted. PMID:23791824

Fuller, David D.; Lee, Kun-Ze; Tester, Nicole J.

2014-01-01

139

Respiratory Management in the Patient with Spinal Cord Injury  

PubMed Central

Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratory muscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VC may require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency. Mechanical ventilation can adversely affect the structure and function of the diaphragm. Early tracheostomy following short orotracheal intubation is probably beneficial in selected patients. Weaning should start as soon as possible, and the best modality is progressive ventilator-free breathing (PVFB). Appropriate candidates can sometimes be freed from mechanical ventilation by electrical stimulation. Respiratory muscle training regimens may improve patients' inspiratory function following a SCI. PMID:24089664

Galeiras Vazquez, Rita; Rascado Sedes, Pedro; Montoto Marques, Antonio; Ferreiro Velasco, M. Elena

2013-01-01

140

Toll-like receptor 2-mediated alternative activation of microglia is protective after spinal cord injury.  

PubMed

Improving neurological outcome after spinal cord injury is a major clinical challenge because axons, once severed, do not regenerate but 'dieback' from the lesion site. Although microglia, the immunocompetent cells of the brain and spinal cord respond rapidly to spinal cord injury, their role in subsequent injury or repair remains unclear. To assess the role of microglia in spinal cord white matter injury we used time-lapse two-photon and spectral confocal imaging of green fluorescent protein-labelled microglia, yellow fluorescent protein-labelled axons, and Nile Red-labelled myelin of living murine spinal cord and revealed dynamic changes in white matter elements after laser-induced spinal cord injury in real time. Importantly, our model of acute axonal injury closely mimics the axonopathy described in well-characterized clinically relevant models of spinal cord injury including contusive-, compressive- and transection-based models. Time-lapse recordings revealed that microglia were associated with some acute pathophysiological changes in axons and myelin acutely after laser-induced spinal cord injury. These pathophysiological changes included myelin and axonal spheroid formation, spectral shifts in Nile Red emission spectra in axonal endbulbs detected with spectral microscopy, and 'bystander' degeneration of axons that survived the initial injury, but then succumbed to secondary degeneration. Surprisingly, modulation of microglial-mediated release of neurotoxic molecules failed to protect axons and myelin. In contrast, sterile stimulation of microglia with the specific toll-like receptor 2 agonist Pam2CSK4 robustly increased the microglial response to ablation, reduced secondary degeneration of central myelinated fibres, and induced an alternative (mixed M1:M2) microglial activation profile. Conversely, Tlr2 knock out: Thy1 yellow fluorescent protein double transgenic mice experienced greater axonal dieback than littermate controls. Thus, promoting an alternative microglial response through Pam2CSK4 treatment is neuroprotective acutely following laser-induced spinal cord injury. Therefore, anti-inflammatory treatments that target microglial activation may be counterintuitive after spinal cord injury. PMID:24369381

Stirling, David P; Cummins, Karen; Mishra, Manoj; Teo, Wulin; Yong, V Wee; Stys, Peter

2014-03-01

141

Sexual Dysfunction Following Spinal Cord Injury: the Experiences of Malaysian Women  

Microsoft Academic Search

The aim of the study is to assess the changes in sexual life and sexual function in women after spinal cord injury using the\\u000a validated Malay Version of Female Sexual Function Index. Thirty-three women with spinal cord injury from the Spinal Rehabilitation\\u000a Unit of a tertiary hospital in Malaysia participated in this study. A comparison was made between this group

Aiza Shafrina Othman; Julia Patrick Engkasan

142

Autonomic Dysreflexia Causes Chronic Immune Suppression after Spinal Cord Injury  

PubMed Central

Autonomic dysreflexia (AD), a potentially dangerous complication of high-level spinal cord injury (SCI) characterized by exaggerated activation of spinal autonomic (sympathetic) reflexes, can cause pulmonary embolism, stroke, and, in severe cases, death. People with high-level SCI also are immune compromised, rendering them more susceptible to infectious morbidity and mortality. The mechanisms underlying postinjury immune suppression are not known. Data presented herein indicate that AD causes immune suppression. Using in vivo telemetry, we show that AD develops spontaneously in SCI mice with the frequency of dysreflexic episodes increasing as a function of time postinjury. As the frequency of AD increases, there is a corresponding increase in splenic leucopenia and immune suppression. Experimental activation of spinal sympathetic reflexes in SCI mice (e.g., via colorectal distension) elicits AD and exacerbates immune suppression via a mechanism that involves aberrant accumulation of norepinephrine and glucocorticoids. Reversal of postinjury immune suppression in SCI mice can be achieved by pharmacological inhibition of receptors for norepinephrine and glucocorticoids during the onset and progression of AD. In a human subject with C5 SCI, stimulating the micturition reflex caused AD with exaggerated catecholamine release and impaired immune function, thus confirming the relevance of the mouse data. These data implicate AD as a cause of secondary immune deficiency after SCI and reveal novel therapeutic targets for overcoming infectious complications that arise due to deficits in immune function. PMID:23926252

Zhang, Yi; Guan, Zhen; Reader, Brenda; Shawler, Todd; Mandrekar-Colucci, Shweta; Huang, Kun; Weil, Zachary; Bratasz, Anna; Wells, Jonathan; Powell, Nicole D.; Sheridan, John F.; Whitacre, Caroline C.; Rabchevsky, Alexander G.; Nash, Mark S.

2013-01-01

143

Musculoskeletal Deterioration and Hemicorporectomy After Spinal Cord Injury  

PubMed Central

Background and Purpose The long-term management following an hemicorporectomy (HCP) is not well documented in the scientific literature. The purpose of this case report is to describe the 25-year history of a man with a spinal cord injury who experienced severe musculoskeletal deterioration and hemicorporectomy. Case Description The client sustained T10 complete paraplegia at age 18 years, developed severe decubitus ulcers, and required an HCP as a lifesaving measure 13 years later. The authors describe the chronology of several rehabilitation and prosthetic strategies and speculate on factors that may have contributed to their successes and failures. Outcomes The client survived 12 years after the HCP and returned to independent mobility, self-care, and schooling despite complications with continued skin breakdown. Over the 12 years following discharge from the hospital after the spinal cord injury, he spent 749 days in the hospital. During the 12 years he lived after discharge from the hospital following the HCP, he was hospitalized 190 days. Discussion The authors discuss factors contributing to the client’s musculoskeletal deterioration including chronic wounds, postural deviations, and incomplete adherence to pressure-relief recommendations and raise considerations for physical therapists who treat patients after HCP. PMID:12620090

Dudley-Javoroski, Shauna

2014-01-01

144

Wheelchair cushions for persons with spinal cord injury: an update.  

PubMed

Occupational therapists frequently prescribe wheelchair cushions to reduce the risk of pressure sores in patients with spinal cord injury. In an earlier study (Garber, 1985b), Roho cushions were prescribed for the greatest number of subjects studied. The present study of 197 subjects updates these data and describes current prescription patterns, the use of cushions over time, satisfaction with prescribed cushions, and the occurrence of pressure sores with prescribed cushions. The study shows that the Jay cushion was prescribed most frequently for the current subjects, although it was not recommended for all persons with spinal cord injury. In the second phase of the present study, involving 30 subjects, 30% of the subjects discontinued use of the prescribed cushion. Skin breakdown and the discovery of alternative solutions were given as primary reasons. There was no significant difference in the incidence of pressure sores between subjects who continued to use their prescribed cushions and those who did not. This research supports the conclusion of earlier studies that no one wheelchair cushion is universally effective for all persons and that individual evaluation and routine reassessment are essential in reducing the occurrence of pressure sores. PMID:2063944

Garber, S L; Dyerly, L R

1991-06-01

145

Using the Spinal Cord Injury Common Data Elements.  

PubMed

International Spinal Cord Injury (SCI) Data Sets include core, basic, and extended data sets. To date, 13 data sets have been published on the Web site of the International Spinal Cord Injury Society (ISCoS; www.iscos.org.uk), and several more are forthcoming. The data sets are constituted of data elements, which may be appropriate to use in trials conducted to test novel therapeutic candidates including neuroprotective drugs, various cell types, and rehabilitative strategies and devices. The National Institute of Neurological Disorders and Stroke (NINDS), the National Institutes of Health (NIH), embarked on a Common Data Element (CDE) Project 5 years ago. The mission of the NINDS CDE Project is to develop data standards for clinical research. The NINDS CDE team has since developed variable names and database structures for the International SCI Data Sets (ie, the SCI CDEs; http://www.commondataelements.ninds.nih.gov/SCI.aspx). Dataset variable names and database structure are exemplified with the International SCI Core Data Set and the International SCI Cardiovascular Function Basic Data Set. The consistency of the data sets and the CDE format may improve the ability to transfer critical medical information electronically from one center to another. The goals of the SCI CDE initiative are to increase the efficiency and effectiveness of clinical research studies and clinical treatment, increase data quality, facilitate data sharing, and help educate new clinical investigators. Pilot testing the SCI CDEs is an important step to ensure the SCI CDE effort achieves its goals. PMID:22408366

Biering-Sørensen, Fin; Charlifue, Susan; Devivo, Michael J; Grinnon, Stacie T; Kleitman, Naomi; Lu, Yun; Odenkirchen, Joanne

2012-01-01

146

A 10-year population survey of spinal trauma and spinal cord injuries after road accidents in the Rhône area.  

PubMed

Fatalities or injuries following motorized and non-motorized vehicle accidents (MNMVA) are reported by police or health care systems. However, limited data exist for spinal injuries. Using an epidemiological database of road accidents occurring in a defined geographic area, we measured the incidence of major spinal trauma (MST, Abbreviated Injury Scale [AIS] score 2 or more), spinal cord injury (SCI, AIS score 4 or more), and associated lesions over a 10-year period (1997-2006). Among the 97,341 victims included, 21,623 (22.2%) suffered spinal trauma, but only 1523 (1.6%) and 144 (0.2%) sustained an MST or SCI, respectively, and among those 10% and 43% died, respectively, before reaching hospital facilities. Men were more likely to have SCI and die. Cervical injuries were more frequently observed for SCI (58%) than for MST (39%; p < 0.001). Motorcyclists were overrepresented in SCI (33%) compared to MST (21%; p < 0.001), and were at significant risk for fatality. Non-restrained car occupants were at risk of MST and SCI, whereas motorcyclists wearing helmets were not. The chest was the most frequently-injured body region. Nearly half of MNMVA victims suffering SCI die quickly after the crash. Young age, male gender, a motorcyclist, and non-restrained car occupant were risk factors for serious injury. These groups should be targeted in specific programs to decrease fatalities, spinal trauma, and SCI after MNMVA. PMID:20233040

Lieutaud, Thomas; Ndiaye, Amina; Frost, Fanny; Chiron, Mireille

2010-06-01

147

Role of electrical stimulation for rehabilitation and regeneration after spinal cord injury: an overview  

Microsoft Academic Search

Structural discontinuity in the spinal cord after injury results in a disruption in the impulse conduction resulting in loss\\u000a of various bodily functions depending upon the level of injury. This article presents a summary of the scientific research\\u000a employing electrical stimulation as a means for anatomical or functional recovery for patients suffering from spinal cord\\u000a injury. Electrical stimulation in the

Samar Hamid; Ray Hayek

2008-01-01

148

Operative Timing and Management of Spinal Injuries in Multiply Injured Patients  

Microsoft Academic Search

Spinal injuries occurring in polytrauma patients are caused by high impact trauma. Due to high velocity mechanism, trauma\\u000a of the vertebral column may be accompanied by injuries of adjacent body cavities such as thorax, abdomen, and pelvis. Neurologic\\u000a examination is mandatory and has to be documented preferably using the ASIA\\/IMSOP-classification. Clinical symptoms may point\\u000a towards spinal injury. However, absence of

Christian Hierholzer; Volker Bühren; Alexander Woltmann

2007-01-01

149

Ginsenoside Rd inhibits apoptosis following spinal cord ischemia/reperfusion injury  

PubMed Central

Ginsenoside Rd has a clear neuroprotective effect against ischemic stroke. We aimed to verify the neuroprotective effect of ginsenoside Rd in spinal cord ischemia/reperfusion injury and explore its anti-apoptotic mechanisms. We established a spinal cord ischemia/reperfusion injury model in rats through the occlusion of the abdominal aorta below the level of the renal artery for 1 hour. Successfully established models were injected intraperitoneally with 6.25, 12.5, 25 or 50 mg/kg per day ginsenoside Rd. Spinal cord morphology was observed at 1, 3, 5 and 7 days after spinal cord ischemia/reperfusion injury. Intraperitoneal injection of ginsenoside Rd in ischemia/reperfusion injury rats not only improved hindlimb motor function and the morphology of motor neurons in the anterior horn of the spinal cord, but it also reduced neuronal apoptosis. The optimal dose of ginsenoside Rd was 25 mg/kg per day and the optimal time point was 5 days after ischemia/reperfusion. Immunohistochemistry and western blot analysis showed ginsenoside Rd dose-dependently inhibited expression of pro-apoptotic Caspase 3 and down-regulated the expression of the apoptotic proteins ASK1 and JNK in the spinal cord of rats with spinal cord ischemia/reperfusion injury. These findings indicate that ginsenoside Rd exerts neuroprotective effects against spinal cord ischemia/reperfusion injury and the underlying mechanisms are achieved through the inhibition of ASK1-JNK pathway and the down-regulation of Caspase 3 expression. PMID:25374589

Wang, Baogang; Zhu, Qingsan; Man, Xiaxia; Guo, Li; Hao, Liming

2014-01-01

150

Physical therapy treatment time during inpatient spinal cord injury rehabilitation  

PubMed Central

Background/objective To describe the nature and distribution of activities during physical therapy (PT) delivered in inpatient spinal cord injury (SCI) rehabilitation and discuss predictors (patient and injury characteristics) of the amount of time spent in PT for specific treatment activities. Methods Six hundred patients from six inpatient SCI centers were enrolled in the SCIRehab study. Physical therapists documented details, including time spent, of treatment provided during 37 306 PT sessions that occurred during inpatient SCI rehabilitation. Ordinary least squares regression models associated patient and injury characteristics with time spent in specific PT activities. Results SCIRehab patients received a mean total of 55.3 hours of PT over the course of their rehabilitation stay. Significant differences among four neurologic groups were seen in the amount of time spent on most activities, including the most common PT activities of strengthening exercises, stretching, transfer training, wheelchair mobility training, and gait training. Most PT work (77%) was provided in individual therapy sessions; the remaining 23% was done in group settings. Patient and injury characteristics explained only some of the variations seen in time spent on wheelchair mobility, transfer and bed mobility training, and range of motion/stretching. Conclusion Analysis yielded both expected and unexpected trends in SCI rehabilitation. Significant variation was seen in time spent on PT activities within and among injury groups. Providing therapeutic strengthening treatments consumed the greatest proportion of PT time. About one-quarter of all PT services were provided in group settings. Details about services provided, including time spent, will serve as a starting point in detailing the optimal treatment delivery for maximal outcomes. PMID:21675354

Taylor-Schroeder, Sally; LaBarbera, Jacqueline; McDowell, Shari; Zanca, Jeanne M.; Natale, Audrey; Mumma, Sherry; Gassaway, Julie; Backus, Deborah

2011-01-01

151

Mesoporous silica nanoparticles for treating spinal cord injury  

NASA Astrophysics Data System (ADS)

An estimated 12,000 new cases of spinal cord injury (SCI) occur every year in the United States. A small oxidative molecule responsible for secondary injury, acrolein, is an important target in SCI. Acrolein attacks essential proteins and lipids, creating a feed-forward loop of oxidative stress in both the primary injury area and the surrounding areas. A small molecule used and FDA-approved for hypertension, hydralazine, has been found to "scavenge" acrolein after injury, but its delivery and short half-life, as well as its hypertension effects, hinder its application for SCI. Nanomedical systems broaden the range of therapeutic availability and efficacy over conventional medicine. They allow for targeted delivery of therapeutic molecules to tissues of interest, reducing side effects of untargeted therapies in unwanted areas. Nanoparticles made from silica form porous networks that can carry therapeutic molecules throughout the body. To attenuate the acrolein cascade and improve therapeutic availability, we have used a one-step, modified Stober method to synthesize two types of silica nanoparticles. Both particles are "stealth-coated" with poly(ethylene) glycol (PEG) (to minimize interactions with the immune system and to increase circulation time), which is also a therapeutic agent for SCI by facilitating membrane repair. One nanoparticle type contains an amine-terminal PEG (SiNP-mPEG-Am) and the other possesses a terminal hydrazide group (SiNP-mPEG-Hz). The former allows for exploration of hydralazine delivery, loading, and controlled release. The latter group has the ability to react with acrolein, allowing the nanoparticle to scavenge directly. The nanoparticles have been characterized and are being explored using neuronal PC-12 cells in vitro, demonstrating the potential of novel silica nanoparticles for use in attenuating secondary injury after SCI.

White-Schenk, Désirée.; Shi, Riyi; Leary, James F.

2013-02-01

152

Respiratory Dysfunction and Management in Spinal Cord Injury  

PubMed Central

Respiratory dysfunction is a major cause of morbidity and mortality in spinal cord injury (SCI), which causes impairment of respiratory muscles, reduced vital capacity, ineffective cough, reduction in lung and chest wall compliance, and excess oxygen cost of breathing due to distortion of the respiratory system. Severely affected individuals may require assisted ventilation, which can cause problems with speech production. Appropriate candidates can sometimes be liberated from mechanical ventilation by phrenic-nerve pacing and pacing of the external intercostal muscles. Partial recovery of respiratory-muscle performance occurs spontaneously. The eventual vital capacity depends on the extent of spontaneous recovery, years since injury, smoking, a history of chest injury or surgery, and maximum inspiratory pressure. Also, respiratory-muscle training and abdominal binders improve performance of the respiratory muscles. For patients on long-term ventilation, speech production is difficult. Often, practitioners are reluctant to deflate the tracheostomy tube cuff to allow speech production. Yet cuff-deflation can be done safely. Standard ventilator settings produce poor speech quality. Recent studies demonstrated vast improvement with long inspiratory time and positive end-expiratory pressure. Abdominal binders improve speech quality in patients with phrenic-nerve pacers. Recent data show that the level and completeness of injury and older age at the time of injury may not be related directly to mortality in SCI, which suggests that the care of SCI has improved. The data indicate that independent predictors of all-cause mortality include diabetes mellitus, heart disease, cigarette smoking, and percent-of-predicted forced expiratory volume in the first second. An important clinical problem in SCI is weak cough, which causes retention of secretions during infections. Methods for secretion clearance include chest physical therapy, spontaneous cough, suctioning, cough assistance by forced compression of the abdomen (“quad cough”), and mechanical insufflation-exsufflation. Recently described but not yet available for general use is activation of the abdominal muscles via an epidural electrode placed at spinal cord level T9-L1. PMID:16867197

Brown, Robert; DiMarco, Anthony F; Hoit, Jeannette D; Garshick, Eric

2008-01-01

153

Physical exercise improves arterial stiffness after spinal cord injury.  

PubMed

Objective/background Aortic pulse wave velocity (PWV), the gold-standard assessment of central arterial stiffness, has prognostic value for cardiovascular disease risk in able-bodied individuals. The aim of this study was to compare aortic PWV in athletes and non-athletes with spinal cord injury (SCI). Design Cross-sectional comparison. Methods Aortic PWV was assessed in 20 individuals with motor-complete, chronic SCI (C2-T5; 18 ± 8 years post-injury) using applanation tonometry at the carotid and femoral arterial sites. Ten elite hand-cyclists were matched for sex to 10 non-athletes; age and time since injury were comparable between the groups. Heart rate and discrete brachial blood pressure measurements were collected throughout testing. Outcome measures Aortic PWV, blood pressure, heart rate. Results Aortic PWV was significantly lower in athletes vs. non-athletes (6.9 ± 1.0 vs. 8.7 ± 2.5 m/second, P = 0.044). There were no significant between-group differences in resting supine mean arterial blood pressure (91 ± 19 vs. 81 ± 10 mmHg) and heart rate (60 ± 10 vs. 58 ± 6 b.p.m.). Conclusion Athletes with SCI exhibited improved central arterial stiffness compared to non-athletes, which is in agreement with the previous able-bodied literature. This finding implies that chronic exercise training may improve arterial health and potentially lower cardiovascular disease risk in the SCI population. PMID:24976366

Hubli, Michèle; Currie, Katharine D; West, Christopher R; Gee, Cameron M; Krassioukov, Andrei V

2014-11-01

154

Spinal Cord Injury and Osteoporosis: Causes, Mechanisms, and Rehabilitation Strategies  

PubMed Central

Spinal cord injury (SCI) has a huge impact on the individual, society and the economy. Though advances in acute care resulted in greatly reduced co-morbidities, there has been much less progress preventing long-term sequelae of SCI. Among the long-term consequences of SCI is bone loss (osteoporosis) due to the mechanical unloading of the paralyzed limbs and vascular dysfunction below the level of injury. Though osteoporosis may be partially prevented via pharmacologic interventions during the acute post-injury phase, there are no clinical guidelines to treat osteoporosis during the chronic phase. Thus there is need for scientific advances to improve the rehabilitative approaches to SCI-related osteoporosis. Recent advances in application of a new technology, functional electrical stimulation, provide a new and exciting opportunity to improve bone metabolism and to provide mechanical strain to the paralyzed lower limbs sufficient to stimulate new bone formation in individuals with SCI. The purpose of this minireview is to delineate our current understanding of SCI-related osteoporosis and to highlight recent literature towards its prevention and treatment.

Tan, Can Ozan; Battaglino, Ricardo A; Morse, Leslie R

2014-01-01

155

Cell Therapy in Spinal Cord Injury: a Mini- Reivew  

PubMed Central

Spinal cord injury (SCI) is a debilitating disease which leads to progressive functional damages. Because of limited axonal regeneration in the central nervous system, there is no or little recovery expected in the patients. Different cellular and molecular approaches were investigated in SCI animal models. Cellular transplantation of stem cells can potentially replace damaged tissue and provide a suitable microenvironment for axons to regenerate. Here, we reviewed the last approaches applied by our colleagues and others in order to improve axonal regeneration following SCI. We used different types of stem cells via different methods. First, fetal olfactory mucosa, schwann, and bone marrow stromal cells were transplanted into the injury sites in SCI models. In later studies, was applied simultaneous transplantation of stem cells with chondroitinase ABC in SCI models with the aid of nanoparticles. Using these approaches, considerable functional recovery was observed. However, considering some challenges in stem cell therapy such as rejection, infection, and development of a new cancer, our more recent strategy was application of cytokines. We observed a significant improvement in motor function of rats when stromal derived factor-1 was used to attract innate stem cells to the injury site. In conclusion, it seems that co-transplantation of different cells accompanies with other factors like enzymes and growth factors via new delivery systems may yield better results in SCI.

Mehrabi, Soraya; Eftekhari, Sanaz; Moradi, Fateme; Delaviz, Hamdollah; Pourheidar, Bagher; Azizi, Monir; Zendehdel, Adib; Shahbazi, Ali; Joghataei, Mohammad Taghi

2013-01-01

156

Noninvasive respiratory management of high level spinal cord injury  

PubMed Central

This article describes noninvasive acute and long-term management of the respiratory muscle paralysis of high spinal cord injury (SCI). This includes full-setting, continuous ventilatory support by noninvasive intermittent positive pressure ventilation (NIV) to support inspiratory muscles and mechanically assisted coughing (MAC) to support inspiratory and expiratory muscles. The NIV and MAC can also be used to extubate or decannulate ‘unweanable’ patients with SCI, to prevent intercurrent respiratory tract infections from developing into pneumonia and acute respiratory failure (ARF), and to eliminate tracheostomy and resort to costly electrophrenic/diaphragm pacing (EPP/DP) for most ventilator users, while permitting glossopharyngeal breathing (GPB) for security in the event of ventilator failure. PMID:22525322

Bach, John R.

2012-01-01

157

Bowel dysfunction in spinal cord injury: current perspectives.  

PubMed

Permanent disruptions of gastrointestinal function are very common sequel of spinal cord injury (SCI). When motor and sensory nervous integrity are severely affected, neurogenic gastrointestinal dysfunction is an inevitable consequence. Autonomic nervous system miss function has significantly diminished or lost sensory sensations followed with incomplete evacuation of stool from the rectal vault, immobility, and reduced anal sphincter tone all of those predisposing to increased risk of fecal incontinence (FI). The FI is, beside paralysis of extremities, one of the symptoms most profoundly affecting quality of life (QOL) in patients with SCI. We are reviewing current perspectives in management of SCI, discussing some pathophysiology mechanisms which could be addressed and pointing toward actual practical concepts in use for evaluation and improvements necessary to sustain SCI patients QOL. PMID:24549854

Pan, Yuehai; Liu, Bin; Li, Ruijun; Zhang, Zhixin; Lu, Laijin

2014-07-01

158

Sympathetic skin responses and autonomic dysfunction in spinal cord injury.  

PubMed

Abstract Sympathetic skin responses (SSRs), a measure of sympathetic cholinergic sudomotor function, have been used in the assessment of autonomic dysfunction in patients with spinal cord injury (SCI). This review highlights the basic mechanisms underlying SSRs as well as their application to the SCI population. We address the utility of SSRs in assessing autonomic function, the relationship between autonomic and sensorimotor impairment, and the association between SSRs and the sequelae of autonomic dysfunction in SCI, particularly autonomic dysreflexia and orthostatic hypotension. Overall, SSRs are a rapid, convenient and non-invasive method illustrating that the severity of autonomic impairment can be independent from sensorimotor impairment. We suggest that SSRs be used in conjunction with other validated autonomic tests in order to predict or document autonomic dysfunction in SCI. PMID:24874269

Berger, Michael J; Hubli, Michèle; Krassioukov, Andrei V

2014-09-15

159

Spinal cord injuries due to close combat weapons.  

PubMed

A 17-year-old patient was aggressively attacked and stabbed in the dorsal region of his back by a knife. He was admitted to the emergency room of the Hammoud Hospital University Medical Center, Saida, Lebanon lying in the prone position. The neurological examination revealed that the stabbing object was fixed at the dorsal spine level at the T-7 level, where it was inserted inside the vertebral body. Luckily, the blade of the knife was parallel to the nervous tracts of the spinal cord; thus, he showed no neurological deficits. This case provides an overview of how neurosurgical principles can be applied to trauma patients with spine injuries due to close combat weapons. PMID:24141462

Fares, Youssef H; Fares, Jawad Y; Gebeily, Souheil E; Khazim, Rabi M

2013-10-01

160

Upper gastrointestinal motility changes following spinal cord injury.  

PubMed

Spinal cord injury (SCI) is associated with severe autonomic dysfunction in both the acute and chronic phases. Upper gastrointestinal (GI) motor dysfunction has been previously reported in humans and rats. Gastric emptying (GE) of a solid meal--as measured by the [(13)C]-octanoic acid breath test--is delayed in the first 3 weeks after either spinal cord transection (SCT) or contusion (SCC) in rats. This is one of the main findings of a new paper by Qualls-Creekmore et al. in the current issue of this journal. Previous studies in rats only reported impairment of GE, intestinal and GI transit of liquid after SCI, but the authors observed that the delay of the GE of solid was more prominent after SCT than SCC. Recovery of the delay of GE of solid occurred at 6 weeks after SCC, but not after SCT. However, gastric motility changes persisted despite the functional normalization of the GE in rats with SCC. Bowel dysfunction is a major physical and psychological burden for SCI patients. Collaborative efforts, like the development of international standards to evaluate autonomic function after SCI will likely clarify the mechanisms of dysfunction and lead to the development of new therapeutic strategies. PMID:20047639

Gondim, F A A; de Oliveira, G R; Thomas, F P

2010-01-01

161

Dietary therapy to promote neuroprotection in chronic spinal cord injury  

PubMed Central

Object The pathogenesis of cervical spondylotic myelopathy (CSM) is related to both primary mechanical and secondary biological injury. The authors of this study explored a novel, noninvasive method of promoting neuroprotection in myelopathy by using curcumin to minimize oxidative cellular injury and the capacity of omega-3 fatty acids to support membrane structure and improve neurotransmission. Methods An animal model of CSM was created using a nonresorbable expandable polymer placed in the thoracic epidural space, which induced delayed myelopathy. Animals that underwent placement of the expandable polymer were exposed to either a diet rich in docosahexaenoic acid and curcumin (DHA-Cur) or a standard Western diet (WD). Twenty-seven animals underwent serial gait testing, and spinal cord molecular assessments were performed after the 6-week study period. Results At the conclusion of the study period, gait analysis revealed significantly worse function in the WD group than in the DHA-Cur group. Levels of brain-derived neurotrophic factor (BDNF), syntaxin-3, and 4-hydroxynonenal (4-HNE) were measured in the thoracic region affected by compression and lumbar enlargement. Results showed that BDNF levels in the DHA-Cur group were not significantly different from those in the intact animals but were significantly greater than in the WD group. Significantly higher lumbar enlargement syntaxin-3 in the DHA-Cur animals combined with a reduction in lipid peroxidation (4-HNE) indicated a possible healing effect on the plasma membrane. Conclusions Data in this study demonstrated that DHA-Cur can promote spinal cord neuroprotection and neutralize the clinical and biochemical effects of myelopathy. PMID:22735048

Holly, Langston T.; Blaskiewicz, Donald; Wu, Aiguo; Feng, Cameron; Ying, Zhe; Gomez-Pinilla, Fernando

2013-01-01

162

[Complications after spinal cord injuries and their influence on the effectiveness of rehabilitation].  

PubMed

In this article, literature data on complications after spinal cord injuries and their influence on the efficiency of rehabilitation are analyzed. The spinal cord injury is associated with physical and psychological disorder that causes disability and requires intensive treatment. Authors in their articles indicate that many people after spinal cord injuries have complications. The most common complications are: skin breakdown, urinary tract infection, pulmonary complications, spasticity, pain, autonomic dysreflexia, cardiovascular disease, osteoporosis and fractures, heterotopic ossification, deep vein thrombosis. These complications make patients' rehabilitation more difficult and limit their self-care independence, and the treatment of such complications is very expensive. PMID:17172787

Drigotaite, Neringa; Krisci?nas, Aleksandras

2006-01-01

163

Posttraumatic Stress Disorder in Veterans with Spinal Cord Injury: Trauma-related Risk Factors  

Microsoft Academic Search

Trauma-related risk factors for posttraumatic stress disorder (PTSD) were examined in a sample of 125 veterans with spinal cord injury. Category of injury was found to be the most consistent predictor of PTSD diagnosis and symptom severity with paraplegia predicting more PTSD symptoms than quadriplegia. The occurrence of a head injury at the time of the trauma was found to

Cynthia L. Radnitz; Louis Hsu; Jeffrey Willard; Lysandra Perez-Strumolo; Joanne Festa; Lynn B. Lillian; Stacey Walczak; Dennis D. Tirch; Ilana S. Schlein; Martin Binks; Charles P. Broderick

1998-01-01

164

Neonatal Hind-Paw Injury Disrupts Acquisition of an Instrumental Response in Adult Spinal Rats  

Microsoft Academic Search

The present study was designed to evaluate the impact of neonatal injury on adult spinal plasticity in rats. Subjects were randomly assigned to 1 of 4 experimental conditions: (a) hind-paw injury at Postnatal Day (PD) 2, (b) hind-paw injury at PD 5, (c) anesthesia exposure only on PD 2, or (d) anesthesia exposure only on PD 5. Subjects receiving a

Erin E. Young; Kyle M. Baumbauer; Audrea Elliot; Robin L. Joynes

2007-01-01

165

Stress protein expression in early phase spinal cord ischemia/reperfusion injury  

PubMed Central

Spinal cord ischemia/reperfusion injury is a stress injury to the spinal cord. Our previous studies using differential proteomics identified 21 differentially expressed proteins (n > 2) in rabbits with spinal cord ischemia/reperfusion injury. Of these proteins, stress-related proteins included protein disulfide isomerase A3, stress-induced-phosphoprotein 1 and heat shock cognate protein 70. In this study, we established New Zealand rabbit models of spinal cord ischemia/reperfusion injury by abdominal aorta occlusion. Results demonstrated that hind limb function initially improved after spinal cord ischemia/reperfusion injury, but then deteriorated. The pathological morphology of the spinal cord became aggravated, but lessened 24 hours after reperfusion. However, the numbers of motor neurons and interneurons in the spinal cord gradually decreased. The expression of protein disulfide isomerase A3, stress-induced-phosphoprotein 1 and heat shock cognate protein 70 was induced by ischemia/reperfusion injury. The expression of these proteins increased within 12 hours after reperfusion, and then decreased, reached a minimum at 24 hours, but subsequently increased again to similar levels seen at 6–12 hours, showing a characterization of induction-inhibition-induction. These three proteins were expressed only in cytoplasm but not in the nuclei. Moreover, the expression was higher in interneurons than in motor neurons, and the survival rate of interneurons was greater than that of motor neurons. It is assumed that the expression of stress-related proteins exhibited a protective effect on neurons.

Zhang, Shanyong; Wu, Dankai; Wang, Jincheng; Wang, Yongming; Wang, Guoxiang; Yang, Maoguang; Yang, Xiaoyu

2013-01-01

166

Providers' Perceptions of Spinal Cord Injury Pressure Ulcer Guidelines  

PubMed Central

Background/Objective: Pressure ulcers are a serious complication for people with spinal cord injury (SCI). The Consortium for Spinal Cord Medicine (CSCM) published clinical practice guidelines (CPGs) that provided guidance for pressure ulcer prevention and treatment after SCI. The aim of this study was to assess providers' perceptions for each of the 32 CPG recommendations regarding their agreement with CPGs, degree of CPG implementation, and CPG implementation barriers and facilitators. Methods: This descriptive mixed-methods study included both qualitative (focus groups) and quantitative (survey) data collection approaches. The sample (n = 60) included 24 physicians and 36 nurses who attended the 2004 annual national conferences of the American Paraplegia Society or American Association of Spinal Cord Injury Nurses. This sample drew from two sources: a purposive sample from a list of preregistered participants and a convenience sample of conference attendee volunteers. We analyzed quantitative data using descriptive statistics and qualitative data using a coding scheme to capture barriers and facilitators. Results: The focus groups agreed unanimously on the substance of 6 of the 32 recommendations. Nurse and physician focus groups disagreed on the degree of CGP implementation at their sites, with nurses as a group perceiving less progress in implementation of the guideline recommendations. The focus groups identified only one recommendation, complications of surgery, as being fully implemented at their sites. Categories of barriers and facilitators for implementation of CPGs that emerged from the qualitative analysis included (a) characteristics of CPGs: need for research/evidence, (b) characteristics of CPGs: complexity of design and wording, (c) organizational factors, (d) lack of knowledge, and (e) lack of resources. Conclusions: Although generally SCI physicians and nurses agreed with the CPG recommendations as written, they did not feel these recommendations were fully implemented in their respective clinical settings. The focus groups identified multiple barriers to the implementation of the CPGs and suggested several facilitators/solutions to improve implementation of these guidelines in SCI. Participants identified organizational factors and the lack of knowledge as the most substantial systems/issues that created barriers to CPG implementation. PMID:17591223

Thomason, Susan S; Evitt, Celinda P; Harrow, Jeffrey J; Love, Linda; Moore, D. Helen; Mullins, Maria A; Powell-Cope, Gail; Nelson, Audrey L

2007-01-01

167

Axon regeneration and exercise-dependent plasticity after spinal cord injury  

PubMed Central

Current dogma is that meaningful recovery of function after spinal cord injury (SCI) likely will require a combination of therapeutic interventions comprised of regenerative/neuroprotective transplants, addition of neurotrophic factors, elimination of inhibitory molecules, functional sensorimotor training, and/or stimulation of paralyzed muscles or spinal circuits. We routinely use: (1) peripheral nerve grafts to support and direct axonal regeneration across an incomplete cervical or a complete thoracic transection injury, (2) matrix modulation with chondroitinase (ChABC) to facilitate axonal extension beyond the distal graft-spinal cord interface and (3) exercise, such as forced wheel walking, bicycling or step training on a treadmill. We (and others) have demonstrated an increase in spinal cord levels of endogenous neurotrophic factors with exercise, which may be useful in facilitating elongation and/or synaptic activity of regenerating axons and plasticity of spinal neurons below the level of injury PMID:23531013

Houle, John D; Cote, Marie-Pascale

2013-01-01

168

The effects of systemically administered methylprednisolone and recombinant human erythropoietin after acute spinal cord compressive injury in rats  

Microsoft Academic Search

The study design was to decrease the damage of spinal cord on the experimentally induced acute spinal cord injury in rats. The objective of this study was to evaluate whether recombinant human erythropoietin (rHu-EPO) and methylprednisolone (MPSS) improve neurological function and histopathological changes if systemically administered after traumatic spinal cord injury. This study included 48 rats that underwent experimental SCI.

Abdurrahman Çetin; Kemal Nas; Hüseyin Büyükbayram; Adnan Ceviz; Gönül Ölmez

2006-01-01

169

Differences in Affect, Life Satisfaction, and Depression between Successfully and Unsuccessfully Rehabilitated Persons with Spinal Cord Injuries  

ERIC Educational Resources Information Center

This study assessed whether persons with spinal cord injuries who were successfully rehabilitated differed from those who were not with regard to positive and negative affect, life satisfaction, and depression. An ex post facto research design compared persons with spinal cord injuries who were previously employed with persons with spinal cord…

Chapin, Martha H.; Holbert, Donald

2009-01-01

170

Role of calpain in spinal cord injury: increased calpain immunoreactivity in rat spinal cord after impact trauma.  

PubMed

Impact spinal cord injury (20 g-cm) was induced in rat by weight drop. The immunoreactivity of mcalpain was examined in the lesion and adjacent areas of the cord following trauma. Increased calpain immunoreactivity was evident in the lesion compared to control and the immunostaining intensity progressively increased after injury. The calpain immunoreactivity was also increased increased in tissue adjacent to the lesion. mCalpain immunoreactivity was significantly stronger in glial and endothelial cells, motor neurons and nerve fibers in the lesion. The calpain immunoreactivity also increased in astrocytes and microglial cells in the adjacent areas. Proliferation of microglia and astrocytes identified by GSA histochemical staining and GFAP immunostaining, respectively, was seen at one and three days after injury. Many motor neurons in the ventral horn showed increased calpain immunoreactivity and were shrunken in the lesion. These studies indicate a pivotal role for calpain and the involvement of glial cells in the tissue destruction in spinal cord injury. PMID:8734437

Li, Z; Hogan, E L; Banik, N L

1996-04-01

171

Original Article Functional electrical therapy: retraining grasping in spinal cord injury  

E-print Network

to be an effective treatment modality to restore grasping function in quadriplegia. It can be implemented electrical therapy; spinal cord injury; quadriplegia; grasping and hand functions Introduction In recent

Popovic, Milos R.

172

Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?  

PubMed Central

An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury. PMID:23533315

da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio

2013-01-01

173

U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

174

Prophylactic low dose heparin anticoagulant therapy in patients with spinal cord injuries: a retrospective study.  

PubMed

A retrospective study was performed of 100 consecutive acute traumatic spinal injury patients with neurological deficit admitted to the Yorkshire regional spinal injuries centre prior to May 1990. Ninety-seven of these patients received prophylactic low dose subcutaneous heparin and 3 patients were excluded because of noted complications. Twenty-six patients developed thromboembolic complications. Apart from the fact that acute spinal cord injury patients are considered to be in an hypercoaguable state, the occurrence of deep vein thrombosis/pulmonary embolism (DVT/PE) in our study, even though these patients were on prophylactic low dose subcutaneous heparin, was related to delay in transfers, operative intervention, level of spinal cord injury and was possibly due to loss of some amount of heparin solution from the prefilled syringe during removal of air bubbles prior to the subcutaneous heparin injection. PMID:1630842

Kulkarni, J R; Burt, A A; Tromans, A T; Constable, P D

1992-03-01

175

"Low-intensity laser therapy effect on the recovery of traumatic spinal cord injury".  

PubMed

Scientific advances have been made to optimize the healing process in spinal cord injury. Studies have been developed to obtain effective treatments in controlling the secondary injury that occurs after spinal cord injury, which substantially changes the prognosis. Low-intensity laser therapy (LILT) has been applied in neuroscience due to its anti-inflammatory effects on biological tissue in the repairing process. Few studies have been made associating LILT to the spinal cord injury. The objective of this study was to investigate the effect of the LILT (GaAlAs laser-780 nm) on the locomotor functional recovery, histomorphometric, and histopathological changes of the spinal cord after moderate traumatic injury in rats (spinal cord injury at T9 and T10). Thirty-one adult Wistar rats were used, which were divided into seven groups: control without surgery (n?=?3), control surgery (n?=?3), laser 6 h after surgery (n?=?5), laser 48 h after surgery (n?=?5), medullar lesion (n?=?5) without phototherapy, medullar lesion?+?laser 6 h after surgery (n?=?5), and medullar lesion?+?laser 48 h after surgery (n?=?5). The assessment of the motor function was performed using Basso, Beattie, and Bresnahan (BBB) scale and adapted Sciatic Functional Index (aSFI). The assessment of urinary dysfunction was clinically performed. After 21 days postoperative, the animals were euthanized for histological and histomorphometric analysis of the spinal cord. The results showed faster motor evolution in rats with spinal contusion treated with LILT, maintenance of the effectiveness of the urinary system, and preservation of nerve tissue in the lesion area, with a notorious inflammation control and increased number of nerve cells and connections. In conclusion, positive effects on spinal cord recovery after moderate traumatic spinal cord injury were shown after LILT. PMID:24858233

Paula, Alecsandra Araujo; Nicolau, Renata Amadei; Lima, Mario de Oliveira; Salgado, Miguel Angel Castillo; Cogo, José Carlos

2014-11-01

176

Overview of Psychosocial Health Among Youth with Spinal Cord Injury  

PubMed Central

Background: Psychosocial health can be conceptualized as being mentally, emotionally, and socially well. Little is known about normative psychosocial development among children and adolescents with spinal cord injury (SCI). Objective: To provide a comprehensive overview of psychosocial health of 410 youth with SCI from ages 2 to 18 years. To understand developmental trends, data are presented separately for ages 2-5, 6-12, 13-15, and 16-18 years. Methods: Youth with SCI were recruited from 1 of 3 pediatric specialty hospitals within a single hospital system. Structured surveys assessing community participation, quality of life (QOL), and mental health (including anxiety and depression) were completed by youth with SCI (for ages 6-18) or their primary caregivers (for ages 2-5). Descriptive statistics were used to assess how patients scored on all standardized measures. Results: Of the 410 participants, 56% were male, 64% were Caucasian, 66% had paraplegia, and 55% had complete injuries. On average, the participants were 12 years old (SD 4.87) at interview and 7.26 years old (SD 5.97) at injury. Psychosocial health outcomes were described for each of the 4 age groups: 2-5 years (n = 52), 6-12 (n = 142), 13-15 (n = 82), and 16-18 (n = 134) years. Conclusions: As compared to published norms, this sample of youth with SCI seemed to be experiencing decreased levels of community participation and QOL, but also decreased levels of anxiety and depression. These data provide needed information to clinicians regarding how youth with SCI may typically experience psychosocial health and where their patients fit into that typical experience. PMID:23671383

2013-01-01

177

Neuroprotective effects of rosuvastatin against traumatic spinal cord injury in rats.  

PubMed

Rosuvastatin, which is a potent statin, has never been studied in traumatic spinal cord injury. The aim of this study was to investigate whether rosuvastatin treatment could protect the spinal cord after experimental spinal cord injury. Rats were randomized into the following five groups of eight animals each: control, sham, trauma, rosuvastatin, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumor necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analyzed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test.After traumatic spinal cord injury, increases in caspase-3 activity, tumor necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. In contrast, the superoxide dismutase levels were decreased. After the administration of rosuvastatin, decreases were observed in the tissue caspase-3 activity, tumor necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. In contrast, tissue superoxide dismutase levels were increased. Furthermore, rosuvastatin treatment showed improved results concerning the histopathological scores, the ultrastructural score and the functional tests. Biochemical, histopathological, ultrastructural analysis and functional tests revealed that rosuvastatin exhibits meaningful neuroprotective effects against spinal cord injury. PMID:25084223

Kahveci, Ramazan; Gökçe, Emre Cemal; Gürer, Bora; Gökçe, Aysun; Kisa, Uçler; Cemil, Duran Berker; Sargon, Mustafa Fevzi; Kahveci, Fatih Ozan; Aksoy, Nurkan; Erdo?an, Bülent

2014-10-15

178

Promote Pressure Ulcer Healing in Individuals with Spinal Cord Injury Using an Individualized  

E-print Network

Promote Pressure Ulcer Healing in Individuals with Spinal Cord Injury Using an Individualized Chen, MD INTRODUCTION Pressure ulcer (PrU) management continues to be an important medical challenge users with established pressure ulcers (PrUs). DESIGN: Randomized controlled study. SETTING: Spinal cord

Makhsous, Mohsen

179

Anti-NGF Local Therapy for Autonomic Dysreflexia in Spinal Cord Injury.  

National Technical Information Service (NTIS)

Autonomic dysreflexia (AD), which induces excessive elevation of blood pressure, is a potentially life-threatening medical emergency that occurs in persons with spinal cord injury (SCI) at or above the mid-thoracic spinal cord segment. Since the most comm...

N. Yoshimura

2012-01-01

180

Mechanical and thermal allodynia in chronic central pain following spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) results in variable motor recoveries and chronic central pain syndromes develop in the majority of SCI patients. To provide a basis for further studies, we report a new rodent model of chronic central pain following spinal cord trauma. Male Sprague-Dawley rats (N = 10) were hemisectioned at T13 and were tested both preoperatively and postoperatively and

Marc D Christensen; Alex W Everhart; Jason T Pickelman; Claire E Hulsebosch

1996-01-01

181

Chondroitin Sulfate Proteoglycan Immunoreactivity Increases Following Spinal Cord Injury and Transplantation  

Microsoft Academic Search

Extrinsic factors appear to contribute to the lack of regeneration in the injured adult spinal cord. It is likely that these extrinsic factors include a group of putative growth inhibitory molecules known as chondroitin sulfate proteoglycans (CSPGs). The aims of this study were to determine: (1) the consequences of spinal cord contusion injury on CSPG expression, (2) if CSPGs can

Michele L. Lemons; Dena R. Howland; Douglas K. Anderson

1999-01-01

182

Return to work after spinal cord injury: the potential contribution of physical fitness  

Microsoft Academic Search

The history, physical characteristics and fitness status of 60 persons who had sustained a spinal cord injury at least 3 years previously were considered in relation to current occupation. All subjects had completed their education, 39 being gainfully employed and 21 unemployed. The general characteristics of the sample, mainly beneficiaries of the Quebec Automobile Insurance Plan, were typical of spinal

L Noreau; R J Shephard

1992-01-01

183

Setting the stage for functional repair of spinal cord injuries: a cast of thousands  

Microsoft Academic Search

Here we review mechanisms and molecules that necessitate protection and oppose axonal growth in the injured spinal cord, representing not only a cast of villains but also a company of therapeutic targets, many of which have yet to be fully exploited. We next discuss recent progress in the fields of bridging, overcoming conduction block and rehabilitation after spinal cord injury

L M Ramer; M S Ramer; J D Steeves

2005-01-01

184

INTRATHECAL MIDAZOLAM REGULATES SPINAL AMPA RECEPTOR EXPRESSION AND FUNCTION AFTER NERVE INJURY IN RATS  

PubMed Central

Spinal ?-aminobutyric acid (GABA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors have been implicated in the mechanisms of neuropathic pain after nerve injury; however, how these two receptors interact at the spinal level remains unclear. Here we show that intrathecal midazolam through activation of spinal GABAA receptors attenuated the expression and function of spinal AMPA receptors in rats following peripheral nerve injury. Thermal hyperalgesia and mechanical allodynia induced by chronic constriction nerve injury (CCI) in rats were attenuated by the short-acting benzodiazepine midazolam (20=10>5 ?g > vehicle) administered intrathecally once daily for seven postoperative days. CCI-induced upregulation of AMPA receptors within the spinal cord dorsal horn was also significantly reduced by the intrathecal midazolam (10, 20 ?g) treatment. The inhibitory effects of midazolam (10, 20 ?g) on neuropathic pain behaviors and AMPA receptor expression were prevented by co-administration of midazolam with the GABAA receptor antagonist bicuculline (3 ?g), whereas intrathecal treatment with bicuculline (1 or 3 ?g) alone in naive rats induced the upregulation of spinal AMPA receptor expression and nociceptive responses, indicating a tonic regulatory effect from endogenous GABAergic activity on the AMPA receptor expression and spinal nociceptive processing. These results indicate that modulation of spinal AMPA receptor expression and function by the GABAergic activity may serve as a mechanism contributory to the spinal nociceptive processing. PMID:17049496

Lim, Jeongae; Lim, Grewo; Sung, Backil; Wang, Shuxing; Mao, Jianren

2007-01-01

185

Implanted electro-acupuncture electric stimulation improves outcome of stem cells' transplantation in spinal cord injury.  

PubMed

Spinal cord injury (SCI) is one of the most serious disorders in clinics, and the high disability rate and functional deficits are common issues in patients. Transplantation of bone-marrow-derived mesenchymal stromal cells (BMSCs) into the injured spinal cord is emerging as a novel method in the therapeutics of SCI; however, its application is limited by the poor survival rate of the transplanted cells and low differentiation rate into neurons. Our laboratory recently reported that electrical stimulation (ES) dramatically improves the survival rate of transplanted BMSCs and increases spinal cord functions in animals with spinal cord injury. In this paper, we asked whether implanted electro-acupuncture (iEA) can advance the beneficial effects from the ES treatment in animals with spinal cord injury. We showed that BMSCs transplantation alone resulted in significant functional recovery in animals. Interestingly, iEA with BMSCs treatment induced a significantly higher functional improvement in locomotor functions and SSEP compared to the BMSCs treatment alone. Additionally, we used molecular biology techniques and showed that BMSCs transplantation with iEA treatment significantly increased the number of surviving BMSCs compared to the BMSCs alone group. In conclusion, our experiment showed that the approach of coupling iEA electric stimulation and BMSCs transplantation remarkably promotes functional improvements in animals with spinal cord injury and holds promising potential to treat spinal cord injury in humans. PMID:22384853

Liu, Haichun; Yang, Kaiyun; Xin, Tao; Wu, Wenliang; Chen, Yunzhen

2012-10-01

186

Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient: Case report.  

PubMed

Over the last decade, human cell transplantation and neural stem cell trials have examined the feasibility and safety of these potential therapies for treatment of a variety of neurological disorders. However, significant safety concerns have surrounded these trials due to the possibility of ectopic, uncontrolled cellular growth and tumor formation. The authors present the case of an 18-year-old woman who sustained a complete spinal cord injury at T10-11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell implantation at the site of injury. She developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material. Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs. This is the first report of a human spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy. Given the prolonged time to presentation, safety monitoring of all patients with cell transplantation and neural stem cell implantation should be maintained for many years. PMID:25002238

Dlouhy, Brian J; Awe, Olatilewa; Rao, Rajesh C; Kirby, Patricia A; Hitchon, Patrick W

2014-10-01

187

What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review  

Microsoft Academic Search

AimSystematic review of ‘What are the clinical and radiological characteristics of inflicted spinal injury?’MethodsLiterature search of 20 electronic databases, websites, references and bibliographies (1950–2009) using selected keywords. Critical appraisal: by two trained reviewers, (a third review, if discrepant). Inclusion criteria: primary studies of inflicted spinal injury in children <18 years, alive at presentation, with a high surety of diagnosis of

A. M. Kemp; A. H. Joshi; M. Mann; V. Tempest; A. Liu; S. Holden; S. Maguire

2010-01-01

188

Complications that may occur in those with spinal cord injuries who participate in sport  

Microsoft Academic Search

The purpose of this study was to determine the risk of developing complications in paraplegics taking part in sport. It is a retrospective study of patients with complete spinal cord injury at the spinal level of C7—cauda equina\\/conus injury, and consists of 61 patients admitted to the Beitøstolen Healthsportcenter, Norway.All of them had achieved satisfactory bladder \\/bowel function. The wheelchair

Richard Nilsen; Paal Nygaard; Per Gunnar Bjørholt

1985-01-01

189

The prevalence of orthostatic hypotension during physiotherapy treatment in patients with an acute spinal cord injury  

Microsoft Academic Search

Study design: Prospective, observational.Objectives: To investigate the prevalence of orthostatic hypotension (OH), its associated signs and symptoms, and the resulting limitation to treatment during initial physiotherapy treatments involving mobilisation for patients with an acute spinal cord injury (SCI).Setting: Spinal Injuries Units, Royal Adelaide Hospital and Hampstead Rehabilitation Centre, Adelaide, South Australia.Methods: Fourteen of 17 consecutive patients admitted with an acute

A Illman; K Stiller; M Williams

2000-01-01

190

Analgesia or Addiction: Implications for Morphine Use After Spinal Cord Injury  

E-print Network

ANALGESIA OR ADDICTION: IMPLICATIONS FOR MORPHINE USE AFTER SPINAL CORD INJURY A Thesis by SARAH ANN WOLLER Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements... Ann Woller ANALGESIA OR ADDICTION: IMPLICATIONS FOR MORPHINE USE AFTER SPINAL CORD INJURY A Thesis by SARAH ANN WOLLER Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment...

Woller, Sarah Ann

2012-07-16

191

Neural Substrates for the Motivational Regulation of Motor Recovery after Spinal-Cord Injury  

Microsoft Academic Search

It is believed that depression impedes and motivation enhances functional recovery after neuronal damage such as spinal-cord injury and stroke. However, the neuronal substrate underlying such psychological effects on functional recovery remains unclear. A longitudinal study of brain activation in the non-human primate model of partial spinal-cord injury using positron emission tomography (PET) revealed a contribution of the primary motor

Yukio Nishimura; Hirotaka Onoe; Kayo Onoe; Yosuke Morichika; Hideo Tsukada; Tadashi Isa; Kelvin E. Jones

2011-01-01

192

Reliability characteristics of the Donovan spinal cord injury pain classification system  

Microsoft Academic Search

Richards JS, Hicken BL, Putzke JD, Ness T, Kezar L. Reliability characteristics of the Donovan spinal cord injury pain classification system. Arch Phys Med Rehabil 2002;83:1290-4. Objective: To determine the interrater reliability of the Donovan system for classification of pain in spinal cord injury (SCI) as well as the clinician-based usefulness of each of the classification criteria used in the

J. Scott Richards; Bret L. Hicken; John D. Putzke; Timothy Ness; Laura Kezar

2002-01-01

193

Ways of Coping and Perceived Stress in Women with Spinal Cord Injury  

Microsoft Academic Search

Using a cross-sectional design, this research aimed to assess whether a three-factor model of Positive Reappraisal, Escape-Avoidance, and Seeking Social Support based on the Ways of Coping Questionnaire (WOCQ) appropriately depicts coping within a sample of women with spinal cord injury (SCI). Forty-four community-dwelling women with spinal cord injury were interviewed from two urban rehabilitation facilities in the Midwestern United

Anthony H. Lequerica; Martin Forschheimer; Denise G. Tate; Sunny Roller; Loren Toussaint

2008-01-01

194

Spinal Injury Rates in Three Wild Trout Populations in Colorado after Eight Years of Backpack Electrofishing  

Microsoft Academic Search

We examined long-term effects of annual intensive backpack electrofishing on rates of spinal injury and population abundance of three salmonid and one catostomid species in three small northern Colorado streams and compared rates of externally evident injuries to actual injuries determined by X ray. After 6–8 years of annual three-pass removal electrofishing, injury rates for brook trout Salvelinus fontinalis in

Patrick M. Kocovsky; Charles Gowan; Kurt D. Fausch; Stephen C. Riley

1997-01-01

195

In vivo imaging of spinal cord in contusion injury model mice by multi-photon microscopy  

NASA Astrophysics Data System (ADS)

Fluorescent imaging technique is a promising method and has been developed for in vivo applications in cellular biology. In particular, nonlinear optical imaging technique, multi-photon microscopy has make it possible to analyze deep portion of tissues in living animals such as axons of spinal code. Traumatic spinal cord injuries (SCIs) are usually caused by contusion damages. Therefore, observation of spinal cord tissue after the contusion injury is necessary for understanding cellular dynamics in response to traumatic SCI and development of the treatment for traumatic SCI. Our goal is elucidation of mechanism for degeneration of axons after contusion injuries by establishing SCI model and chronic observation of injured axons in the living animals. Firstly we generated and observed acute SCI model by contusion injury. By using a multi-photon microscope, axons in dorsal cord were visualized approximately 140 micron in depth from the surface. Immediately after injury, minimal morphological change of spinal cord was observed. At 3 days after injury, spinal cord was swelling and the axons seem to be fragmented. At 7 days after injury, increased degradation of axons could be observed, although the image was blurred due to accumulation of the connective tissue. In the present study, we successfully observed axon degeneration after the contusion SCI in a living animal in vivo. Our final goal is to understand molecular mechanisms and cellular dynamics in response to traumatic SCIs in acute and chronic stage.

Oshima, Y.; Horiuchi, H.; Ogata, T.; Hikita, A.; Miura, H.; Imamura, T.

2014-03-01

196

Conus medullaris injury following both tetracaine and lidocaine spinal anesthesia  

Microsoft Academic Search

Multiple reports of cauda equina syndrome and transient radicular nerve root irritation have suggested that lidocaine spinal anesthesia may be responsible. In this case report, a patient with a preexisting diabetic neuropathy received a partial block following a tetracaine spinal, which was followed by a lidocaine spinal. Following block resolution, a new conus medullaris syndrome was diagnosed. Because of the

Jonathan H. Waters; Timothy B. Watson; Michael G. Ward

1996-01-01

197

Sleep Disordered Breathing in Chronic Spinal Cord Injury  

PubMed Central

Study Objectives: Spinal cord injury (SCI) is associated with 2-5 times greater prevalence of sleep disordered breathing (SDB) than the general population. The contribution of SCI on sleep and breathing at different levels of injury using two scoring methods has not been assessed. The objectives of this study were to characterize the sleep disturbances in the SCI population and the associated physiological abnormalities using quantitative polysomnography and to determine the contribution of SCI level on the SDB mechanism. Methods: We studied 26 consecutive patients with SCI (8 females; age 42.5 ± 15.5 years; BMI 25.9 ± 4.9 kg/m2; 15 cervical and 11 thoracic levels) by spirometry, a battery of questionnaires and by attended polysomnography with flow and pharyngeal pressure measurements. Inclusion criteria for SCI: chronic SCI (> 6 months post injury), level T6 and above and not on mechanical ventilation. Ventilation, end-tidal CO2 (PETCO2), variability in minute ventilation (VI-CV) and upper airway resistance (RUA) were monitored during wakefulness and NREM sleep in all subjects. Each subject completed brief history and exam, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire (BQ) and fatigue severity scale (FSS). Sleep studies were scored twice, first using standard 2007 American Academy of Sleep Medicine (AASM) criteria and second using new 2012 recommended AASM criteria. Results: Mean PSQI was increased to 10.3 ± 3.7 in SCI patients and 92% had poor sleep quality. Mean ESS was increased 10.4 ± 4.4 in SCI patients and excessive daytime sleepiness (ESS ? 10) was present in 59% of the patients. Daytime fatigue (FSS > 20) was reported in 96% of SCI, while only 46% had high-risk score of SDB on BQ. Forced vital capacity (FVC) in SCI was reduced to 70.5% predicted in supine compared to 78.5% predicted in upright positions (p < 0.05). Likewise forced expiratory volume in first second (FEV1) was 64.9% predicted in supine compared to 74.7% predicted in upright positions (p < 0.05). Mean AHI in SCI patients was 29.3 ± 25.0 vs. 20.0 ± 22.8 events/h using the new and conventional AASM scoring criteria, respectively (p < 0.001). SCI patients had SDB (AHI > 5 events/h) in 77% of the cases using the new AASM scoring criteria compared to 65% using standard conventional criteria (p < 0.05). In cervical SCI, VI decreased from 7.2 ± 1.6 to 5.5 ± 1.3 L/min, whereas PETCO2 and VI-CV, increased during sleep compared to thoracic SCI. Conclusion: The majority of SCI survivors have symptomatic SDB and poor sleep that may be missed if not carefully assessed. Decreased VI and increased PETCO2 during sleep in patients with cervical SCI relative to thoracic SCI suggests that sleep related hypoventilation may contribute to the pathogenesis SDB in patients with chronic cervical SCI. Citation: Sankari A; Bascom A; Oomman S; Badr MS. Sleep disordered breathing in chronic spinal cord injury. J Clin Sleep Med 2014;10(1):65-72. PMID:24426822

Sankari, Abdulghani; Bascom, Amy; Oomman, Sowmini; Badr, M. Safwan

2014-01-01

198

Reflex conditioning: A new strategy for improving motor function after spinal cord injury  

PubMed Central

Spinal reflex conditioning changes reflex size, induces spinal cord plasticity, and modifies locomotion. Appropriate reflex conditioning can improve walking in rats after spinal cord injury (SCI). Reflex conditioning offers a new therapeutic strategy for restoring function in people with SCI. This approach can address the specific deficits of individuals with SCI by targeting specific reflex pathways for increased or decreased responsiveness. In addition, once clinically significant regeneration can be achieved, reflex conditioning could provide a means of re-educating the newly (and probably imperfectly) reconnected spinal cord. PMID:20590534

Chen, Xiang Yang; Chen, Yi; Wang, Yu; Thompson, Aiko; Carp, Jonathan S.; Segal, Richard L.; Wolpaw, Jonathan R.

2010-01-01

199

A global perspective on spinal cord injury epidemiology.  

PubMed

Spinal cord injury (SCI) is a devastating condition often affecting young and healthy individuals around the world. This debilitating condition not only creates enormous physical and emotional cost to individuals but also is a significant financial burden to society at large. This review was undertaken to understand the global impact of SCI on society. We also attempted to summarize the worldwide demographics and preventative strategies for SCI in varying economic and climatic environments and to evaluate how cultural and economic differences affect the etiology of SCI. A PUBMED database search was performed in order to identify clinical epidemiological studies of SCI within the last decade. In addition, World Bank and World Health Organization websites were used to obtain demographics, economics, and health statistics of countries of interest. A total of 20 manuscripts were selected from 17 countries. We found that SCI varies in etiology, male-to-female ratios, age distributions, and complications in different countries. Nations with similar economies tend to have similar features and incidences in all the above categories. However, diverse methods of classifying SCI were found, making comparisons difficult. Based upon these findings, it is clear that the categorization and evaluation of SCI must be standardized. The authors suggest improved methods of reporting in the areas of etiology, neurological classification, and incidence of SCI so that, in the future, more useful global comprehensive studies and comparisons can be undertaken. Unified injury prevention programs should be implemented through methods involving the Internet and international organizations, targeting the different etiologies of SCI found in different countries. PMID:15672627

Ackery, Alun; Tator, Charles; Krassioukov, Andrei

2004-10-01

200

CSF Proteomics of Secondary Phase Spinal Cord Injury in Human Subjects: Perturbed Molecular Pathways Post Injury  

PubMed Central

Recovery of sensory and motor functions following traumatic spinal cord injury (SCI) is dependent on injury severity. Here we identified 49 proteins from cerebrospinal fluid (CSF) of SCI patients, eight of which were differentially abundant among two severity groups of SCI. It was observed that the abundance profiles of these proteins change over a time period of days to months post SCI. Statistical analysis revealed that these proteins take part in several molecular pathways including DNA repair, protein phosphorylation, tRNA transcription, iron transport, mRNA metabolism, immune response and lipid and ATP catabolism. These pathways reflect a set of mechanisms that the system may adopt to cope up with the assault depending on the injury severity, thus leading to observed physiological responses. Apart from putting forward a picture of the molecular scenario at the injury site in a human study, this finding further delineates consequent pathways and molecules that may be altered by external intervention to restrict neural degeneration. PMID:25350754

Sengupta, Mohor Biplab; Basu, Mahashweta; Iswarari, Sourav; Mukhopadhyay, Kiran Kumar; Sardar, Krishna Pada; Acharyya, Biplab; Mohanty, Pradeep K.; Mukhopadhyay, Debashis

2014-01-01

201

Epidemiology of spinal cord injuries in Novosibirsk, Russia.  

PubMed

The incidence of spinal cord injuries (SCI) in Novosibirsk is 29.7 per million per year. Almost all of these SCI patients (94.3%) are hospitalized to our clinic. Over the past 5 years (since 1989), a total of 196 patients with SCI were admitted. SCI were distributed as follows: cervical, 96 patients (49.0%); thoracic, 54 (27.5%); and lumbar, 46 23.5%). SCI was diagnosed using computed tomography (CT), magnetic resonance imaging (MRI), pneumomyelography, epidurography, radiography and electrophysiological methods (neuromyography, evoked potentials). All patients had a neurological deficit of varying degree; Frankel grade A, 64 patients (32.7%); B, 22 (11.2%); C, 67 (34.2%); and D, 43 (21.9%). Almost 40% (39.7%) of the patients had unstable fractures, most of them being in the cervical spine. One hundred and ninety patients were operated on, 52 within 3-4 h after trauma. Several types of operation were used: anterior decompression (106 patients); posterior decompression (64 patients); omentomyelopexia (seven patients); meningomyeloradiculolysis (13 patients). Conservative treatment ('halo' traction) was applied in six patients. No patient was made worse because of the surgery. Twenty four patients had a complete neurological recovery, 113 patients could be reclassified into a higher group (Frankel classification), and 59 patients had no neurological improvement. The overall mortality was 16.8% (13.7 postoperatively). PMID:7644257

Silberstein, B; Rabinovich, S

1995-06-01

202

Dysphagia and Associated Respiratory Considerations in Cervical Spinal Cord Injury  

PubMed Central

Background: Dysphagia is a relatively common secondary complication that occurs after acute cervical spinal cord injury (SCI). The detrimental consequences of dysphagia in SCI include transient hypoxemia, chemical pneumonitis, atelectasis, bronchospasm, and pneumonia. The expedient diagnosis of dysphagia is imperative to reduce the risk of the development of life-threatening complications. Objective: The objective of this study was to identify risk factors for dysphagia after SCI and associated respiratory considerations in acute cervical SCI. Methods: Bedside swallow evaluation (BSE) was conducted in 68 individuals with acute cervical SCI who were admitted to an SCI specialty unit. Videofluroscopy swallow study was conducted within 72 hours of BSE when possible. Results: This prospective study found dysphagia in 30.9% (21 out of 68) of individuals with acute cervical SCI. Tracheostomy (P = .028), ventilator use (P = .012), and nasogastric tube (P = .049) were found to be significant associated factors for dysphagia. Furthermore, individuals with dysphagia had statistically higher occurrences of pneumonia when compared with persons without dysphagia (P < .001). There was also a trend for individuals with dysphagia to have longer length of stay (P = .087). Conclusion: The role of respiratory care practitioners in the care of individuals with SCI who have dysphagia needs to be recognized. Aggressive respiratory care enables individuals with potential dysphagia to be evaluated by a speech pathologist in a timely manner. Early evaluation and intervention for dysphagia could decrease morbidity and improve overall clinical outcomes. PMID:23459678

Chaw, Edward; Shem, Kazuko; Castillo, Kathleen; Wong, Sandra Lynn; Chang, James

2012-01-01

203

Infertility in Men with Spinal Cord Injury: Research and Treatment  

PubMed Central

Spinal cord injury (SCI) occurs most often to young men. Following SCI, most men are infertile due to a combination of erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Erectile dysfunction may be treated by the same therapies that are used in the general population. Similarly, the same treatments that are effective to assist conception in couples with non-SCI male factor patients are effective in assisting conception in SCI male-factor patients. The most apparent differences in male-factor symptoms between SCI and non-SCI patients are the high occurrences of anejaculation and atypical semen profiles in men with SCI. Methods available to assist ejaculation in men with SCI include penile vibratory stimulation and EEJ. Use of surgical sperm retrieval as the first line of treatment for anejaculation in men with SCI is controversial. Most men with SCI have a unique semen profile characterized by normal sperm concentration, but abnormally low sperm motility. Toxic substances in the semen contribute to this problem. Despite impaired sperm parameters, pregnancy outcomes using sperm from men with SCI are similar to pregnancy outcomes using sperm from non-SCI men. Future studies should focus on improving natural ejaculation and improving semen quality in these men. PMID:24278717

Brackett, Nancy L.

2012-01-01

204

Cell Transplantation for Spinal Cord Injury: A Systematic Review  

PubMed Central

Cell transplantation, as a therapeutic intervention for spinal cord injury (SCI), has been extensively studied by researchers in recent years. A number of different kinds of stem cells, neural progenitors, and glial cells have been tested in basic research, and most have been excluded from clinical studies because of a variety of reasons, including safety and efficacy. The signaling pathways, protein interactions, cellular behavior, and the differentiated fates of experimental cells have been studied in vitro in detail. Furthermore, the survival, proliferation, differentiation, and effects on promoting functional recovery of transplanted cells have also been examined in different animal SCI models. However, despite significant progress, a “bench to bedside” gap still exists. In this paper, we comprehensively cover publications in the field from the last years. The most commonly utilized cell lineages were covered in this paper and specific areas covered include survival of grafted cells, axonal regeneration and remyelination, sensory and motor functional recovery, and electrophysiological improvements. Finally we also review the literature on the in vivo tracking techniques for transplanted cells. PMID:23484157

Li, Jun; Lepski, Guilherme

2013-01-01

205

Erythropoietin: Recent Developments in the Treatment of Spinal Cord Injury  

PubMed Central

Erythropoietin (EPO), originally identified for its critical function in regulating production and survival of erythrocytes, is a member of the type 1 cytokine superfamily. Recent studies have shown that EPO has cytoprotective effects in a wide variety of cells and tissues. Here is presented the analysis of EPO effects on spinal cord injury (SCI), considering both animal experiments concerning to mechanisms of neurodegeneration in SCI and EPO as a neuroprotective agent, and some evidences coming from ongoing clinical trials. The evidences underling that EPO could be a promising therapeutic agent in a variety of neurological insults, including trauma, are mounting. In particular, it is highlighted that administration of EPO or other recently generated EPO analogues such as asialo-EPO and carbamylated-EPO demonstrate interesting preclinical and clinical characteristics, rendering the evaluation of these tissue-protective agents imperative in human clinical trials. Moreover the demonstration of rhEPO and its analogues' broad neuroprotective effects in animal models of cord lesion and in human trial like stroke, should encourage scientists and clinicians to design clinical trials assessing the efficacy of these pharmacological compounds on SCI. PMID:21766022

Carelli, Stephana; Marfia, Giovanni; Di Giulio, Anna Maria; Ghilardi, Giorgio; Gorio, Alfredo

2011-01-01

206

Effect of gender on recovery after spinal cord injury.  

PubMed

Spinal cord injury (SCI) is a debilitating condition that affects thousands of new individuals each year, the majority of which are males. Males with SCI tend to be injured at an earlier age, mostly during sports or motor vehicle accidents, whereas females tend be injured later in life, particularly in the age group 65 and older. In both experimental and clinical studies, the question as to whether gender affects outcome has been addressed in a variety of patient groups and animal models. Results from experimental paradigms have suggested that a gender bias in outcome exists that favors females and appears to involve the advantageous or disadvantageous effects of the gonadal sex hormones estrogen and progesterone or testosterone, respectively. However, other studies have shown an absence of gender differences in outcome in specific SCI models and work has also questioned the involvement of female sex hormones in the observed outcome improvements in females. Similar controversy exists clinically, in studies that have examined gender disparities in outcome after SCI. The current review examines the experimental and clinical evidence for a gender bias in outcome following SCI and discusses issues that have made it difficult to conclusively answer this question. PMID:24323341

Chan, Wai-Man; Mohammed, Yahya; Lee, Isabel; Pearse, Damien D

2013-08-01

207

Recent Advances in Pathophysiology and Treatment of Spinal Cord Injury  

NSDL National Science Digital Library

Thirty years ago, patients with spinal cord injury (SCI) and their families were told "nothing can be done" to improve function. Since the SCI patient population is reaching normal life expectancy through better health care, it has become an obviously worthwhile enterprise to devote considerable research effort to SCI. Targets for intervention in SCI toward improved function have been identified using basic research approaches and can be simplified into a list: 1) reduction of edema and free-radical production, 2) rescue of neural tissue at risk of dying in secondary processes such as abnormally high extracellular glutamate concentrations, 3) control of inflammation, 4) rescue of neuronal/glial populations at risk of continued apoptosis, 5) repair of demyelination and conduction deficits, 6) promotion of neurite growth through improved extracellular environment, 7) cell replacement therapies, 8) efforts to bridge the gap with transplantation approaches, 9) efforts to retrain and relearn motor tasks, 10) restoration of lost function by electrical stimulation, and 11) relief of chronic pain syndromes. Currently, over 70 clinical trials are in progress worldwide. Consequently, in this millennium, unlike in the last, no SCI patient will have to hear "nothing can be done."

Claire E. Hulsebosch (University of Texas Medical Branch Department of Anatomy and Neurosciences)

2002-12-01

208

Human spinal cord injury: motor unit properties and behaviour.  

PubMed

Spinal cord injury (SCI) results in widespread variation in muscle function. Review of motor unit data shows that changes in the amount and balance of excitatory and inhibitory inputs after SCI alter management of motoneurons. Not only are units recruited up to higher than usual relative forces when SCI leaves few units under voluntary control, the force contribution from recruitment increases due to elevation of twitch/tetanic force ratios. Force gradation and precision are also coarser with reduced unit numbers. Maximal unit firing rates are low in hand muscles, limiting voluntary strength, but are low, normal or high in limb muscles. Unit firing rates during spasms can exceed voluntary rates, emphasizing that deficits in descending drive limit force production. SCI also changes muscle properties. Motor unit weakness and fatigability seem universal across muscles and species, increasing the muscle weakness that arises from paralysis of units, motoneuron death and sensory impairment. Motor axon conduction velocity decreases after human SCI. Muscle contractile speed is also reduced, which lowers the stimulation frequencies needed to grade force when paralysed muscles are activated with patterned electrical stimulation. This slowing does not necessarily occur in hind limb muscles after cord transection in cats and rats. The nature, duration and level of SCI underlie some of these species differences, as do variations in muscle function, daily usage, tract control and fibre-type composition. Exploring this diversity is important to promote recovery of the hand, bowel, bladder and locomotor function most wanted by people with SCI. PMID:23901835

Thomas, C K; Bakels, R; Klein, C S; Zijdewind, I

2014-01-01

209

Minimizing Errors in Acute Traumatic Spinal Cord Injury Trials by Acknowledging the Heterogeneity of Spinal Cord Anatomy and Injury Severity: An Observational Canadian Cohort Analysis  

PubMed Central

Abstract Clinical trials of therapies for acute traumatic spinal cord injury (tSCI) have failed to convincingly demonstrate efficacy in improving neurologic function. Failing to acknowledge the heterogeneity of these injuries and under-appreciating the impact of the most important baseline prognostic variables likely contributes to this translational failure. Our hypothesis was that neurological level and severity of initial injury (measured by the American Spinal Injury Association Impairment Scale [AIS]) act jointly and are the major determinants of motor recovery. Our objective was to quantify the influence of these variables when considered together on early motor score recovery following acute tSCI. Eight hundred thirty-six participants from the Rick Hansen Spinal Cord Injury Registry were analyzed for motor score improvement from baseline to follow-up. In AIS A, B, and C patients, cervical and thoracic injuries displayed significantly different motor score recovery. AIS A patients with thoracic (T2-T10) and thoracolumbar (T11-L2) injuries had significantly different motor improvement. High (C1-C4) and low (C5-T1) cervical injuries demonstrated differences in upper extremity motor recovery in AIS B, C, and D. A hypothetical clinical trial example demonstrated the benefits of stratifying on neurological level and severity of injury. Clinically meaningful motor score recovery is predictably related to the neurological level of injury and the severity of the baseline neurological impairment. Stratifying clinical trial cohorts using a joint distribution of these two variables will enhance a study's chance of identifying a true treatment effect and minimize the risk of misattributed treatment effects. Clinical studies should stratify participants based on these factors and record the number of participants and their mean baseline motor scores for each category of this joint distribution as part of the reporting of participant characteristics. Improved clinical trial design is a high priority as new therapies and interventions for tSCI emerge. PMID:24811484

Noonan, Vanessa K.; Fallah, Nader; Fisher, Charles G.; Rivers, Carly S.; Ahn, Henry; Tsai, Eve C.; Linassi, A.G.; Christie, Sean D.; Attabib, Najmedden; Hurlbert, R. John; Fourney, Daryl R.; Johnson, Michael G.; Fehlings, Michael G.; Drew, Brian; Bailey, Christopher S.; Paquet, Jerome; Parent, Stefan; Townson, Andrea; Ho, Chester; Craven, B.C.; Gagnon, Dany; Tsui, Deborah; Fox, Richard; Mac-Thiong, Jean-Marc; Kwon, Brian K.

2014-01-01

210

Cannabidiol-treated rats exhibited higher motor score after cryogenic spinal cord injury.  

PubMed

Cannabidiol (CBD), a non-psychoactive constituent of cannabis, has been reported to induce neuroprotective effects in several experimental models of brain injury. We aimed at investigating whether this drug could also improve locomotor recovery of rats submitted to spinal cord cryoinjury. Rats were distributed into five experimental groups. Animals were submitted to laminectomy in vertebral segment T10 followed or not by application of liquid nitrogen for 5 s into the spinal cord at the same level to cause cryoinjury. The animals received injections of vehicle or CBD (20 mg/kg) immediately before, 3 h after and daily for 6 days after surgery. The Basso, Beattie, and Bresnahan motor evaluation test was used to assess motor function post-lesion one day before surgery and on the first, third, and seventh postoperative days. The extent of injury was evaluated by hematoxylin-eosin histology and FosB expression. Cryogenic lesion of the spinal cord resulted in a significant motor deficit. Cannabidiol-treated rats exhibited a higher Basso, Beattie, and Bresnahan locomotor score at the end of the first week after spinal cord injury: lesion + vehicle, day 1: zero, day 7: four, and lesion + Cannabidiol 20 mg/kg, day 1: zero, day 7: seven. Moreover, at this moment there was a significant reduction in the extent of tissue injury and FosB expression in the ventral horn of the spinal cord. The present study confirmed that application of liquid nitrogen to the spinal cord induces reproducible and quantifiable spinal cord injury associated with locomotor function impairments. Cannabidiol improved locomotor functional recovery and reduced injury extent, suggesting that it could be useful in the treatment of spinal cord lesions. PMID:21915768

Kwiatkoski, Marcelo; Guimarães, Francisco Silveira; Del-Bel, Elaine

2012-04-01

211

Relationship of Personality and Locus of Control With Employment Outcomes among Participants with Spinal Cord Injury  

ERIC Educational Resources Information Center

We investigated relationships among personality, locus of control, and current post-injury employment status for 1,391 participants with spinal cord injury. Participants with higher internality locus-of-control scores and activity scores (personality) reported more favorable employment outcomes. Higher scores on chance and powerful others (locus…

Krause, James S.; Broderick, Lynne

2006-01-01

212

Coping Effectiveness Training During Acute Rehabilitation of Spinal Cord Injury\\/Dysfunction: A Randomized Clinical Trial  

Microsoft Academic Search

Purpose: To compare coping effectiveness training (CET) with supportive group therapy (SGT) for anxiety, depression, and adjustment to injury in an acute spinal cord injury\\/dysfunction (SCI\\/D) rehabilitation population. CET was shown to result in decreased anxiety and depression symptoms when compared to historical no-treatment control groups (Kennedy, Duff, Evans, & Beedie, 2003; King & Kennedy, 1999). The present study sought

Jennifer J. Duchnick; Elizabeth A. Letsch; Glenn Curtiss

2009-01-01

213

Death Anxiety as a Predictor of Posttraumatic Stress Levels among Individuals with Spinal Cord Injuries  

ERIC Educational Resources Information Center

Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to…

Martz, Erin

2004-01-01

214

Spinal Cord Injury as a Permanent Consequence of Victimization in Random Violence: A Public Health Perspective.  

ERIC Educational Resources Information Center

Traumatic spinal cord injuries resulting from criminal violence is a growing public health concern. Citing the criminal justice system's failure to reduce violence and the costs of treating injuries, a public health-education approach is advocated. Approaches to prevention, gun control, and a comprehensive family policy are discussed. (Author/EMK)

Anderson, James F.; Dyson, Laronistine; Grandison, Terry

1998-01-01

215

Neurological outcome in a series of 58 patients operated for traumatic thoracolumbar spinal cord injuries  

PubMed Central

Background: Traumatic thoracolumbar spinal fractures represent approximately 65% of all traumatic spinal fractures and are frequently associated to permanent disability with significant social and economic impact. These injuries create severe physical limitations depending on neurological status, level of fracture, severity of injury, patient age and comorbidities. Predicting neurological improvement in patients with traumatic spinal cord injuries (SCIs) is very difficult because it is related to different preoperative prognostic factors. We evaluated the neurological improvement related to the preoperative neurological conditions and the anatomic level of spinal cord injury. Methods: From January 2004 to June 2010, we operated 207 patients for unstable thoracolumbar spinal fractures. We carried out a retrospective analysis of 69 patients with traumatic SCIs operated on by a posterior fixation performed within 24 hours from the trauma. The preoperative neurological conditions (ASIA grade), the type of the fracture, the anatomic level of spinal cord injury and the postoperative neurological improvement were evaluated for each patient. Results: The ASIA grade at admission (P = 0,0005), the fracture type according to the AO spine classification (P = 0,0002), and the anatomic location of the injury (P = 0,0213) represented predictive factors of neurological improvement at univariate analysis. The preoperative neurological status (P = 0,0491) and the fracture type (P = 0,049) confirmed a positive predictive value also in the multivariate analysis. Conclusions: Our study confirms that the preoperative neurological status, the fracture type and the anatomic location of the fracture are predictive factors of the neurological outcome in patients with spinal cord injury.

Dobran, Mauro; Iacoangeli, Maurizio; Di Somma, Lucia Giovanna Maria; Di Rienzo, A.; Colasanti, Roberto; Nocchi, Niccolo; Alvaro, Lorenzo; Moriconi, Elisa; Nasi, Davide; Scerrati, Massimo

2014-01-01

216

The asparaginyl endopeptidase legumain is essential for functional recovery after spinal cord injury in adult zebrafish.  

PubMed

Unlike mammals, adult zebrafish are capable of regenerating severed axons and regaining locomotor function after spinal cord injury. A key factor for this regenerative capacity is the innate ability of neurons to re-express growth-associated genes and regrow their axons after injury in a permissive environment. By microarray analysis, we have previously shown that the expression of legumain (also known as asparaginyl endopeptidase) is upregulated after complete transection of the spinal cord. In situ hybridization showed upregulation of legumain expression in neurons of regenerative nuclei during the phase of axon regrowth/sprouting after spinal cord injury. Upregulation of Legumain protein expression was confirmed by immunohistochemistry. Interestingly, upregulation of legumain expression was also observed in macrophages/microglia and neurons in the spinal cord caudal to the lesion site after injury. The role of legumain in locomotor function after spinal cord injury was tested by reducing Legumain expression by application of anti-sense morpholino oligonucleotides. Using two independent anti-sense morpholinos, locomotor recovery and axonal regrowth were impaired when compared with a standard control morpholino. We conclude that upregulation of legumain expression after spinal cord injury in the adult zebrafish is an essential component of the capacity of injured neurons to regrow their axons. Another feature contributing to functional recovery implicates upregulation of legumain expression in the spinal cord caudal to the injury site. In conclusion, we established for the first time a function for an unusual protease, the asparaginyl endopeptidase, in the nervous system. This study is also the first to demonstrate the importance of legumain for repair of an injured adult central nervous system of a spontaneously regenerating vertebrate and is expected to yield insights into its potential in nervous system regeneration in mammals. PMID:24747977

Ma, Liping; Shen, Yan-Qin; Khatri, Harsh P; Schachner, Melitta

2014-01-01

217

[Lactic acidosis: a complication of spinal cord injury in multiple trauma].  

PubMed

Large-dose methylprednisolone has been advocated to lessen neurologic deficits in spinal cord injury for nearly a decade despite confounding statistical results in the Second National Acute Spinal Cord Injury Study (NASCIS-2). Recent retrospective studies found lack of significant functional improvement, increases in the incidence of infectious complications and an increase in ventilated and intensive care days in steroid-treated groups. We report on five cases with severe hyperglycemia and nonketotic metabolic acidosis in otherwise non-diabetic patients with multiple blunt injuries and an associated spinal cord injury. Those adverse effects were induced by epinephrine and aggravated by methylprednisolone. We conclude that high-dose methylprednisolone should be avoided in multiple injured or otherwise compromised patients potentially needing catecholamine support. PMID:10925653

Hasse, W; Weidtmann, A; Voeltz, P

2000-06-01

218

Sox11 promotes endogenous neurogenesis and locomotor recovery in mice spinal cord injury.  

PubMed

We introduced a lentiviral vector containing the Sox11 gene into injured spinal cords of mice to evaluate the therapeutic potential of Sox11 in spinal cord injury. Sox11 markedly improved locomotor recovery after spinal cord injury and this recovery was accompanied by an up-regulation of Nestin/Doublecortin expression in the injured spinal cord. Sox11 was mainly located in endogenous neural stem cells lining the central canal and in newly-generated neurons in the spinal cord. In addition, Sox 11 significantly induced expressions of BDNF in the spinal cords of LV-Sox11-treated mice. We concluded that Sox11 induced activation of endogenous neural stem cells into neuronal determination and migration within the injured spinal cord. The resultant increase of BDNF at the injured site might form a distinct neurogenic niche which induces a final neuronal differentiation of these neural stem cells. Enhancing Sox11 expression to induce neurogenic differentiation of endogenous neural stem cells after injury may be a promising strategy in restorative therapy after SCI in mammals. PMID:24589730

Guo, Yuji; Liu, Shangming; Zhang, Xianghong; Wang, Liyan; Zhang, Xiaoli; Hao, Aijun; Han, Aiqing; Yang, Jie

2014-04-18

219

Assessing limb apraxia in traumatic brain injury and spinal cord injury  

PubMed Central

People with traumatic brain injury (TBI) may demonstrate action planning disorders and limb apraxia. Many patients, who sustain a spinal cord injury (SCI), sustain a co-occurring TBI (11-29 percent of people with SCI) and therefore are at risk for limb apraxia. People with SCI and TBI (SCI/TBI) rely on powered assistive devices which amplify movement. Their ability to learn complex motor compensatory strategies, that is, limb praxis, is critical to function. We wished to identify methods of screening for apraxia in patients with SCI/TBI. We reviewed instruments available for limb praxis assessment, presenting information on psychometric development, patient groups tested, commercial/clinical availability, and appropriateness for administration to people with motor weakness. Our review revealed that insufficient normative information exists for apraxia assessment in populations comparable to SCI/TBI patients who are typically young adults at the time of injury. There are few apraxia assessment instruments which do not require a motor response. Non-motoric apraxia assessments would be optimal for patients with an underlying motor weakness. PMID:23277082

McKenna, Cristin; Thakur, Uma; Marcus, Bradley; Barrett, Anna Mariya

2013-01-01

220

Air gun impactor--a novel model of graded white matter spinal cord injury in rodents.  

PubMed

Understanding mechanisms of spinal cord injury and repair requires a reliable experimental model. We have developed a new device that produces a partial damage of spinal cord white matter by means of a precisely adjusted stream of air applied under high pressure. This procedure is less invasive than standard contusion or compression models and does not require surgical removal of vertebral bones. We investigated the effects of spinal cord injury made with our device in 29 adult rats, applying different experimental parameters. The rats were divided into three groups in respect to the applied force of the blast wave. Functional outcome and histopathological effects of the injury were analyzed during 12-week follow-up. The lesions were also examined by means of magnetic resonance imaging (MRI) scans. The weakest stimulus produced transient hindlimb paresis with no cyst visible in spinal cord MRI scans, whereas the strongest was associated with permanent neurological deficit accompanied by pathological changes resembling posttraumatic syringomyelia. Obtained data revealed that our apparatus provided a spinal cord injury animal model with structural changes very similar to that present in patients after moderate spinal cord trauma. PMID:22711195

Marcol, Wies?aw; Slusarczyk, Wojciech; Gzik, Marek; Larysz-Brysz, Magdalena; Bobrowski, Micha?; Grynkiewicz-Bylina, Beata; Rosicka, Paulina; Kalita, Katarzyna; W?glarz, W?adys?aw; Barski, Jaros?aw J; Kotulska, Katarzyna; Labuzek, Krzysztof; Lewin-Kowalik, Joanna

2012-10-01

221

[Current role of methylprednisolone in the treatment of acute spinal cord injury].  

PubMed

High doses of methylprednisolone (MPSS) came into use as part of a therapeutic protocol for acute spinal cord injuries following the published results from the NASCIS II study in 1992; they soon became a standard of care around the world. However, the results of this study have been critically reviewed and questioned by many authors since the beginning. The major argument is based on the fact that its effectiveness in reducing post-injury neurological damage has not been conclusively proved; in addition, there has been increasing evidence of serious side effects of steroids administered at high doses. In the Czech Republic, as part of pre-hospital care, MPSS according to the NASCIS II (or NASCIS III) protocol is used in all regional centres of emergency medical service. In the Czech spinal surgery centres involved in treating acute spinal cord injuries, there are 19 of them, attitudes towards the use of MPSS vary. In 16% of the centres a certainty of its beneficial effect is still maintained, faith in its effect together with fear of a "non-lege artis" procedure is the reason for MSPP use in 21%, and the fear of sanctions only leads to its use in 63% of the centres. There is no standard practice in application of the NASCIS II and NASCIS III protocols and no standard exclusion criteria exist. The two protocols are used equally, and one institution has its own modification. The recommended MPSS dose is administered with no exception in 63% of the centres; dose adjustment is employed according to the form of spinal cord lesion in 11%, the level of spinal cord injury in 5%, associated diseases in 16% and patient age in 11% of the spinal surgery centres. After the results of studies on MPSS administration in acute spinal cord injury have been analysed, many medical societies have changed their recommendations. In view of later relevant publications it is no longer possible to regard MPSS administration as a standard of cure for acute spinal cord injury. Current evidence suggests that MPSS administration in a 24-hour regimen after an initial dose given within 8 hours of injury is the therapeutic procedure that needs individual consideration in each patient according to their state of health and potential complications. MPSS administration at an interval longer than 8 hours after injury and for more than 24 hours is not justified, nor is it justified to use a high MPSS dose at the place of injury by an emergency ambulance crew. Key words: corticosteroids, methylprednisolone, spinal cord trauma, neurological damage. PMID:21888840

Lukáš, R; Zýková, I; Barsa, P; Srám, J

2011-01-01

222

Development of a database for translational spinal cord injury research.  

PubMed

Abstract Efforts to understand spinal cord injury (SCI) and other complex neurotrauma disorders at the pre-clinical level have shown progress in recent years. However, successful translation of basic research into clinical practice has been slow, partly because of the large, heterogeneous data sets involved. In this sense, translational neurological research represents a "big data" problem. In an effort to expedite translation of pre-clinical knowledge into standards of patient care for SCI, we describe the development of a novel database for translational neurotrauma research known as Visualized Syndromic Information and Outcomes for Neurotrauma-SCI (VISION-SCI). We present demographics, descriptive statistics, and translational syndromic outcomes derived from our ongoing efforts to build a multi-center, multi-species pre-clinical database for SCI models. We leveraged archived surgical records, postoperative care logs, behavioral outcome measures, and histopathology from approximately 3000 mice, rats, and monkeys from pre-clinical SCI studies published between 1993 and 2013. The majority of animals in the database have measures collected for health monitoring, such as weight loss/gain, heart rate, blood pressure, postoperative monitoring of bladder function and drug/fluid administration, behavioral outcome measures of locomotion, and tissue sparing postmortem. Attempts to align these variables with currently accepted common data elements highlighted the need for more translational outcomes to be identified as clinical endpoints for therapeutic testing. Last, we use syndromic analysis to identify conserved biological mechanisms of recovery after cervical SCI between rats and monkeys that will allow for more-efficient testing of therapeutics that will need to be translated toward future clinical trials. PMID:25077610

Nielson, Jessica L; Guandique, Cristian F; Liu, Aiwen W; Burke, Darlene A; Lash, A Todd; Moseanko, Rod; Hawbecker, Stephanie; Strand, Sarah C; Zdunowski, Sharon; Irvine, Karen-Amanda; Brock, John H; Nout-Lomas, Yvette S; Gensel, John C; Anderson, Kim D; Segal, Mark R; Rosenzweig, Ephron S; Magnuson, David S K; Whittemore, Scott R; McTigue, Dana M; Popovich, Phillip G; Rabchevsky, Alexander G; Scheff, Stephen W; Steward, Oswald; Courtine, Grégoire; Edgerton, V Reggie; Tuszynski, Mark H; Beattie, Michael S; Bresnahan, Jacqueline C; Ferguson, Adam R

2014-11-01

223

Depression and Depression Treatment in Women With Spinal Cord Injury  

PubMed Central

Background: Research has documented high rates of depression in people with spinal cord injury (SCI); however, most SCI research is conducted with predominantly male study participants. Additional research is needed on depression and depression treatment among women with SCI. Objective: Study objectives were to examine depression, correlates of depression, and depression treatment in a sample of women with SCI. Methods: The sample included 51 ethnically and racially diverse women with SCI who participated in a larger study on secondary conditions of women with diverse physical disabilities. Recruited through health clinics and community organizations in a large metropolitan area, participants completed structured interviews that included demographic and disability characteristics and measures of health and health care utilization. Results: Scores on the Beck Depression Inventory–II (BDI-II) indicated that 41% of the women had depressive symptomatology in the mild to severe range. BDI-II scores were significantly related to more severe secondary conditions, greater pain, and poorer health perceptions but not to demographic or disability variables. Nearly a third (n = 16) of the women had scores exceeding the standard cutoff for significant clinical depressive symptomatology, yet only 5 of those had received any treatment for depression in the past 3 months and only 1 had received counseling or psychotherapy. Lifelong depression treatment showed a similar pattern of predominantly pharmacologic treatment. Conclusion: Depression is a common problem for women with SCI, and many do not receive treatment, particularly psychological treatment. Disability-sensitive and affordable depression treatment must be made available to women with SCI. PMID:24574819

Robinson-Whelen, Susan

2014-01-01

224

Neuroprosthetics of the upper extremity — clinical application in spinal cord injury and challenges for the future  

Microsoft Academic Search

The complete restoration of movements lost due to a spinal cord injury (SCI) is the greatest hope of physicians, therapists\\u000a and certainly of the patients themselves. Particularly, in patients with lesions of the cervical spinal cord every little\\u000a improvement of missing or weak grasp function will result in a large gain in quality of life. Despite the fact that novel

Rüdiger Rupp; H. J. Gerner

225

Effects of methylprednisolone and dextromethorphan on lipid peroxidation in an experimental model of spinal cord injury  

Microsoft Academic Search

.   \\u000a Objective. This study examines the effects of agents purported to improve recovery following spinal cord trauma, methylprednisolone\\u000a sodium succinate, dextromethorphan, and the combination of both, on the post-traumatic alterations of membrane lipid metabolism.\\u000a Methods. After sparing ten rats for a control group (G1) and performing T3–T6 laminectomies in 150 rats, spinal cord injuries were\\u000a accomplished in 120 of 150

Cahide Topsakal; Fatih S. Erol; Faik M. Ozveren; Nejat Yilmaz; Nevin Ilhan

2002-01-01

226

Asymmetric bipedal locomotion – an adaptive response to incomplete spinal injury in the chick  

Microsoft Academic Search

The purpose of this study was to compare the asymmetric gait induced by unilateral spinal cord injury in chicks with asymmetric\\u000a gaits of other bipeds and quadrupeds. After lateral hemisection of the left thoracic spinal cord, kinetic (ground reaction\\u000a forces) and kinematic (distance and timing) data were recorded as chicks moved overground unrestrained. Ground reaction forces\\u000a were analyzed to obtain

Gillian D. Muir; Stephen L. Katz; John M. Gosline; John D. Steeves

1998-01-01

227

Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury  

Microsoft Academic Search

A spinal cord injury (SCI) is an interruption of the neural pathways in the spinal canal\\u000aand is characterized by muscle weakness, loss of sensation and autonomic dysfunction\\u000abelow the level of the lesion. The extent of these neurological deficits is determined\\u000aby both the level and completeness of the lesion. A complete lesion results in loss\\u000aof motor function

J. A. Haisma

2008-01-01

228

Motoneuron Intrinsic Properties, but Not Their Receptive Fields, Recover in Chronic Spinal Injury  

PubMed Central

Proper movement execution relies on precise input processing by spinal motoneurons (MNs). Spinal MNs are activated by limb joint rotations. Typically, their movement-related receptive fields (MRRFs) are sharply focused and joint-specific. After acute spinal transection MRRFs become wide, but their manifestation is not apparent, as intrinsic excitability, primarily resulting from the loss of persistent inward currents (PICs), dramatically decreases. PICs undergo a remarkable recovery with time after injury. Here we investigate whether MRRFs undergo a recovery that parallels that of the PIC. Using the chronic spinal cat in acute terminal decerebrate preparations, we found that MRRFs remain expanded 1 month after spinal transaction, whereas PICs recovered to >80% of their preinjury amplitudes. These recovered PICs substantially amplified the expanded inputs underlying the MRRFs. As a result, we show that single joint rotations lead to the activation of muscles across the entire limb. These results provide a potential mechanism for the propagation of spasms throughout the limb. PMID:24285887

Kajtaz, Elma; Cain, Charlette M.; Heckman, C.J.

2013-01-01

229

Transcriptional regulation of gene expression clusters in motor neurons following spinal cord injury  

PubMed Central

Background Spinal cord injury leads to neurological dysfunctions affecting the motor, sensory as well as the autonomic systems. Increased excitability of motor neurons has been implicated in injury-induced spasticity, where the reappearance of self-sustained plateau potentials in the absence of modulatory inputs from the brain correlates with the development of spasticity. Results Here we examine the dynamic transcriptional response of motor neurons to spinal cord injury as it evolves over time to unravel common gene expression patterns and their underlying regulatory mechanisms. For this we use a rat-tail-model with complete spinal cord transection causing injury-induced spasticity, where gene expression profiles are obtained from labeled motor neurons extracted with laser microdissection 0, 2, 7, 21 and 60 days post injury. Consensus clustering identifies 12 gene clusters with distinct time expression profiles. Analysis of these gene clusters identifies early immunological/inflammatory and late developmental responses as well as a regulation of genes relating to neuron excitability that support the development of motor neuron hyper-excitability and the reappearance of plateau potentials in the late phase of the injury response. Transcription factor motif analysis identifies differentially expressed transcription factors involved in the regulation of each gene cluster, shaping the expression of the identified biological processes and their associated genes underlying the changes in motor neuron excitability. Conclusions This analysis provides important clues to the underlying mechanisms of transcriptional regulation responsible for the increased excitability observed in motor neurons in the late chronic phase of spinal cord injury suggesting alternative targets for treatment of spinal cord injury. Several transcription factors were identified as potential regulators of gene clusters containing elements related to motor neuron hyper-excitability, the manipulation of which potentially could be used to alter the transcriptional response to prevent the motor neurons from entering a state of hyper-excitability. PMID:20534130

2010-01-01

230

Delayed acute spinal cord injury following intracranial gunshot trauma: case report.  

PubMed

The authors report the case of a patient who presented with a hoarse voice and left hemiparesis following a gunshot injury with trajectory entering the left scapula, traversing the suboccipital bone, and coming to rest in the right lateral medullary cistern. Following recovery from the hemiparesis, abrupt quadriparesis occurred coincident with fall of the bullet into the anterior spinal canal. The bullet was retrieved following a C-2 and C-3 laminectomy, and postoperative MR imaging confirmed signal change in the cord at the level where the bullet had lodged. The patient then made a good neurological recovery. Bullets can fall from the posterior fossa with sufficient momentum to cause an acute spinal cord injury. Consideration for craniotomy and bullet retrieval should be given to large bullets lying in the CSF spaces of the posterior fossa as they pose risk for acute spinal cord injury. PMID:22242667

Cheng, Jason S; Richardson, R Mark; Gean, Alisa D; Stiver, Shirley I

2012-04-01

231

Postoperative management and acute rehabilitation of patients with spinal cord injuries.  

PubMed

The mortality and morbidity rates of patients with spinal cord injury have decreased greatly. Prior to World War II, few patients survived their acute injuries. Now even severely involved respiratory-dependent patients may return to live in the community. Advanced surgical procedures, when appropriately applied, are decreasing the time of immobility and preventing late spinal deformities. Exciting new developments in basic science research such as the use of thyrotropin-releasing hormone and functional electrical stimulation may alter the whole course of recovery for patients within the foreseeable future. It is likely, however, that the acute management of the patient with spinal cord injury will still demand systematic care by an experienced, multidisciplinary team of professionals. PMID:3945478

McCagg, C

1986-01-01

232

Nerve Regeneration Restores Supraspinal Control of Bladder Function after Complete Spinal Cord Injury  

PubMed Central

A life-threatening disability after complete spinal cord injury is urinary dysfunction, which is attributable to lack of regeneration of supraspinal pathways that control the bladder. Although numerous strategies have been proposed that can promote the regrowth of severed axons in the adult CNS, at present, the approaches by which this can be accomplished after complete cord transection are quite limited. In the present study, we modified a classic peripheral nerve grafting technique with the use of chondroitinase to facilitate the regeneration of axons across and beyond an extensive thoracic spinal cord transection lesion in adult rats. The novel combination treatment allows for remarkably lengthy regeneration of certain subtypes of brainstem and propriospinal axons across the injury site and is followed by markedly improved urinary function. Our studies provide evidence that an enhanced nerve grafting strategy represents a potential regenerative treatment after severe spinal cord injury. PMID:23804083

Lin, Ching-Yi; Jiang, Hai-Hong; DePaul, Marc; Lin, Vernon W.

2013-01-01

233

Spinal cord injury - there is not just one way of treating it  

PubMed Central

In the last century, research in the field of spinal cord trauma has brought insightful knowledge which has led to a detailed understanding of mechanisms that are involved in injury- and recovery-related processes. The quest for a cure for the yet generally incurable condition as well as the exponential rise in gained information has brought about the development of numerous treatment approaches while at the same time the abundance of data has become quite unmanageable. Owing to an enormous amount of preclinical therapeutic approaches, this report highlights important trends rather than specific treatment strategies. We focus on current advances in the treatment of spinal cord injury and want to further draw attention to arising problems in spinal cord injury (SCI) research and discuss possible solutions. PMID:25343041

Estrada, Veronica

2014-01-01

234

Glial and neuronal connexin expression patterns in the rat spinal cord during development and following injury.  

PubMed

Spinal cord injury induces a complex cascade of degenerative and remodeling events evolving over time. The possible roles of changed intercellular communication via gap junctions after spinal cord injury (SCI) have remained relatively unexplored. We investigated the temporospatial expression patterns of gap junctional genes and proteins, connexin 43 (Cx43), Cx36, and Cx32, by in situ hybridization and immunohistochemistry in the rat neonatal, adult normal, and adult injured spinal cord. Cx36 was strongly expressed in immature neurons, and levels declined markedly during development, whereas Cx43 and Cx32 persisted throughout adulthood. After a complete transection of the adult spinal cord, the levels of Cx43 mRNA and protein were up-regulated within hours, especially in gray matter rostral to the lesion, reaching over three times normal levels at 4 weeks postinjury. Cx43 immunoreactivity was seen primarily in astrocytes and rarely in microglia. In contrast, Cx36 and Cx32 mRNA and proteins were relatively sparse and unchanged after spinal cord injury along the entire axis of the spinal cord. Cx43 is the most abundant gap junctional protein in the adult CNS and has been shown to form channels between astrocytes as well as between astrocytes and oligodendrocytes. Long-term up-regulation of Cx43 in reactive astrocytes may be one critical component in the rearrangement of the local astroglial network following SCI. PMID:15977163

Lee, I-Hui; Lindqvist, Eva; Kiehn, Ole; Widenfalk, Johan; Olson, Lars

2005-08-15

235

Endogenous Neural Progenitor Cells as Therapeutic Target After Spinal Cord Injury  

NSDL National Science Digital Library

Growing knowledge about the role of neural progenitor cells supports the hope that stem cell-based therapeutic approaches aimed at restoring function in the lesioned central nervous system can be established. Possible therapies for promoting recovery after spinal cord injury include stimulating the formation of neurons and glial cells by endogenous progenitor cells. This article reviews the current knowledge about the nature of adult progenitor cells in the intact and injured spinal cord and summarizes possibilities and limitations of cellular replacement strategies based on manipulations of endogenous spinal cord progenitor cells and their environment.

Franz-Josef Obermair (University of Zurich Neuromorphology); Aileen Schroter (University of Zurich Neuromorphology); Michaela Thallmair (University of Zurich Neuromorphology)

2008-10-18

236

Outcome of abdominal aortic aneurysm repair in patients with previous spinal cord injury in the Department of Veterans' Affairs hospitals  

Microsoft Academic Search

A retrospective review was carried out to determine the morbidity and mortality of abdominal aortic aneurysm repair in patients with previous spinal cord injury. A population-based study utilizing computer records on all patients in Department of Veterans' Affairs medical centers from 1987–1991 identified 31 patients with spinal cord injury who underwent subsequent infrarenal abdominal aortic aneurysm repair. Additional information was

D. L Jacobs; W. E Longo; G. J Peterson; L. W McKirgan; K. S Virgo; F. E Johnson

1997-01-01

237

Attachment Style, Social Support, and Coping as Psychosocial Correlates of Happiness in Persons with Spinal Cord Injuries  

ERIC Educational Resources Information Center

Objective: To examine the roles of attachment, social support, and coping as psychosocial correlates in predicting happiness in people with spinal cord injuries. Design: Quantitative descriptive research design using multiple regression and correlation techniques. Participants: 274 individuals with spinal cord injuries. Outcome Measures: Happiness…

Wilson, Lisa; Catalano, Denise; Sung, Connie; Phillips, Brian; Chou, Chih-Chin; Chan, Jacob Yui Chung; Chan, Fong

2013-01-01

238

Diffuse Idiopathic Skeletal Hyperostosis with Cervical Spinal Cord Injury - A Report of 3 Cases and a Literature Review  

Microsoft Academic Search

Introduction: Diffuse idiopathic skeletal hyperostosis (DISH), though common, is often asymptomatic. However, spinal hyperostosis can predispose the affected to chronic myelopathic symptoms and acute spinal cord injury. Clinical Picture: We report on 3 patients with DISH, who sustained traumatic cervical cord injuries. Two were tetraplegic at presentation. The radiologic findings of the patients are also discussed. Treatment: Both the tetraplegic

S Sreedharan

239

[11C]PK11195 PET imaging of spinal glial activation after nerve injury in rats.  

PubMed

The role of glial activation has been implicated in the development and persistence of neuropathic pain after nerve injury by recent studies. PK11195 binding to the translocator protein 18kDa (TSPO) has been shown to be enhanced in activated microglia. This study was designed to assess PK11195 imaging in spinal microglia during activation after nerve injury. The development of neuropathic pain was induced by partial sciatic nerve ligation (PSL). PSL rats on days 7 and 14 after nerve injury were subjected to imaging with a small-animal positron emission tomography/computed tomography (PET/CT) scanner using [(11)C]PK11195 to detect spinal microglial activation by means of noninvasive in vivo imaging. Spinal [(3)H]PK11195 autoradiography was performed to confirm the results of [(11)C]PK11195 PET in PSL rats. Quantitative RT-PCR of CD11b and GFAP mRNA, and the immunohistochemistry of Iba1 and GFAP were investigated to detect activated microglia and astrocytes. Mechanical allodynia was observed in the ipsilateral paw of PSL rats from day 3 after nerve injury and stably persisted from days 7 to 14. PET/CT fusion images clearly showed large amounts of accumulation of [(11)C]PK11195 in the lumbar spinal cord on days 7 and 14 after nerve injury. [(11)C]PK11195 enhanced images were restricted to the L3-L6 area of the spinal cord. The standardized uptake value (SUV) of [(11)C]PK11195 was significantly increased in the lumbar spinal cord compared to that of the thoracic region. Increased specific binding of [(11)C]PK11195 to TSPO in the spinal cord of PSL rats was confirmed by competition studies using unlabeled (R, S)-PK11195. Increased [(3)H]PK11195 binding was also observed in the ipsilateral dorsal horn of the L3-L6 spinal cord on days 7 and 14 after nerve injury. CD11b mRNA and Iba1 immunoreactive cells increased significantly on days 7 and 14 after nerve injury by PSL. However, changes in GFAP mRNA and immunoreactivity were slight in the ipsilateral side of PSL rats. In the present study, we showed that glial activation could be quantitatively imaged in the spinal cord of neuropathic pain rats using [(11)C]PK11195 PET, suggesting that high resolution PET using TSPO-specific radioligands might be useful for imaging to assess the role of glial activation, including neuroinflammatory processes, in neuropathic pain patients. PMID:23611861

Imamoto, Natsumi; Momosaki, Sotaro; Fujita, Masahide; Omachi, Shigeki; Yamato, Hiroko; Kimura, Mika; Kanegawa, Naoki; Shinohara, Shunji; Abe, Kohji

2013-10-01

240

The Effect of Safflower Yellow on Spinal Cord Ischemia Reperfusion Injury in Rabbits  

PubMed Central

Safflower yellow (SY) is the safflower extract and is the one of traditional Chinese medicine. The aim of the present work was to investigate the effect of SY on spinal cord ischemia reperfusion injury (SCIRI) in rabbits. The models of spinal cord ischemia reperfusion (SI/R) were constructed, and the degree of the post-ischemic injury was assessed by means of the neurological deficit scores and plasma levels of lipid peroxidation reactioin and neuronal morphologic changes. SCIRI remarkably affected the functional activities of the hind limbs and activated lipid peroxidation reaction. SY could attenuate apoptosis and SCIRI by enhancing Bcl-2 expression and inhibiting Bax and caspase-3 activation. PMID:24381717

Zhou, Daiwei; Liu, Bingbing; Xiao, Xiaoshan; Dai, Peng; Ma, Songmei; Huang, Weihua

2013-01-01

241

The effect of safflower yellow on spinal cord ischemia reperfusion injury in rabbits.  

PubMed

Safflower yellow (SY) is the safflower extract and is the one of traditional Chinese medicine. The aim of the present work was to investigate the effect of SY on spinal cord ischemia reperfusion injury (SCIRI) in rabbits. The models of spinal cord ischemia reperfusion (SI/R) were constructed, and the degree of the post-ischemic injury was assessed by means of the neurological deficit scores and plasma levels of lipid peroxidation reactioin and neuronal morphologic changes. SCIRI remarkably affected the functional activities of the hind limbs and activated lipid peroxidation reaction. SY could attenuate apoptosis and SCIRI by enhancing Bcl-2 expression and inhibiting Bax and caspase-3 activation. PMID:24381717

Zhou, Daiwei; Liu, Bingbing; Xiao, Xiaoshan; Dai, Peng; Ma, Songmei; Huang, Weihua

2013-01-01

242

Coronary slow flow and acute coronary syndrome in a patient with spinal cord injury.  

PubMed

We report the case of a 55-year-old man who presented with acute coronary syndrome due to coronary slow flow after spinal cord injury. Data regarding the causes and clinical manifestations of coronary slow flow are inconclusive, but the autonomic nervous system is believed to be at least a contributing factor. The predominant vagal activity causes vasodilation and hemostasis, which can lead to acute coronary syndrome. We hereby call attention to hyperactive parasympathetic tonicity, which can lead to coronary slow flow and acute coronary syndrome in acute spinal cord injury patients. PMID:21841878

Aktoz, Meryem; Tatli, Ersan; Barutcu, Ahmet; Ozkalayci, Flora; Umit, Elif; Altun, Armagan

2011-01-01

243

Hope and despair: the awakening of hope following acute spinal cord injury-an interpretative study.  

PubMed

The aim of this paper was to explore the patients' experiences of hope during the first months following acute spinal cord injury. This qualitative study has a descriptive and explorative design. Data were collected by personal interviews (N = 10) at a rehabilitation centre in Norway. A phenomenological-hermeneutic approach inspired by Ricoeur was used to extract the meaning content of the patients' experiences. The findings revealed one main interpretation; the awakening of hope, expressed by two themes: hope and despair, and uncertainty. Awakening hopes, even sometimes silent hopes, constituted a contextual background in the immediate aftermath of spinal cord injury. PMID:15476761

Lohne, Vibeke; Severinsson, Elisabeth

2004-11-01

244

One day of motor training with amphetamine impairs motor recovery following spinal cord injury.  

PubMed

It has previously been reported that a single dose of amphetamine paired with training on a beam walking task can enhance locomotor recovery following brain injury (Feeney et al., 1982). Here, we investigated whether this same drug/training regimen could enhance functional recovery following either thoracic (T9) or cervical (C5) spinal cord injury. Different groups of female Sprague-Dawley rats were trained on a beam walking task, and in a straight alley for assessment of hindlimb locomotor recovery using the BBB locomotor scale. For rats that received C5 hemisections, forelimb grip strength was assessed using a grip strength meter. Three separate experiments assessed the consequences of training rats on the beam walking task 24 h following a thoracic lateral hemisection with administration of either amphetamine or saline. Beginning 1 h following drug administration, rats either received additional testing/retraining on the beam hourly for 6 h, or they were returned to their home cages without further testing/retraining. Rats with thoracic spinal cord injuries that received amphetamine in conjunction with testing/retraining on the beam at 1 day post injury (DPI) exhibited significantly impaired recovery on the beam walking task and BBB. Rats with cervical spinal cord injuries that received training with amphetamine also exhibited significant impairments in beam walking and locomotion, as well as impairments in gripping and reaching abilities. Even when administered at 14 DPI, the drug/training regimen significantly impaired reaching ability in cervical spinal cord injured rats. Impairments were not seen in rats that received amphetamine without training. Histological analyses revealed that rats that received training with amphetamine had significantly larger lesions than saline controls. These data indicate that an amphetamine/training regimen that improves recovery after cortical injury has the opposite effect of impairing recovery following spinal cord injury because early training with amphetamine increases lesion severity. PMID:22078754

Wong, Jamie K; Steward, Oswald

2012-02-01

245

Effects of sensorimotor trunk impairments on trunk and upper limb joint kinematics and kinetics during sitting pivot transfers in individuals with a spinal cord injury  

E-print Network

during sitting pivot transfers in individuals with a spinal cord injury Guillaume Desroches a,b, ,1 November 2012 Keywords: Biomechanics Rehabilitation Spinal cord injury Task performance and analysis Upper pivot transfers. Methods: Twenty-six individuals with a spinal cord injury participated and were

Popovic, Milos R.

246

Thalamic activity and biochemical changes in individuals with neuropathic pain after spinal cord injury.  

PubMed

There is increasing evidence relating thalamic changes to the generation and/or maintenance of neuropathic pain. We have recently reported that neuropathic orofacial pain is associated with altered thalamic anatomy, biochemistry, and activity, which may result in disturbed thalamocortical oscillatory circuits. Despite this evidence, it is possible that these thalamic changes are not responsible for the presence of pain per se, but result as a consequence of the injury. To clarify this subject, we compared brain activity and biochemistry in 12 people with below-level neuropathic pain after complete thoracic spinal cord injury with 11 people with similar injuries and no neuropathic pain and 21 age- and gender-matched healthy control subjects. Quantitative arterial spinal labelling was used to measure thalamic activity, and magnetic resonance spectroscopy was used to determine changes in neuronal variability quantifying N-acetylaspartate and alterations in inhibitory function quantifying gamma amino butyric acid. This study revealed that the presence of neuropathic pain is associated with significant changes in thalamic biochemistry and neuronal activity. More specifically, the presence of neuropathic pain after spinal cord injury is associated with significant reductions in thalamic N-acetylaspartate, gamma amino butyric acid content, and blood flow in the region of the thalamic reticular nucleus. Spinal cord injury on its own did not account for these changes. These findings support the hypothesis that neuropathic pain is associated with altered thalamic structure and function, which may disturb central processing and play a key role in the experience of neuropathic pain. PMID:24530612

Gustin, S M; Wrigley, P J; Youssef, A M; McIndoe, L; Wilcox, S L; Rae, C D; Edden, R A E; Siddall, P J; Henderson, L A

2014-05-01

247

Global prevalence and incidence of traumatic spinal cord injury  

PubMed Central

Background Spinal cord injury (SCI) is a traumatic event that impacts a patient’s physical, psychological, and social well-being and places substantial financial burden on health care systems. To determine the true impact of SCI, this systematic review aims to summarize literature reporting on either the incidence or prevalence of SCI. Methods A systematic search was conducted using PubMed, MEDLINE, MEDLINE in process, EMBASE, Cochrane Controlled Trial Register, and Cochrane Database of Systematic Reviews to identify relevant literature published through June 2013. We sought studies that provided regional, provincial/state, or national data on the incidence of SCI or reported estimates of disease prevalence. The level of evidence of each study was rated using a scale that evaluated study design, methodology, sampling bias, and precision of estimates. Results The initial search yielded 5,874 articles, 48 of which met the inclusion criteria. Forty-four studies estimated the incidence of SCI and nine reported the prevalence, with five discussing both. Of the incidence studies, 14 provided figures at a regional, ten at a state or provincial level and 21 at a national level. The prevalence of SCI was highest in the United States of America (906 per million) and lowest in the Rhone-Alpes region, France (250 per million) and Helsinki, Finland (280 per million). With respect to states and provinces in North America, the crude annual incidence of SCI was highest in Alaska (83 per million) and Mississippi (77 per million) and lowest in Alabama (29.4 per million), despite a large percentage of violence injuries (21.2%). Annual incidences were above 50 per million in the Hualien County in Taiwan (56.1 per million), the central Portugal region (58 per million), and Olmsted County in Minnesota (54.8 per million) and were lower than 20 per million in Taipei, Taiwan (14.6 per million), the Rhone-Alpes region in France (12.7 per million), Aragon, Spain (12.1 per million), Southeast Turkey (16.9 per million), and Stockholm, Sweden (19.5 per million). The highest national incidence was 49.1 per million in New Zealand, and the lowest incidences were in Fiji (10.0 per million) and Spain (8.0 per million). The majority of studies showed a high male-to-female ratio and an age of peak incidence of younger than 30 years old. Traffic accidents were typically the most common cause of SCI, followed by falls in the elderly population. Conclusion This review demonstrates that the incidence, prevalence, and causation of SCI differs between developing and developed countries and suggests that management and preventative strategies need to be tailored to regional trends. The rising aging population in westernized countries also indicates that traumatic SCI secondary to falls may become an increasing public health challenge and that incidence among the elderly may rise with increasing life expectancy.

Singh, Anoushka; Tetreault, Lindsay; Kalsi-Ryan, Suhkvinder; Nouri, Aria; Fehlings, Michael G

2014-01-01

248

Spatio-Temporal Expression Pattern of Frizzled Receptors after Contusive Spinal Cord Injury in Adult Rats  

PubMed Central

Background Wnt proteins are a large family of molecules that are critically involved in multiple central nervous system (CNS) developmental processes. Experimental evidences suggest a role for this family of proteins in many CNS disorders, including spinal cord injury (SCI), which is a major neuropathology owing to its high prevalence and chronic sensorimotor functional sequelae. Interestingly, most Wnt proteins and their inhibitors are expressed in the uninjured spinal cord, and their temporal expression patterns are dramatically altered after injury. However, little is known regarding the expression of their better-known receptors, the Frizzled family, after SCI. Thus, the aim of the present study was to evaluate the expression of Frizzled receptors in the damaged spinal cord. Findings Based on the evidence that Wnts are expressed in the spinal cord and are transcriptionally regulated by SCI in adulthood, we analysed the spatio-temporal mRNA and protein expression patterns of Frizzled receptors after contusive SCI using quantitative RT-PCR and single and double immunohistochemistry, respectively. Our results show that almost all of the 10 known Frizzled receptors were expressed in specific spatial patterns in the uninjured spinal cords. Moreover, the Frizzled mRNAs and proteins were expressed after SCI, although their expression patterns were altered during the temporal progression of SCI. Finally, analysis of cellular Frizzled 5 expression pattern by double immunohistochemistry showed that, in the uninjured spinal cord, this receptor was expressed in neurons, oligodendrocytes, astrocytes, microglia and NG2+ glial precursors. After injury, Frizzled 5 was not only still expressed in oligodendrocytes, astrocytes and NG2+ glial precursors but also in axons at all evaluated time points. Moreover, Frizzled 5 was expressed in reactive microglia/macrophages from 3 to 14 days post-injury. Conclusions Our data suggest the involvement of Frizzled receptors in physiological spinal cord function and in the cellular and molecular events that characterise its neuropathology. PMID:23251385

Arenas, Ernest; Rodriguez, Francisco Javier

2012-01-01

249

Intraspinal microstimulation for the recovery of function following spinal cord injury  

PubMed Central

Spinal cord injury is a devastating neurological trauma, often resulting in the impairment of bladder, bowel, and sexual function as well as the loss of voluntary control of muscles innervated by spinal cord segments below the lesion site. Research is ongoing into several classes of therapies to restore lost function. These include the encouragement of neural sparing and regeneration of the affected tissue, and the intervention with pharmacological and rehabilitative means to improve function. This review will focus on the application of electrical current in the spinal cord in order to reactivate extant circuitry which coordinates and controls smooth and skeletal muscle below the injury. We first present a brief historical review of intraspinal microstimulation (ISMS) focusing on its use for restoring bladder function after spinal cord injury as well as its utilization as a research tool for mapping spinal cord circuits that coordinate movements. We then present a review of our own results related to the use of ISMS for restoring standing and walking movements after spinal cord injury. We discuss the mechanisms of action of ISMS and how they relate to observed functional outcomes in animal models. These include the activation of fibers-in-passage which lead to the transsynaptic spread of activation through the spinal cord and the ability of ISMS to produce fatigue-resistant, weight-bearing movements. We present our thoughts on the clinical potential for ISMS with regard to implantation techniques, stability, and damage induced by mechanical and electrical factors. We conclude by suggesting improvements in materials and techniques that are needed in preparation for a clinical proof-of-principle and review our current attempts to achieve these. PMID:21867807

Bamford, Jeremy A.; Mushahwar, Vivian K.

2011-01-01

250

A typology of alcohol use patterns among persons with recent traumatic brain injury or spinal cord injury: Implications for treatment matching  

Microsoft Academic Search

Turner AP, Bombardier CH, Rimmele CT. A typology of alcohol use patterns among persons with recent traumatic brain injury or spinal cord injury: implications for treatment matching. Arch Phys Med Rehabil 2003;84:358-64. Objective: To describe empirically valid and clinically meaningful types of alcohol use among persons with recent traumatic brain or spinal cord injury. Design: Cross-sectional cohort survey. Setting: Acute

Aaron P. Turner; Charles H. Bombardier; Carl T. Rimmele

2003-01-01

251

ProNGF Induces p75-Mediated Death of Oligodendrocytes following Spinal Cord Injury  

PubMed Central

Summary The neurotrophin receptor p75 is induced by various injuries to the nervous system, but its role after injury has remained unclear. Here, we report that p75 is required for the death of oligodendrocytes following spinal cord injury, and its action is mediated mainly by proNGF. Oligodendrocytes undergoing apoptosis expressed p75, and the absence of p75 resulted in a decrease in the number of apoptotic oligodendrocytes and increased survival of oligodendrocytes. ProNGF is likely responsible for activating p75 in vivo, since the proNGF from the injured spinal cord induced apoptosis among p75+/+, but not among p75-/-, oligodendrocytes in culture, and its action was blocked by proNGF-specific antibody. Together, these data suggest that the role of proNGF is to eliminate damaged cells by activating the apoptotic machinery of p75 after injury. PMID:12408842

Beattie, Michael S.; Harrington, Anthony W.; Lee, Ramee; Kim, Ju Young; Boyce, Sheri L.; Longo, Frank M.; Bresnahan, Jacqueline C.; Hempstead, Barbara L.; Yoon, Sung Ok

2009-01-01

252

Long-term medical complications after traumatic spinal cord injury: A regional model systems analysis  

Microsoft Academic Search

Objective: To analyze the incidence, risk factors, and trends of long-term secondary medical complications in individuals with traumatic spinal cord injury.Design: Data were reviewed from the National SCI Statistical Center on annual evaluations performed at 1, 2, 5, 10, 15, and 20 years after injury on patients injured between 1973 and 1998.Setting: Multicenter Regional SCI Model Systems.Main Outcome Measures: Secondary

William O. McKinley; Amie B. Jackson; Diana D. Cardenas; Michael J. De Vivo

1999-01-01

253

Resistance training and locomotor recovery after incomplete spinal cord injury: a case series  

Microsoft Academic Search

Study design:Longitudinal intervention case series.Objective:To determine if a 12-week resistance and plyometric training program results in improved muscle function and locomotor speed after incomplete spinal cord injury (SCI).Setting:University research setting.Methods:Three ambulatory individuals with chronic (18.7±2.2 months post injury) motor incomplete SCI completed 12 weeks of lower extremity resistance training combined with plyometric training (RPT). Muscle maximum cross-sectional area (max-CSA) of

C M Gregory; M G Bowden; A Jayaraman; P Shah; A Behrman; S A Kautz; K Vandenborne

2007-01-01

254

Stem Cell Clinical Trials for Spinal Cord Injury: Readiness, Reluctance, Redefinition  

Microsoft Academic Search

A wealth of scientific and clinical research has focused on the use of stem cells as a potential therapy for spinal cord injury\\u000a (SCI), culminating most recently in the initiation of clinical trials. However, with the urgency that scientists and clinicians\\u000a have undertaken to move forward with novel therapies for this devastating injury, the perspectives of stakeholders who live\\u000a with

J. Illes; J. C. Reimer; B. K. Kwon

255

Patient perception of the impact of sporting activity on rehabilitation in a spinal cord injuries unit  

Microsoft Academic Search

Objective: To establish patients’ perception of the effect of sport on rehabilitation.Design: Single investigator telephone questionnaire survey.Setting: Spinal Cord Injuries Unit, Musgrave Park Hospital, Belfast, Northern Ireland, UK.Method: A telephone questionnaire was administered to patients admitted over a 12-month period. Information on patient demographics, sports participation before and after injury and patients’ perception of the impact of sports on rehabilitation

S B O'Neill; S Maguire

2004-01-01

256

Sialidase, chondroitinase ABC, and combination therapy after spinal cord contusion injury.  

PubMed

Axon regeneration in the central nervous system is severely hampered, limiting functional recovery. This is in part because of endogenous axon regeneration inhibitors that accumulate at the injury site. Therapeutic targeting of these inhibitors and their receptors may facilitate axon outgrowth and enhance recovery. A rat model of spinal cord contusion injury was used to test the effects of two bacterial enzyme therapies that target independent axon regeneration inhibitors, sialidase (Vibrio cholerae) and chondroitinase ABC (ChABC, Proteus vulgaris). The two enzymes, individually and in combination, were infused for 2 weeks via implanted osmotic pumps to the site of a moderate thoracic spinal cord contusion injury. Sialidase was completely stable, whereas ChABC retained>30% of its activity in vivo over the 2 week infusion period. Immunohistochemistry revealed that infused sialidase acted robustly throughout the spinal cord gray and white matter, whereas ChABC activity was more intense superficially. Sialidase treatment alone resulted in improved behavioral and anatomical outcomes. Rats treated exclusively with sialidase showed significantly increased hindlimb motor function, evidenced by higher Basso Beattie and Bresnahan (BBB) and BBB subscores, and fewer stepping errors on a horizontal ladder. Sialidase-treated rats also had increased serotonergic axons caudal to the injury. ChABC treatment, in contrast, did not enhance functional recovery or alter axon numbers after moderate spinal cord contusion injury, and dampened the response of sialidase in the dual enzyme treatment group. We conclude that sialidase infusion enhanced recovery from spinal cord contusion injury, and that combining sialidase with ChABC failed to improve outcomes. PMID:22934782

Mountney, Andrea; Zahner, Matthew R; Sturgill, Elizabeth R; Riley, Christopher J; Aston, Jeffrey W; Oudega, Martin; Schramm, Lawrence P; Hurtado, Andres; Schnaar, Ronald L

2013-02-01

257

Sialidase, Chondroitinase ABC, and Combination Therapy after Spinal Cord Contusion Injury  

PubMed Central

Abstract Axon regeneration in the central nervous system is severely hampered, limiting functional recovery. This is in part because of endogenous axon regeneration inhibitors that accumulate at the injury site. Therapeutic targeting of these inhibitors and their receptors may facilitate axon outgrowth and enhance recovery. A rat model of spinal cord contusion injury was used to test the effects of two bacterial enzyme therapies that target independent axon regeneration inhibitors, sialidase (Vibrio cholerae) and chondroitinase ABC (ChABC, Proteus vulgaris). The two enzymes, individually and in combination, were infused for 2 weeks via implanted osmotic pumps to the site of a moderate thoracic spinal cord contusion injury. Sialidase was completely stable, whereas ChABC retained>30% of its activity in vivo over the 2 week infusion period. Immunohistochemistry revealed that infused sialidase acted robustly throughout the spinal cord gray and white matter, whereas ChABC activity was more intense superficially. Sialidase treatment alone resulted in improved behavioral and anatomical outcomes. Rats treated exclusively with sialidase showed significantly increased hindlimb motor function, evidenced by higher Basso Beattie and Bresnahan (BBB) and BBB subscores, and fewer stepping errors on a horizontal ladder. Sialidase-treated rats also had increased serotonergic axons caudal to the injury. ChABC treatment, in contrast, did not enhance functional recovery or alter axon numbers after moderate spinal cord contusion injury, and dampened the response of sialidase in the dual enzyme treatment group. We conclude that sialidase infusion enhanced recovery from spinal cord contusion injury, and that combining sialidase with ChABC failed to improve outcomes. PMID:22934782

Mountney, Andrea; Zahner, Matthew R.; Sturgill, Elizabeth R.; Riley, Christopher J.; Aston, Jeffrey W.; Oudega, Martin; Schramm, Lawrence P.; Hurtado, Andres

2013-01-01

258

A Spatiotemporal Pattern of Concurrent Spinal and Supraspinal NF-?B Expression Following Peripheral Nerve Injury  

PubMed Central

The expression of NF-?B in the spinal cord is associated with neuropathic pain. However, little is known about its expression beyond the spinal cord. Here we examined a spatial and temporal pattern of the NF-?B expression in both spinal and supraspinal regions. After chronic constriction injury (CCI) of the sciatic nerve, the NF-?B (p65) expression was significantly increased in the ipsilateral spinal cord. In contrast, the NF-?B expression in the contralateral primary somatosensory cortex was decreased with no significant differences seen in the thalamus. In the contralateral anterior cingulate cortex, the NF-?B expression was increased significantly on day 14 as compared to the sham group. In the contralateral amygdala, the NF-?B expression showed a time-dependent downregulation after CCI, which became significant on day 14. MK-801 reduced nociceptive behaviors and reversed the direction of NF-?B expression. These results indicate that the CCI-induced expression of p65 NF-?B is both time-dependent and region-specific, in areas that process both sensory-discriminative and motivational-affective dimensions of pain. Perspective This article presents a spatiotemporal mapping of the NF-?B expression in spinal and supraspinal regions following peripheral nerve injury. These findings point to an involvement of NF-?B beyond the spinal cord in both the sensory discriminative and emotional affective aspects of neuropathic pain processing. PMID:20537956

Chou, Chiu-Wen; Wong, Gordon T.C.; Lim, Grewo; Wang, Shuxing; Irwin, Michael G.; Mao, Jianren

2010-01-01

259

Glycyrrhizin attenuates rat ischemic spinal cord injury by suppressing inflammatory cytokines and HMGB1  

PubMed Central

Aim: To investigate the neuroprotective effect of glycyrrhizin (Gly) against the ischemic injury of rat spinal cord and the possible role of the nuclear protein high-mobility group box 1 (HMGB1) in the process. Methods: Male Sprague-Dawley rats were subjected to 45 min aortic occlusion to induce transient lumbar spinal cord ischemia. The motor functions of the animals were assessed according to the modified Tarlov scale. The animals were sacrificed 72 h after reperfusion and the lumbar spinal cord segment (L2–L4) was taken out for histopathological examination and Western blotting analysis. Serum inflammatory cytokine and HMGB1 levels were analyzed using ELISA. Results: Gly (6 mg/kg) administered intravenously 30 min before inducing the transient lumbar spinal cord ischemia significantly improved the hind-limb motor function scores, and reduced the number of apoptotic neurons, which was accompanied by reduced levels of tumor necrosis factor-? (TNF-?), interleukin-1? (IL-1?) and interleukin-6 (IL-6) in the plasma and injured spinal cord. Moreover, the serum HMGB1 level correlated well with the serum TNF-?, IL-1? and IL-6 levels during the time period of reperfusion. Conclusion: The results suggest that Gly can attenuate the transient spinal cord ischemic injury in rats via reducing inflammatory cytokines and inhibiting the release of HMGB1. PMID:22158106

Gong, Gu; Yuan, Li-bang; Hu, Ling; Wu, Wei; Yin, Liang; Hou, Jing-li; Liu, Ying-hai; Zhou, Le-shun

2012-01-01

260

Effects of hip joint angle changes on intersegmental spinal coupling in human spinal cord injury  

Microsoft Academic Search

Pathological expression of movement and muscle tone in human upper motor neuron disorders has been partly associated with\\u000a impaired modulation of spinal inhibitory mechanisms, such as reciprocal or presynaptic inhibition. In addition, input from\\u000a specific afferent systems contributes significantly to spinal reflex circuits coupled with posture or locomotion. Accordingly,\\u000a the objectives of this study were to identify the involved afferents

Maria Knikou

2005-01-01

261

Behavioral and Histological Outcomes Following Graded Spinal Cord Contusion Injury in the C57Bl\\/6 Mouse  

Microsoft Academic Search

A computer-controlled electromagnetic spinal cord injury device (ESCID) has been adapted to develop a mouse model of spinal cord contusion injury. In the present study, we have extended this model in C57Bl\\/6 mice with behavioral and histopathological outcome assessment. Three groups of mice received a laminectomy at the T9 vertebral level followed by a contusion injury from a predetermined starting

Manhong Ma; D. Michele Basso; Patricia Walters; Bradford T. Stokes; Lyn B. Jakeman

2001-01-01

262

Decreased Immune Reactivity and Neuroendocrine Alterations Related to Chronic Stress in Spinal Cord Injury and Stroke Patients  

Microsoft Academic Search

Both natural and adaptive immune responses were found to be strikingly decreased 2 weeks after injury in 54 spinal cord injury and stroke patients, i.e., 28 quadriplegics, 21 paraplegics and 5 stroke patients, compared with those of age-matched controls. All values are expressed as means. Natural-killer (NK)-cell function decreased to 21.0% 2 weeks after spinal cord injury compared with 48.6%

Julius M. Cruse; Reid Bishop; William F. Kliesch; Eduardo Gaitan; Robert Britt

1993-01-01

263

Central glucocorticoid receptors regulate the upregulation of spinal cannabinoid-1 receptors after peripheral nerve injury in rats.  

PubMed

Previous studies have shown that peripheral nerve injury upregulated both glucocorticoid receptors (GR) and cannabinoid-1 receptors (CB1R) within the spinal cord dorsal horn in rats. However, the relationship between the expression of spinal GR and CB1R after nerve injury remains unclear. Here, we examined the hypothesis that the upregulation of spinal CB1R induced by chronic constriction nerve injury (CCI) in rats would be regulated by spinal GR. CCI induced the upregulation of spinal CB1R primarily within the ipsilateral spinal cord dorsal horn as revealed by Western blot and immunohistochemistry. The expression of CB1R in CCI rats was substantially attenuated by intrathecal treatment with either the GR antagonist RU38486 or a GR antisense oligonucleotide given twice daily for postoperative day 1-6, whereas the expression of spinal CB1R was enhanced following intrathecal administration of a GR sense oligonucleotide twice daily for postoperative day 1-6. Furthermore, the upregulation of spinal CB1R after nerve injury was prevented in adrenalectomized rats, which was at least partially restored with the intrathecal administration of an exogenous GR agonist dexamethasone, indicating that corticosteroids (endogenous GR agonists) were critical to spinal GR actions. Since the development of neuropathic pain behaviors in CCI rats was attenuated by either RU38486 or a GR antisense oligonucleotide, these results suggest that CB1R is a downstream target for spinal GR actions contributory to the mechanisms of neuropathic pain. PMID:17258396

Wang, Shuxing; Lim, Grewo; Mao, Ji; Sung, Backil; Yang, Liling; Mao, Jianren

2007-09-01

264

Management of Spasticity After Spinal Cord Injury: Current Techniques and Future Directions  

PubMed Central

Spasticity, resulting in involuntary and sustained contractions of muscles, may evolve in patients with stroke, cerebral palsy, multiple sclerosis, brain injury, and spinal cord injury (SCI). The authors critically review the neural mechanisms that may contribute to spasticity after SCI and assess their likely degree of involvement and relative significance to its pathophysiology. Experimental data from patients and animal models of spasticity as well as computer simulations are evaluated. The current clinical methods used for the management of spasticity and the pharmacological actions of drugs are discussed in relation to their effects on spinal mechanisms. Critical assessment of experimental findings indicates that increased excitability of both motoneurons and interneurons plays a crucial role in pathophysiology of spasticity. New interventions, including forms of spinal electrical stimulation to suppress increased neuronal excitability, may reduce the severity of spasticity and its complications. PMID:19723923

Elbasiouny, Sherif M.; Moroz, Daniel; Bakr, Mohamed M.; Mushahwar, Vivian K.

2010-01-01

265

Temporal profile of endogenous anatomical repair and functional recovery following spinal cord injury in adult zebrafish.  

PubMed

Regenerated cerebrospinal axons are considered to be involved in the spontaneous recovery of swimming ability following a spinal cord injury in adult zebrafish. We employed behavioral analysis, neuronal tracing, and immunocytochemistry to determine the exact temporal relationship between swimming ability and regenerated cerebrospinal axon number in adult zebrafish with a complete spinal cord transection. Between two and eight weeks post-lesion, swimming gradually improved to 44% of sham-injured zebrafish. Neurons within the reticular formation, magnocellular octaval nucleus, and nucleus of the medial longitudinal fascicle grew their axon across and at least four millimeters beyond the lesion. The largest increases in swimming ability and number of regenerated cerebrospinal axons were observed between two and four weeks post-lesion. Regression analyses revealed a significant correlation between swimming ability and the number of regenerated axons. Our results indicate the involvement of cerebrospinal axons in swimming recovery after spinal cord injury in adult zebrafish. PMID:25157957

Vajn, Katarina; Suler, Denis; Plunkett, Jeffery A; Oudega, Martin

2014-01-01

266

Temporal Profile of Endogenous Anatomical Repair and Functional Recovery following Spinal Cord Injury in Adult Zebrafish  

PubMed Central

Regenerated cerebrospinal axons are considered to be involved in the spontaneous recovery of swimming ability following a spinal cord injury in adult zebrafish. We employed behavioral analysis, neuronal tracing, and immunocytochemistry to determine the exact temporal relationship between swimming ability and regenerated cerebrospinal axon number in adult zebrafish with a complete spinal cord transection. Between two and eight weeks post-lesion, swimming gradually improved to 44% of sham-injured zebrafish. Neurons within the reticular formation, magnocellular octaval nucleus, and nucleus of the medial longitudinal fascicle grew their axon across and at least four millimeters beyond the lesion. The largest increases in swimming ability and number of regenerated cerebrospinal axons were observed between two and four weeks post-lesion. Regression analyses revealed a significant correlation between swimming ability and the number of regenerated axons. Our results indicate the involvement of cerebrospinal axons in swimming recovery after spinal cord injury in adult zebrafish. PMID:25157957

Vajn, Katarina; Suler, Denis; Plunkett, Jeffery A.; Oudega, Martin

2014-01-01

267

[Nursing care in males with spinal cord injury and sexual dysfunction].  

PubMed

The impact of spinal cord injury and its sequels requires important efforts of adaptation. In several studies, people with spinal cord injury claim to have covered most of their needs at physical, emotional and social level, but they are not yet fully satisfied with their sexual life. Sexual function is usually impaired in men with spinal cord injuries, and is sometimes related to problems of erection, ejaculation and/or orgasm. This issue is not a priority in the first phase, but it appears over the subsequent periods when patients often ask for a solution to this problem. A case-study is presented of a 25 year old male with chronic complete spinal cord injury (ASIA A), L4-L5 level, who reported sexual dysfunction and attended an annual review in the National Hospital for Paraplegics. After performing a nursing assessment using the functional health patterns of Gordon, the team proposed a nursing care plan according to the taxonomy of NANDA (North American Nursing Association), NOC (Nursing Outcome Classification) and NIC (Nursing Intervention Classification). Nurses are the healthcare professionals who have more direct and continuous contact with these patients. Specific programs need to be designed to provide them with the sexual education, which should contain adequate emotional and sexual information. We believe that an appropriate and systematic assessment of patient's sexuality, as well as the application of the (NANDA, NOC, NIC) nurse methodology, may be very helpful in improving the outcomes of these specific interventions. PMID:23746665

Cobo-Cuenca, Ana Isabel; Martín-Espinosa, Noelia M; Píriz Campos, Rosa M

2013-01-01

268

Musculo-skeletal modelling of NMES-evoked knee extension in spinal cord injury  

Microsoft Academic Search

The objective of this study was to explore relationships among constants used in musculo-skeletal models predicting torque generated about the knee by the quadriceps muscles. A model was developed and matched to data collected from individuals with spinal cord injury performing quadriceps contractions evoked using neuromuscular electrical stimulation. After fitting tendon slack lengths to the quadriceps muscles, the model was

Peter J. Sinclair; Glen M. Davis; Richard M. Smith

2006-01-01

269

Feasibility of an upper extremity neuroprosthesis for high cervical spinal cord injury  

Microsoft Academic Search

A musculoskeletal model of the human shoulder and elbow was adapted to reflect the paralysis of an individual with a C4 level spinal cord injury. Simulations were then performed to determine the minimum number of muscles needed to restore a small set of simple but functionally important arm movements. We found that six was the minimum number of muscles and

R. F. Kirsch; A. M. Acosta

270

Prevention Practice Differences Among Persons With Spinal Cord Injuries Who Rarely Versus Frequently Sustain Pressure Ulcers  

ERIC Educational Resources Information Center

Pressure ulcers are common among people with spinal cord injury (SCI) and not only are costly to treat but also affect the quality of life of those affected by them. Despite a plethora of literature on prevention, there are few wellness studies focusing on the practices of people who do not develop pressure ulcers. This preliminary study sought to…

Jones, Michael L.; Marini, Irmo; Slate, John R.

2005-01-01

271

Sensation Seeking as a Psychological Trait of Drug Abuse among Persons with Spinal Cord Injury.  

ERIC Educational Resources Information Center

Conceptualization of the role of personality constructs in the drug usage behavior of individuals with disabilities has both preventive and treatment relevance. The purpose of this study is to investigate the relationship between sensation seeking and drug usage pattern of persons with spinal cord injury. Implications for rehabilitation research…

Alston, Reginald J.

1994-01-01

272

Couple Support Schemata in Couples with and without Spinal Cord Injury  

ERIC Educational Resources Information Center

This article describes the cognitive schemata of couples' support relationships among 65 couples in which the husband had a long-term spinal cord injury and 65 couples without disability. The structure of the support relations schemata were examined by means of smallest-space analysis. Similarities between men and women in couples with and without…

Gilad, Dvorit; Lavee, Yoav

2010-01-01

273

Cognitive Training Program for Youths/Young Adults Having a Spinal Cord Injury.  

ERIC Educational Resources Information Center

The pilot study determined the effectiveness of a cognitive skills training program on both the vocational retraining of five young adults with traumatic spinal cord injuries and learning difficulties and the adaptation process to an altered lifestyle required by permanent paralysis. After a 40-hour Instrumental Enrichment (IE) program, Ss showed…

Stirling, Gloria; And Others

274

Activation of the unfolded protein response enhances motor recovery after spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) is a major cause of paralysis, and involves multiple cellular and tissular responses including demyelination, inflammation, cell death and axonal degeneration. Recent evidence suggests that perturbation on the homeostasis of the endoplasmic reticulum (ER) is observed in different SCI models; however, the functional contribution of this pathway to this pathology is not known. Here we demonstrate

V Valenzuela; E Collyer; D Armentano; G B Parsons; F A Court; C Hetz

2012-01-01

275

Sport, Spinal Cord Injury, Embodied Masculinities, and the Dilemmas of Narrative Identity  

Microsoft Academic Search

This article focuses on the narrative identity dilemmas of four men who have experienced spinal cord injury (SCI) through playing rugby football union and now define themselves as disabled. The biographical data illustrate how body-self relationships moved from an absent presence in the lives of these men to something that was other, problematic, and alien. This transformation instigated anxieties concerning

ANDREW C. SPARKES; BRETT SMITH

2002-01-01

276

Basic Advances and New Avenues in Therapy of Spinal Cord Injury  

PubMed Central

The prospects for successful clinical trials of neuroprotective and neurorestorative interventions for patients with acute and chronic myelopathies depend on preclinical animal models of injury and repair that reflect the human condition. Remarkable progress continues in the attempt to promote connections between the brain and the sensory and motor neurons below a spinal cord lesion. Recent experiments demonstrate the potential for biological therapies to regenerate or remyelinate axons and to incorporate new neural cells into the milieu of a traumatic spinal cord injury. The computational flexibility and plasticity of the sensorimotor systems of the brain, spinal cord, and motor unit make functional use of new circuitry feasible in patients. To incorporate residual and new pathways, neural repair strategies must be coupled to rehabilitation therapies that drive activity-dependent plasticity for walking, for reaching and grasping, and for bowel and bladder control. Prevention of pain and dysautonomia are also clinical targets. Research aims to define the temporal windows of opportunity for interventions, test the safety and efficacy of delivery systems of agents and cells, and provide a better understanding of the cascades of gene expression and cell interactions both acutely and chronically after injury. These bench-to-bedside studies are defining the neurobiology of spinal cord injury rehabilitation. PMID:14746521

Dobkin, Bruce H.; Havton, Leif A.

2014-01-01

277

Raman spectroscopic investigation of spinal cord injury in a rat model  

NASA Astrophysics Data System (ADS)

Raman spectroscopy was used to study temporal molecular changes associated with spinal cord injury (SCI) in a rat model. Raman spectra of saline-perfused, injured, and healthy rat spinal cords were obtained and compared. Two injury models, a lateral hemisection and a moderate contusion were investigated. The net fluorescence and the Raman spectra showed clear differences between the injured and healthy spinal cords. Based on extensive histological and biochemical characterization of SCI available in the literature, these differences were hypothesized to be due to cell death, demyelination, and changes in the extracellular matrix composition, such as increased expression of proteoglycans and hyaluronic acid, at the site of injury where the glial scar forms. Further, analysis of difference spectra indicated the presence of carbonyl containing compounds, hypothesized to be products of lipid peroxidation and acid catalyzed hydrolysis of glycosaminoglycan moieties. These results compared well with in vitro experiments conducted on chondroitin sulfate sugars. Since the glial scar is thought to be a potent biochemical barrier to nerve regeneration, this observation suggests the possibility of using near infrared Raman spectroscopy to study injury progression and explore potential treatments ex vivo, and ultimately monitor potential remedial treatments within the spinal cord in vivo.

Saxena, Tarun; Deng, Bin; Stelzner, Dennis; Hasenwinkel, Julie; Chaiken, Joseph

2011-02-01

278

Drawing breath without the command of effectors: The control of respiration following spinal cord injury.  

PubMed

The maintenance of blood gas and pH homeostasis is essential to life. As such breathing, and the mechanisms which control ventilation, must be tightly regulated yet highly plastic and dynamic. However, injury to the spinal cord prevents the medullary areas which control respiration from connecting to respiratory effectors and feedback mechanisms below the level of the lesion. This trauma typically leads to severe and permanent functional deficits in the respiratory motor system. However, endogenous mechanisms of plasticity occur following spinal cord injury to facilitate respiration and help recover pulmonary ventilation. These mechanisms include the activation of spared or latent pathways, endogenous sprouting or synaptogenesis, and the possible formation of new respiratory control centres. Acting in combination, these processes provide a means to facilitate respiratory support following spinal cord trauma. However, they are by no means sufficient to return pulmonary function to pre-injury levels. A major challenge in the study of spinal cord injury is to understand and enhance the systems of endogenous plasticity which arise to facilitate respiration to mediate effective treatments for pulmonary dysfunction. PMID:25149585

Warren, Philippa M; Awad, Basem I; Alilain, Warren J

2014-11-01

279

The Effectiveness of a Sexuality Training Program for the Interdisciplinary Spinal Cord Injury Rehabilitation Team  

Microsoft Academic Search

While there is evidence to support consideration of client sexuality needs in the provision of rehabilitation services to people with spinal cord injury (SCI), the interdisciplinary team rarely receives training in this area. The current study aimed to examine the effectiveness of a consumer-driven sexuality training program in improving staff knowledge, comfort (general and personal) and attitudes. Using a local

Patricia Fronek; Susan Booth; Melissa Kendall; Deborah Miller; Timothy Geraghty

2005-01-01

280

Self-Awareness of the Male Sexual Response after Spinal Cord Injury  

ERIC Educational Resources Information Center

The aim of this study was to assess the impact of spinal cord injury on men's sexual motivation, through the sexual desire self-assessment, and the sexual arousal and orgasm physiological responses. This research consisted of a descriptive, nonprobabilistic and comparative study, designed to outline the target population characteristics to compare…

Cardoso, Fernando Luiz; Savall, Ana Carolina R.; Mendes, Aline K.

2009-01-01

281

Plasmid Releasing Multiple Channel Bridges for Transgene Expression After Spinal Cord Injury  

Microsoft Academic Search

The regeneration of tissues with complex architectures requires strategies that promote the appropriate cellular processes, and can direct their organization. Plasmid-loaded multiple channel bridges were engineered for spinal cord regeneration with the ability to support and direct cellular processes and promote gene transfer at the injury site. The bridges were manufactured with a gas foaming technique, and had multiple channels

Laura De Laporte; Yang Yang; Marina L Zelivyanskaya; Brian J Cummings; Aileen J Anderson; Lonnie D Shea

2009-01-01

282

Use of Sexually Explicit Films in Spinal Cord Injury Rehabilitation Programs  

Microsoft Academic Search

Sexual Attitude Reassessment (SAR) seminars, popular in the 1970s for use in progressive spinal cord injury (SCI) rehabilitation programs, have lost favor. The practice, however, of using only one sexually explicit film (SEF) as the primary method of providing sexuality education has taken its place. The use of SEFs is a sensitive teaching issue. Used “properly,” a SEF may facilitate

Mitchell S. Tepper

1997-01-01

283

Intrathecal Morphine Attenuates Recovery of Function after a Spinal Cord Injury  

E-print Network

produced significant analgesia when subjects were exposed to noxious stimuli (thermal and incremented shock an indispensable therapy for the spinally injured population. Despite widespread use of opiate analgesics, little% of subjects (Mills et al., 2001). Rats with a contusion injury exhibit thermal, mechan- ical, and girdle

Grau, James

284

ESTIMATING PERCENT BODY FAT IN DISABLED INDIVIDUALS WITH SPINAL CORD INJURY: A PILOT STUDY  

Microsoft Academic Search

Introduction: Accurate and simple to administer field methods of estimating relative body fat (%BF) do not currently exist for individuals with spinal cord injury. This group of people is more prone to obesity and cardiovascular disease (CVD), among other secondary conditions. Purpose: This pilot study investigated the accuracy of 3 methods of comparing lean body mass to fat mass in

BECKY GARNER

285

THE EFFECTS OF EXERCISE TRAINING ON CARDIOVASCULAR REGULATION IN INDIVIUALS WITH SPINAL CORD INJURY  

Microsoft Academic Search

Introduction. Individuals with spinal cord injury (SCI) are prone to severe cardiovascular dysfunction and an increased risk of mortality from various cardiovascular diseases. The underlying mechanisms responsible for the increased cardiovascular risk are not precisely understood, however, the reduced activity levels that accompany SCI certainly contribute. Unfortunately, muscular paralysis (partial or complete) limits the exercise options for individuals with SCI

DAVID DITOR

2003-01-01

286

Self-awareness of the male sexual response after spinal cord injury.  

PubMed

The aim of this study was to assess the impact of spinal cord injury on men's sexual motivation, through the sexual desire self-assessment, and the sexual arousal and orgasm physiological responses. This research consisted of a descriptive, nonprobabilistic and comparative study, designed to outline the target population characteristics to compare the studied variables. Forty spinal cord injured male patients and a control group composed of 50 able-bodied male individuals filled in a questionnaire that assessed sexual behaviour, functioning and satisfaction. Comparing the control group with the injured group in the postinjury period, there was no significant difference in the sexual desire; however, in relation to sexual arousal and the orgasm intensity, there was a significant difference. The same results were found when comparing the injured participants' preinjury and postinjury period reports. It was clear that the injury significantly reduced sexual arousal among quadriplegic participants and orgasm intensity among both quadriplegic and paraplegic men. The spinal cord injury had a significant impact on sexual arousal and orgasm physiological response, although the sexual desire perception was not significantly altered, indicating that spinal cord injury affects these men's sexual behaviour in terms of sexual performance and body sensitivity. PMID:19011580

Cardoso, Fernando Luiz; Savall, Ana Carolina R; Mendes, Aline K

2009-12-01

287

Reversal of Peripheral Nerve Injury-induced Hypersensitivity in the Postpartum Period: Role of Spinal Oxytocin  

PubMed Central

Background Physical injury, including surgery, can result in chronic pain; yet chronic pain following childbirth, including cesarean delivery in women, is rare. The mechanisms involved in this protection by pregnancy or delivery have not been explored. Methods We examined the effect of pregnancy and delivery on hypersensitivity to mechanical stimuli of the rat hindpaw induced by peripheral nerve injury (spinal nerve ligation) and after intrathecal oxytocin, atosiban and naloxone. Additionally, oxytocin concentration in lumbar spinal cerebrospinal fluid was determined. Results Spinal nerve ligation performed at mid-pregnancy resulted in similar hypersensitivity to nonpregnant controls, but hypersensitivity partially resolved beginning after delivery. Removal of pups after delivery prevented this partial resolution. Cerebrospinal fluid concentrations of oxytocin were greater in normal postpartum rats prior to weaning. To examine the effect of injury at the time of delivery rather than during pregnancy, spinal nerve ligation was performed within 24 h of delivery. This resulted in acute hypersensitivity that partially resolved over the next 2–3 weeks. Weaning of pups resulted only in a temporary return of hypersensitivity. Intrathecal oxytocin effectively reversed the hypersensitivity following separation of the pups. Postpartum resolution of hypersensitivity was transiently abolished by intrathecal injection of the oxytocin receptor antagonist, atosiban. Conclusions These results suggest that the postpartum period rather than pregnancy protects against chronic hypersensitivity from peripheral nerve injury and that this protection may reflect sustained oxytocin signaling in the central nervous system during this period. PMID:23249932

Gutierrez, Silvia; Liu, Baogang; Hayashida, Ken-ichiro; Houle, Timothy T.; Eisenach, James C.

2012-01-01

288

Prolonged nociceptive responses to hind paw formalin injection in rats with a spinal cord injury  

Microsoft Academic Search

Unilateral lesioning of the spinal dorsal horn with the excitotoxin quisqualic acid (QUIS) leads to robust degeneration of dorsal horn grey matter, and robust pain-related symptoms, such as cutaneous hypersensitivity, persist long after injury. A possible mechanism that underlies the pain-related symptoms is the disruption of dorsal horn inhibitory neuron function, leading to decreased inhibition of nociceptive neurons. Five percent

Jeung Woon Lee; Orion Furmanski; Daniel A. Castellanos; Linda A. Daniels; Aldric T. Hama; Jacqueline Sagen

2008-01-01

289

Possible way to reduce fracture rates in patients with traumatic spinal cord injury?  

PubMed

Lower extremity fractures in men with spinal cord injury (SCI) are a major problem. The use of thiazide diuretics, a simple and safe intervention, may be effective in reducing the risk of fracture in patients with traumatic SCI. Furthermore, thiazide diuretics have an added benefit of reducing kidney stone formation. PMID:24862306

Nassaralla, Claudia; Lyles, Kenneth W

2014-06-01

290

W. M. Keck Center for Collaborative Neuroscience THE SPINAL CORD INJURY PROJECT  

E-print Network

REGISTRATION FORM Spinal Cord Injury Research Methods Workshop. (Please indicate 1st and 2nd choice.) ___ March for travel and airport security.) Tuesday Night is Dinner at the Pub for all participants. Cost is included in registration. #12;Transportation from Newark Liberty International Airport (EWR) State Shuttle. Cost is $56

Chen, Kuang-Yu

291

Low-level laser therapy for spinal cord injury in rats: effects of polarization  

PubMed Central

Abstract. The effects of laser polarization on the efficacy of near-infrared low-level laser therapy for spinal cord injury (SCI) are presented. Rat spinal cords were injured with a weight-drop device, and the lesion sites were directly irradiated with a linearly polarized 808-nm diode laser positioned either perpendicular or parallel to the spine immediately after the injury and daily for five consecutive days. Functional recovery was assessed daily by an open-field test. Regardless of the polarization direction, functional scores of SCI rats that were treated with the 808-nm laser irradiation were significantly higher than those of SCI alone group (Group 1) from day 5 after injury. The locomotive function of SCI rats irradiated parallel to the spinal column (Group 3) was significantly improved from day 10 after injury, compared to SCI rats treated with the linear polarization perpendicular to the spinal column (Group 2). There were no significant differences in ATP contents in the injured tissue among the three groups. We speculate that the higher efficacy with parallel irradiation is attributable to the deeper light penetration into tissue with anisotropic scattering. PMID:24030687

Ando, Takahiro; Sato, Shunichi; Kobayashi, Hiroaki; Nawashiro, Hiroshi; Ashida, Hiroshi; Hamblin, Michael R.; Obara, Minoru

2013-01-01

292

Sprouting of axonal collaterals after spinal cord injury is prevented by delayed axonal degeneration.  

PubMed

After an incomplete spinal cord injury (SCI), partial recovery of locomotion is accomplished with time. Previous studies have established a functional link between extension of axon collaterals from spared spinal tracts and locomotor recovery after SCI, but the tissular signals triggering collateral sprouting have not been identified. Here, we investigated whether axonal degeneration after SCI contributes to the sprouting of collaterals from axons spared after injury. To this end, we evaluated collateral sprouting from BDA-labeled uninjured corticospinal axons after spinal cord hemisection (SCI(H)) in wild type (WT) mouse and Wld(S) mouse strains, which shows a significant delay in Wallerian degeneration after injury. After SCI(H), spared fibers of WT mice extend collateral sprouts to both intact and denervated sides of the spinal cord distant from the injury site. On the contrary, in the Wld(S) mice collateral sprouting from spared fibers was greatly reduced after SCI(H). Consistent with a role for collateral sprouting in functional recovery after SCI, locomotor recovery after SCI(H) was impaired in Wld(S) mice compared to WT animals. In conclusion, our results identify axonal degeneration as one of the triggers for collateral sprouting from the contralesional uninjured fibers after an SCI(H). These results open the path for identifying molecular signals associated with tissular changes after SCI that promotes collateral sprouting and functional recovery. PMID:25079366

Collyer, E; Catenaccio, A; Lemaitre, D; Diaz, P; Valenzuela, V; Bronfman, F; Court, F A

2014-11-01

293

Utilizing remaining voluntary muscle synergies to control FES elbow extension after spinal cord injury  

Microsoft Academic Search

Individuals with a C5\\/C6 spinal cord injury (SCI) have paralyzed elbow extensors, yet retain weak to strong voluntary control of elbow flexion and some shoulder movements. They lack elbow extension, which is critical during activities of daily living. This research focuses on development of a synergistic controller employing remaining voluntary elbow flexor and shoulder electromyography (EMG) to control elbow extension

J. P. Giuffrida; P. E. Crago

2004-01-01

294

Virtual reality rehabilitation system for neuropathic pain and motor dysfunction in spinal cord injury patients  

Microsoft Academic Search

Spinal cord injury (SCI) causes both lower limb motor dysfunction and associated neuropathic pain. Although these two conditions share related cortical mechanisms, different interventions are currently used to treat each condition. With intensive training using entertaining virtual reality (VR) scenarios, it may be possible to reshape cortical networks thereby reducing neuropathic pain and improving motor function. We have created the

Michael Villiger; Marie-Claude Hepp-Reymond; Pawel Pyk; Daniel Kiper; Kynan Eng; Jeremy Spillman; Bruno Meilick; Natalia Estevez; Spyros S. Kollias; Armin Curt; Sabina Hotz-Boendermaker

2011-01-01

295

The Prevention and Management of Urinary Tract Infection among People with Spinal Cord Injuries.  

ERIC Educational Resources Information Center

A 1992 Urinary Tract Infection Consensus Validation Conference brought together researchers, clinicians, and consumers to arrive at consensus on the best practices for preventing and treating urinary tract infections (UBI) in people with spinal cord injuries; the risk factors and diagnostic studies that should be done; indications for antibiotic…

NIDRR Consensus Statement, 1992

1992-01-01

296

Activity-dependent plasticity: implications for recovery after spinal cord injury  

Microsoft Academic Search

Spinal cord injury causes devastating loss of function and progressive, potentially life-threatening, secondary complications. Although significant preclinical advances continue to be made in cellular and molecular therapies which promote regeneration, plasticity within remain- ing circuits and how it can be influenced by physical activity is evolving as a key research area. Understand- ing what constitutes plasticity, and how activity shapes

Sarah A. Dunlop

2008-01-01

297

Psychological, Sexual, Social and Vocational Aspects of Spinal Cord Injury. A Selected Bibliography.  

ERIC Educational Resources Information Center

Presented is a bibliography with approximately 700 citations referring to research in the area of spinal cord injury. Entries are listed alphabetically by author under the following sections: psychological aspects (236 entries), sexual aspects (170 entries), social aspects (152 entries), and vocational aspects (134 entries). Information for each…

Scarlett, Sharon, Comp.; And Others

298

Activity-Based Restorative Therapies: Concepts and Applications in Spinal Cord Injury-Related Neurorehabilitation  

ERIC Educational Resources Information Center

Physical rehabilitation following spinal cord injury-related paralysis has traditionally focused on teaching compensatory techniques, thus enabling the individual to achieve day-to-day function despite significant neurological deficits. But the concept of an irreparable central nervous system (CNS) is slowly being replaced with evidence related to…

Sadowsky, Cristina L.; McDonald, John W.

2009-01-01

299

Modulation of inflammatory responses by a cannabinoid-2-selective agonist after spinal cord injury.  

PubMed

The goal of the current investigation was to evaluate the mechanisms through which administration of a selective cannabinoid-2 (CB2) agonist (O-1966) modifies inflammatory responses and helps to improve function following spinal cord injury. A comparison of motor function, autonomic function, and inflammatory responses was made between animals treated with O-1966 (5?mg/kg IP) and animals treated with vehicle 1?h and 24?h following contusion injury to the spinal cord. Motor function was significantly improved in the treated animals at each time point during the 14 days of evaluation. The percentage of animals able to spontaneously void their bladder was also greater over the entire study period in the group treated with the selective CB2 agonist. Seven days following injury there was a significant reduction in both hematopoietic and myeloid cell invasion of the spinal cord, and a reduction in the number of immunoreactive microglia. The results of the evaluation of chemokine/cytokine expression and inflammatory cell invasion also demonstrated a significant effect of treatment on inflammatory reactions following injury. Two days after injury, animals treated with O-1966 had significant reductions in CXCL-9 and CXCL-11, and dramatic reductions in IL-23p19 expression and its receptor IL-23r. Treatment with O-1966 also caused inhibition of toll-like receptor expression (TLR1, TLR4, TLR6 and TLR7) following injury. These results demonstrate that the improvement in motor and autonomic function resulting from treatment with a selective CB2 agonist is associated with a significant effect on inflammatory responses in the spinal cord following injury. PMID:21970496

Adhikary, Sabina; Li, Hongbo; Heller, Joshua; Skarica, Mario; Zhang, Ming; Ganea, Doina; Tuma, Ronald F

2011-12-01

300

The incomprehensible injury--interpretations of patients' narratives concerning experiences with an acute and dramatic spinal cord injury.  

PubMed

Spinal cord injury is one of the most devastating incidents that can occur to an individual as it results in life being suddenly, dramatically, radically and long lastingly changed. Different studies show that a spinal cord injury is a stressful event, leading to physiological dependence, psychological and social illness and suffering, although the situation tends to improve over time. This study is a part of a larger longitudinal study. The aim of this study was to explore and interpret 10 individuals' experiences in connection with their acute and unexpected spinal cord injury. This qualitative study has a descriptive and explorative design and is a part of a larger study. A phenomenological hermeneutic approach inspired by Ricoeur was used to extract the meaningful content of the patients' narratives. In this study, the findings revealed three main themes: (I) 'the incomprehensible shock', (II) 'brave survivors' and (III) 'miracles, luck or coincidences?' The incomprehensible spinal cord injury was often experienced as a dramatic and unexpected shock in the middle of a pleasant occasion, and every participant felt immediately overwhelmed by emotional suffering, such as despair and panic, but also anxiety, confusion, sorrow, guilt, shame, fear, aggression or depression at the moment of injury. Some individuals immediately understood that they had become completely paralysed and that something was seriously wrong with their body. Many also experienced guilt or shame because of choices or decisions made immediately before the injury. Several of the narratives were illuminating participants that had been brave survivors and heroes and saved others (passengers or friends) during the injury, by preventing the car form driving out or by softening the fall of co-passengers, which also entailed more serious injuries to themselves. However, the fact of having survived was experienced as 'being lucky, after all'. They all repeatedly reflected on the accident, and their individual understanding of it changed over time, from, on the whole, as a perspective of a 'miracle' to 'just luck' or a coincidence' which also reflected the meaning and significance of what the injury really meant to their body and to their lives. And these reflections gave rise to different ways; they later on learned to live with their new lives. These important aspects, narrated by the brave survivors, have not been reported in the research literature earlier. PMID:18803603

Lohne, Vibeke

2009-03-01

301

Spinal Cord Injury in the Pediatric Population: A Systematic Review of the Literature  

PubMed Central

Abstract Spinal Cord Injury (SCI) in the pediatric population is relatively rare but carries significant psychological and physiological consequences. An interdisciplinary group of experts composed of medical and surgical specialists treating patients with SCI formulated the following questions: 1) What is the epidemiology of pediatric spinal cord injury and fractures?; 2) Are there unique features of pediatric SCI which distinguish the pediatric SCI population from adult SCI?; 3) Is there evidence to support the use of neuroprotective approaches, including hypothermia and steroids, in the treatment of pediatric SCI? A systematic review of the literature using multiple databases was undertaken to evaluate these three specific questions. A search strategy composed of specific search terms (Spinal Cord Injury, Paraplegia, Quadriplegia, tetraplegia, lapbelt injuries, seatbelt injuries, cervical spine injuries and Pediatrics) returned over 220 abstracts that were evaluated and by two observers. Relevant abstracts were then evaluated and papers were graded using the Downs and Black method. A table of evidence was then presented to a panel of experts using a modified Delphi approach and the following recommendation was then formulated using a consensus approach: Pediatric patients with traumatic SCI have different mechanisms of injury and have a better neurological recovery potential when compared to adults. Patients with SCI before their adolescent growth spurt have a high likelihood of developing scoliosis. Because of these differences, traumatic SCI should be highly suspected in the presence of abnormal neck or neurological exam, a high-risk mechanism of injury or a distracting injury even in the absence of radiological anomaly. PMID:21501096

Mac-Thiong, Jean-Marc; Roy-Beaudry, Marjolaine; Sosa, Jose Felix; Labelle, Hubert

2011-01-01

302

Automated Analysis of Remyelination Therapy for Spinal Cord Injury  

E-print Network

. The therapeutically impor- tant oligodendrocyte-remyelinated axons (OR-axons) are identified and a density map, oligodendrocytes and Schwann cells [4]. One of the many therapies being developed to improve the remyelination in- clude transplantation of oligodendrocyte progenitor cells into the adult spinal cord of rats following

Meenakshisundaram, Gopi

303

Lipopolysaccharide preconditioning attenuates apoptotic processes and improves neuropathologic changes after spinal cord injury in rats.  

PubMed

We have shown earlier that administration of low-dose lipopolysaccharide (LPS) significantly contributed to recovery of motor function after traumatic spinal cord injury in the adult female rat. Using the same standardized animal model, we have now designed a set of experiments to test the hypothesis that LPS preconditioning attenuates stress-related apoptotic processes early after spinal cord trauma. The lower thoracic spinal cord injury in adult female Sprague-Dawley rats was caused by a 10 g weight rod drop from 25 mm on the dural surface of the exposed spinal cord at T10. The rats were randomly assigned to three groups: Sham injury, control (received normal saline alone), and LPS preconditioning (0.2 mg/kg, ip; 72 h prior to the injury). The animals were euthanized at 72 h postinjury. Neuropathologic changes were assessed using hematoxylin and eosin staining. SCI-induced apoptosis were observed by transmission electron microscopy. Caspase-3, cleaved caspase-3, Bax, and Bcl-2 were examined with immunohistochemistry or Western blotting. Compared with the control group, LPS preconditioning group showed significant improvement in the SCI-induced morphology changes. Furthermore, LPS preconditioning reduced the expressions of apoptotic markers caspase-3, cleaved caspase-3, and Bax, upregulated the expression of antiapoptotic marker Bcl-2 in the samples of spinal cord. Low-dose LPS attenuated the recruitment of inflammatory cells and the proliferation of glial cells in the site of injury. LPS preconditioning has neuroprotective effects against TSCI in rats due to its antiapoptosis properties as shown by the inhibition of caspase pathway and the upregulation of antiapoptotic protein. PMID:24205811

Li, Wei-Chao; Jiang, Rong; Jiang, Dian-Ming; Zhu, Feng-Chen; Su, Bao; Qiao, Bo; Qi, Xiao-Tong

2014-08-01

304

Extrinsic inhibitors in axon sprouting and functional recovery after spinal cord injury  

PubMed Central

Summary: The limited axonal growth after central nervous system (CNS) injury such as spinal cord injury presents a major challenge in promoting repair and recovery. The literature in axonal repair has focused mostly on frank regeneration of injured axons. Here, we argue that sprouting of uninjured axons, an innate repair mechanism of the CNS, might be more amenable to modulation in order to promote functional repair. Extrinsic inhibitors of axonal growth modulate axon sprouting after injury and may serve as the first group of therapeutic targets to promote functional repair.

Meves, Jessica M.; Zheng, Binhai

2014-01-01

305

Intraparenchymal microdialysis after acute spinal cord injury reveals differential metabolic responses to contusive versus compressive mechanisms of injury.  

PubMed

In animal models, spinal cord injury (SCI) is typically imparted by contusion alone (e.g., weight drop) or by compression alone (e.g., clip compression). In humans, however, the cord is typically injured by a combination of violent contusion followed by varying degrees of ongoing mechanical compression. Understanding how the combination of contusion and compression influences the early pathophysiology of SCI is important for the pre-clinical development of neuroprotective therapies that are applicable to the human condition. Disturbances in the metabolism of energy-related substrates such as lactate, pyruvate, and glucose are important aspects of secondary damage. In this study, we used a porcine model of traumatic SCI to determine the extent to which these metabolites were influenced by contusion followed by sustained compression, using the microdialysis technique. Following contusion injury, lactate and pyruvate levels near the epicenter both increased, while glucose remained quite stable. When the contusion injury was followed by sustained compression, we observed a transient rise in lactate, while pyruvate and glucose levels dropped rapidly, which may reflect decreased regional spinal cord blood flow. Furthermore, contusion with sustained compression produced a prolonged and dramatic increase in the lactate-pyruvate (L/P) ratio as a marker of tissue hypoxia, whereas after contusion injury alone, a transient and less significant elevation of the L/P ratio was observed. In this study, we demonstrate that disturbances in energy metabolism within the injured spinal cord vary greatly depending upon the biomechanical nature of the injury. Such differences are likely to be relevant to the applicability of novel therapies targeting specific aspects of the early secondary injury cascade after acute human SCI. PMID:23768189

Okon, Elena B; Streijger, Femke; Lee, Jae H T; Anderson, Lisa M; Russell, Amy K; Kwon, Brian K

2013-09-15

306

Independent evaluation of the anatomical and behavioral effects of Taxol in rat models of spinal cord injury.  

PubMed

The goal of the current manuscript was to replicate published data that show intrathecal infusions of Taxol® (paclitaxel), an anti-neoplastic microtubule stabilizing agent, reduce fibrogliotic scarring caused by a dorsal spinal hemisection (DHx) injury and increase functional recovery and growth of serotonergic axons after moderate spinal contusion injury. These experiments were completed as part of an NIH-NINDS contract entitled "Facilities of Research Excellence in Spinal Cord Injury (FORE-SCI) - Replication". Here, data are presented that confirm the anti-scarring effects of Taxol after DHx injury; however, Taxol did not confer neuroprotection or promote serotonergic axon growth nor did it improve functional recovery in a model of moderate spinal contusion injury. Thus, only partial replication was achieved. Possible explanations for disparate results in our studies and published data are discussed. PMID:24999028

Popovich, Phillip G; Tovar, C Amy; Lemeshow, Stanley; Yin, Qin; Jakeman, Lyn B

2014-11-01

307

Unexpected survival of neurons of origin of the pyramidal tract after spinal cord injury  

PubMed Central

There is continuing controversy about whether the cells of origin of the corticospinal tract (CST) undergo retrograde cell death following spinal cord injury (SCI). All previous attempts to assess this have utilized imaging and/or histological techniques to assess upper motoneurons in the cerebral cortex. Here we address the question in a novel way by assessing Wallerian degeneration and axon numbers in the medullary pyramid of Sprague-Dawley rats following both acute SCI, either at cervical level 5 (C5) or thoracic level 9 (T9), and chronic SCI at T9. Our findings demonstrate that only a fraction of a percent of the total axons in the medullary pyramid exhibit any sign of degeneration at any time post-SCI—no more so than in uninjured control rats. Moreover, design-based counts of myelinated axons revealed no decrease in axon number in the medullary pyramid after SCI, regardless of injury level, severity, or time post injury. Spinal cord injured rats had fewer myelinated axons in the medullary pyramid at 1-year post injury than aged matched controls suggesting that injury may affect ongoing myelination of axons during aging. We conclude that SCI does not cause death of the CST cell bodies in the cortex; therefore therapeutic strategies aimed at promoting axon regeneration of the CST in the spinal cord do not require a separate intervention to prevent retrograde degeneration of upper motoneurons in the cortex. PMID:20739574

Nielson, Jessica L.; Sears-Kraxberger, Ilse; Strong, Melissa K.; Wong, Jamie K.; Willenberg, Rafer; Steward, Oswald

2010-01-01

308

Impaired immune responses following spinal cord injury lead to reduced ability to control viral infection.  

PubMed

Spinal cord injuries disrupt central autonomic pathways that regulate immune function, and increasing evidence suggests that this may cause deficiencies in immune responses in people with spinal cord injuries. Here we analyze the consequences of spinal cord injury (SCI) on immune responses following experimental viral infection of mice. Female C57BL/6 mice received complete crush injuries at either thoracic level 3 (T3) or 9 (T9), and 1 week post-injury, injured mice and un-injured controls were infected with different dosages of mouse hepatitis virus (MHV, a positive-strand RNA virus). Following MHV infection, T3- and T9-injured mice exhibited increased mortality in comparison to un-injured and laminectomy controls. Infection at all dosages resulted in significantly higher viral titer in both T3- and T9-injured mice compared to un-injured controls. Investigation of anti-viral immune responses revealed impairment of cellular infiltration and effector functions in mice with SCI. Specifically, cell-mediated responses were diminished in T3-injured mice, as seen by reduction in virus-specific CD4(+) T lymphocyte proliferation and IFN-? production and decreased numbers of activated antigen presenting cells compared to infected un-injured mice. Collectively, these data indicate that the inability to control viral replication following SCI is not level dependent and that increased susceptibility to infection is due to suppression of both innate and adaptive immune responses. PMID:20832407

Held, Katherine S; Steward, Oswald; Blanc, Caroline; Lane, Thomas E

2010-11-01

309

Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application  

PubMed Central

This study focuses on the impact a spinal cord injury may have on achieving physical and emotional intimacy, and potential to maximize sexual ability and quality of life. Spinal cord injury is a traumatic, life-altering event that is usually associated with loss of motor and sensory function, as well as sexual impairment. At the time of injury, the individual is faced with devastating loss and an abundance of new information in a setting of extreme stress and challenge. In the acute rehabilitation setting, there is often a considerable void in providing education and resources regarding sexual concerns and needs. There is a positive relationship between sexual education and sexual activity. The impact of inadequate sexual counseling and education as a part of rehabilitation can be deleterious. PMID:22925747

Hess, Marika J.; Hough, Sigmund

2012-01-01

310

Depressed immunity and impaired proliferation of hematopoietic progenitor cells in patients with complete spinal cord injury.  

PubMed

The bone marrow is supplied with both sensory and autonomic neurons, but their roles in regulating hematopoietic and immunocompetent cells are unknown. Leukocyte growth and activity in patients with stable and complete spinal cord injuries were studied. The innervation of the bone marrow below the injury level lacked normal supraspinal activity, that is, a decentralized bone marrow. Lymphocyte functions were markedly decreased in injured patients. Long-term colony formation of all hematopoietic cell lineages, including dendritic cells, by decentralized bone marrow cells was substantially reduced. It was concluded that nonspecific and adaptive lymphocyte-mediated immunity and growth of early hematopoietic progenitor cells are impaired in patients with spinal cord injuries. Possibly, this reflects cellular defects caused by the malfunctioning neuronal regulation of immune and bone marrow function. PMID:10979951

Iversen, P O; Hjeltnes, N; Holm, B; Flatebo, T; Strom-Gundersen, I; Ronning, W; Stanghelle, J; Benestad, H B

2000-09-15

311

An overview of tissue engineering approaches for management of spinal cord injuries  

PubMed Central

Severe spinal cord injury (SCI) leads to devastating neurological deficits and disabilities, which necessitates spending a great deal of health budget for psychological and healthcare problems of these patients and their relatives. This justifies the cost of research into the new modalities for treatment of spinal cord injuries, even in developing countries. Apart from surgical management and nerve grafting, several other approaches have been adopted for management of this condition including pharmacologic and gene therapy, cell therapy, and use of different cell-free or cell-seeded bioscaffolds. In current paper, the recent developments for therapeutic delivery of stem and non-stem cells to the site of injury, and application of cell-free and cell-seeded natural and synthetic scaffolds have been reviewed. PMID:17501987

Samadikuchaksaraei, Ali

2007-01-01

312

Inhibition by spinal morphine of the tail-flick response is attenuated in rats with nerve ligation injury  

Microsoft Academic Search

Nerve ligation injury in rats produces increased sensitivity and exaggerated responses to nociceptive stimuli (hyperalgesia) as well as nociceptive responses to normally innocuous stimuli (allodynia) analogous to clinical conditions of neuropathic pain. However, the effect of nerve injury on acute nociception has not been extensively studied. Nerve ligation injury was produced by unilateral ligation of the L5 and L6 spinal

Michael H. Ossipov; Yvan Lopez; Michael L. Nichols; Di Bian; Frank Porreca

1995-01-01

313

The paradox of chronic neuroinflammation, systemic immune suppression, autoimmunity after traumatic chronic spinal cord injury.  

PubMed

During the transition from acute to chronic stages of recovery after spinal cord injury (SCI), there is an evolving state of immunologic dysfunction that exacerbates the problems associated with the more clinically obvious neurologic deficits. Since injury directly affects cells embedded within the "immune privileged/specialized" milieu of the spinal cord, maladaptive or inefficient responses are likely to occur. Collectively, these responses qualify as part of the continuum of "SCI disease" and are important therapeutic targets to improve neural repair and neurological outcome. Generic immune suppressive therapies have been largely unsuccessful, mostly because inflammation and immunity exert both beneficial (plasticity enhancing) and detrimental (e.g. glia- and neurodegenerative; secondary damage) effects and these functions change over time. Moreover, "compartimentalized" investigations, limited to only intraspinal inflammation and associated cellular or molecular changes in the spinal cord, neglect the reality that the structure and function of the CNS are influenced by systemic immune challenges and that the immune system is 'hardwired' into the nervous system. Here, we consider this interplay during the progression from acute to chronic SCI. Specifically, we survey impaired/non-resolving intraspinal inflammation and the paradox of systemic inflammatory responses in the context of ongoing chronic immune suppression and autoimmunity. The concepts of systemic inflammatory response syndrome (SIRS), compensatory anti-inflammatory response syndrome (CARS) and "neurogenic" spinal cord injury-induced immune depression syndrome (SCI-IDS) are discussed as determinants of impaired "host-defense" and trauma-induced autoimmunity. PMID:25017893

Schwab, Jan M; Zhang, Yi; Kopp, Marcel A; Brommer, Benedikt; Popovich, Phillip G

2014-08-01

314

Calpain 1 Knockdown Improves Tissue Sparing and Functional Outcomes after Spinal Cord Injury in Rats  

PubMed Central

Abstract To evaluate the hypothesis that calpain 1 knockdown would reduce pathological damage and functional deficits after spinal cord injury (SCI), we developed lentiviral vectors encoding calpain 1 shRNA and eGFP as a reporter (LV-CAPN1 shRNA). The ability of LV-CAPN1 shRNA to knockdown calpain 1 was confirmed in rat NRK cells using Northern and Western blot analysis. To investigate the effects on spinal cord injury, LV-CAPN1shRNA or LV-mismatch control shRNA (LV-control shRNA) were administered by convection enhanced diffusion at spinal cord level T10 in Long-Evans female rats (200–250?g) 1 week before contusion SCI, 180 kdyn force, or sham surgery at the same thoracic level. Intraspinal administration of the lentiviral particles resulted in transgene expression, visualized by eGFP, in spinal tissue at 2 weeks after infection. Calpain 1 protein levels were reduced by 54% at T10 2 weeks after shRNA-mediated knockdown (p<0.05, compared with the LV-control group, n=3 per group) while calpain 2 levels were unchanged. Intraspinal administration of LV-CAPN1shRNA 1 week before contusion SCI resulted in a significant improvement in locomotor function over 6 weeks postinjury, compared with LV-control administration (p<0.05, n=10 per group). Histological analysis of spinal cord sections indicated that pre-injury intraspinal administration of LV-CAPN1shRNA significantly reduced spinal lesion volume and improved total tissue sparing, white matter sparing, and gray matter sparing (p<0.05, n=10 per group). Together, results support the hypothesis that calpain 1 activation contributes to the tissue damage and impaired locomotor function after SCI, and that calpain1 represents a potential therapeutic target. PMID:23102374

Li, Yanzhang; Raza, Kashif; Yu, Xin Xin; Ghoshal, Sarbani; Geddes, James W.

2013-01-01

315

Evidence-Based Practice in Primary Prevention of Spinal Cord Injury  

PubMed Central

A spinal cord injury (SCI) not only causes paralysis, but also has long-term impact on physical and mental health. There are between 236,000 to 327,000 individuals living with the consequences of SCI in the United States, and the economic burden on the individuals sustaining the injury, their support network, and society as a whole is significant. The consequences of SCI require that health care professionals begin thinking about primary prevention. Efforts are often focused on care and cure, but evidence-based prevention should have a greater role. Primary prevention efforts can offer significant cost benefits, and efforts to change behavior and improve safety can and should be emphasized. Primary prevention can be applied to various etiologies of injury, including motor vehicle crashes, sports injuries, and firearm misuse, with a clear goal of eliminating unnecessary injury and its life-changing impact. PMID:23678282

2013-01-01

316

Activity-Based Therapies To Promote Forelimb Use after a Cervical Spinal Cord Injury  

PubMed Central

Abstract Significant interest exists in strategies for improving forelimb function following spinal cord injury. We investigated the effect of enriched housing combined with skilled training on the recovery of skilled and automatic forelimb function after a cervical spinal cord injury in adult rats. All animals were pretrained in skilled reaching, gridwalk crossing, and overground locomotion. Some received a cervical over-hemisection lesion at C4-5, interrupting the right side of the spinal cord and dorsal columns bilaterally, and were housed in standard housing alone or enriched environments with daily training. A subset of animals received rolipram to promote neuronal plasticity. Animals were tested weekly for 4 weeks to measure reaching, errors on the gridwalk, locomotion, and vertical exploration. Biotinylated dextran amine was injected into the cortex to label the corticospinal tract. Enriched environments/daily training significantly increased the number and success of left reaches compared to standard housing. Animals also made fewer errors on the gridwalk, a measure of coordinated forelimb function. However, there were no significant improvements in forelimb use during vertical exploration or locomotion. Likewise, rolipram did not improve any of the behaviors tested. Both enriched housing and rolipram increased plasticity of the corticospinal tract rostral to the lesion. These studies indicate that skilled training after a cervical spinal cord injury improves recovery of skilled forelimb use (reaching) and coordinated limb function (gridwalk) but does not improve automatic forelimb function (locomotion and vertical exploration). These studies suggest that rehabilitating forelimb function after spinal cord injury will require separate strategies for descending and segmental pathways. PMID:19317604

Dai, Haining; MacArthur, Linda; McAtee, Marietta; Hockenbury, Nicole; Tidwell, J. Lille; McHugh, Brian; Mansfield, Kevin; Finn, Tom; Hamers, Frank P.T.

2009-01-01

317

Respiratory motor outputs following unilateral midcervical spinal cord injury in the adult rat.  

PubMed

The present study was designed to investigate the impact of midcervical spinal cord injury on respiratory outputs and compare respiratory recovery following high- vs. midcervical spinal injury. A unilateral hemisection (Hx) in the spinal cord at C2 or C4 was performed in adult rats. Respiratory behaviors of unanesthetized animals were measured at normoxic baseline and hypercapnia by whole body plethysmography at 1 day and 1, 2, 4, and 8 wk after spinal injury. C2Hx and C4Hx induced a similar rapid shallow breathing pattern at 1 day postinjury. The respiratory frequency of C4Hx animals gradually returned to normal, but the tidal volume from 1 to 8 wk postinjury remained lower than that of the control animals. Linear regression analyses indicated that the tidal volume recovery was greater in the C4Hx animals than in the C2Hx animals at the baseline, but not at hypercapnia. The bilateral phrenic nerve activity was recorded in anesthetized animals under different respiratory drives at 8-9 wk postinjury. The phrenic burst amplitude ipsilateral to the lesion reduced following both high- and midcervical Hx; however, the ability to increase activity was lower in the C4Hx animals than in the C2Hx animals. When the data were normalized by the maximal inspiratory effort during asphyxia, the phrenic burst amplitude enhanced in the C4Hx animals, but reduced in the C2Hx animals compared with the control animals. These results suggest that respiratory deficits are evident following midcervical Hx, and that respiratory recovery and neuroplasticity of phrenic outputs are different following high- vs. midcervical spinal injury. PMID:24285148

Lee, Kun-Ze; Huang, Yi-Jia; Tsai, I-Lun

2014-02-15

318

Spasticity and the use of intrathecal baclofen in patients with spinal cord injury.  

PubMed

Muscle spasms and spasticity constitute a significant problem in patients with spinal cord injury, interfering with rehabilitation and leading to impairments in quality of life in addition to medical complications. Administration of intrathecal baclofen (ITB) is indicated when spasticity continues to produce a clinical disability despite trials of oral treatments and other alternatives in patients who have functional goals and/or pain without contractures. Severe spasticity of spinal origin has been shown to respond dramatically to long-term ITB when used in appropriate patients with spasticity. PMID:25064793

Khurana, Seema R; Garg, Deep S

2014-08-01

319

Spinal Autofluorescent Flavoprotein Imaging in a Rat Model of Nerve Injury-Induced Pain and the Effect of Spinal Cord Stimulation  

PubMed Central

Nerve injury may cause neuropathic pain, which involves hyperexcitability of spinal dorsal horn neurons. The mechanisms of action of spinal cord stimulation (SCS), an established treatment for intractable neuropathic pain, are only partially understood. We used Autofluorescent Flavoprotein Imaging (AFI) to study changes in spinal dorsal horn metabolic activity. In the Seltzer model of nerve-injury induced pain, hypersensitivity was confirmed using the von Frey and hotplate test. 14 Days after nerve-injury, rats were anesthetized, a bipolar electrode was placed around the affected sciatic nerve and the spinal cord was exposed by a laminectomy at T13. AFI recordings were obtained in neuropathic rats and a control group of naïve rats following 10 seconds of electrical stimulation of the sciatic nerve at C-fiber strength, or following non-noxious palpation. Neuropathic rats were then treated with 30 minutes of SCS or sham stimulation and AFI recordings were obtained for up to 60 minutes after cessation of SCS/sham. Although AFI responses to noxious electrical stimulation were similar in neuropathic and naïve rats, only neuropathic rats demonstrated an AFI-response to palpation. Secondly, an immediate, short-lasting, but strong reduction in AFI intensity and area of excitation occurred following SCS, but not following sham stimulation. Our data confirm that AFI can be used to directly visualize changes in spinal metabolic activity following nerve injury and they imply that SCS acts through rapid modulation of nociceptive processing at the spinal level. PMID:25279562

Jongen, Joost L. M.; Smits, Helwin; Pederzani, Tiziana; Bechakra, Malik; Hossaini, Mehdi; Koekkoek, Sebastiaan K.; Huygen, Frank J. P. M.; De Zeeuw, Chris I.; Holstege, Jan C.; Joosten, Elbert A. J.

2014-01-01

320

Plasticity of Corticospinal Neural Control after Locomotor Training in Human Spinal Cord Injury  

PubMed Central

Spinal lesions substantially impair ambulation, occur generally in young and otherwise healthy individuals, and result in devastating effects on quality of life. Restoration of locomotion after damage to the spinal cord is challenging because axons of the damaged neurons do not regenerate spontaneously. Body-weight-supported treadmill training (BWSTT) is a therapeutic approach in which a person with a spinal cord injury (SCI) steps on a motorized treadmill while some body weight is removed through an upper body harness. BWSTT improves temporal gait parameters, muscle activation patterns, and clinical outcome measures in persons with SCI. These changes are likely the result of reorganization that occurs simultaneously in supraspinal and spinal cord neural circuits. This paper will focus on the cortical control of human locomotion and motor output, spinal reflex circuits, and spinal interneuronal circuits and how corticospinal control is reorganized after locomotor training in people with SCI. Based on neurophysiological studies, it is apparent that corticospinal plasticity is involved in restoration of locomotion after training. However, the neural mechanisms underlying restoration of lost voluntary motor function are not well understood and translational neuroscience research is needed so patient-orientated rehabilitation protocols to be developed. PMID:22701805

Knikou, Maria

2012-01-01

321

Viability-Dependent Promoting Action of Adult Neural Precursors in Spinal Cord Injury  

PubMed Central

The aim of the study was the assessment of the effects of adult neural stem cell (NSC) transplantation in a mouse model of spinal cord injury (SCI). The contusion injury was performed by means of the Infinite Horizon Device to allow the generation of reproducible traumatic lesion to the cord. We administered green fluorescent-labeled (GFP-)NSCs either by intravenous (i.v.) injection or by direct transplantation into the spinal cord (intraspinal route).We report that NSCs significantly improved recovery of hind limb function and greatly attenuated secondary degeneration. The i.v. route of NSC administration yielded better recovery than the intraspinal route of administration. About 2% of total i.v.-administered NSCs homed to the spinal cord injury site, and survived almost undifferentiated; thus the positive effect of NSC treatment cannot be ascribed to damaged tissue substitution. The NSCs homing to the injury site triggered, within 48 h, a large increase of the expression of neurotrophic factors and chemokines. One wk after transplantation, exogenous GFP-NSCs still retained their proliferation potential and produced neurospheres when recovered from the lesion site and cultured in vitro. At a later time, GFP-NSC were phagocytated by macrophages. We suggest that the process of triggering the recovery of function might be strongly related to the viability of GFP-NSC, still capable ex vivo of producing neurospheres, and their ability to modify the lesion environment in a positive fashion. PMID:18654659

Bottai, Daniele; Madaschi, Laura; Di Giulio, Anna M; Gorio, Alfredo

2008-01-01

322

An in vitro spinal cord injury model to screen neuroregenerative materials.  

PubMed

Implantable 'structural bridges' based on nanofabricated polymer scaffolds have great promise to aid spinal cord regeneration. Their development (optimal formulations, surface functionalizations, safety, topographical influences and degradation profiles) is heavily reliant on live animal injury models. These have several disadvantages including invasive surgical procedures, ethical issues, high animal usage, technical complexity and expense. In vitro 3-D organotypic slice arrays could offer a solution to overcome these challenges, but their utility for nanomaterials testing is undetermined. We have developed an in vitro model of spinal cord injury that replicates stereotypical cellular responses to neurological injury in vivo, viz. reactive gliosis, microglial infiltration and limited nerve fibre outgrowth. We describe a facile method to safely incorporate aligned, poly-lactic acid nanofibre meshes (±poly-lysine + laminin coating) within injury sites using a lightweight construct. Patterns of nanotopography induced outgrowth/alignment of astrocytes and neurons in the in vitro model were strikingly similar to that induced by comparable materials in related studies in vivo. This highlights the value of our model in providing biologically-relevant readouts of the regeneration-promoting capacity of synthetic bridges within the complex environment of spinal cord lesions. Our approach can serve as a prototype to develop versatile bio-screening systems to identify materials/combinatorial strategies for regenerative medicine, whilst reducing live animal experimentation. PMID:24484676

Weightman, Alan P; Pickard, Mark R; Yang, Ying; Chari, Divya M

2014-04-01

323

The Prevalence, Etiologic Agents and Risk Factors for Urinary Tract Infection Among Spinal Cord Injury Patients  

PubMed Central

Background: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days. Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury. Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant. Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract ?nfection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract ?nfection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection. PMID:25147663

Togan, Turhan; Azap, Ozlem Kurt; Durukan, Elif; Arslan, Hande

2014-01-01

324

A Neonatal Mouse Spinal Cord Injury Model for Assessing Post-Injury Adaptive Plasticity and Human Stem Cell Integration  

PubMed Central

Despite limited regeneration capacity, partial injuries to the adult mammalian spinal cord can elicit variable degrees of functional recovery, mediated at least in part by reorganization of neuronal circuitry. Underlying mechanisms are believed to include synaptic plasticity and collateral sprouting of spared axons. Because plasticity is higher in young animals, we developed a spinal cord compression (SCC) injury model in the neonatal mouse to gain insight into the potential for reorganization during early life. The model provides a platform for high-throughput assessment of functional synaptic connectivity that is also suitable for testing the functional integration of human stem and progenitor cell-derived neurons being considered for clinical cell replacement strategies. SCC was generated at T9–T11 and functional recovery was assessed using an integrated approach including video kinematics, histology, tract tracing, electrophysiology, and high-throughput optical recording of descending inputs to identified spinal neurons. Dramatic degeneration of axons and synaptic contacts was evident within 24 hours of SCC, and loss of neurons in the injured segment was evident for at least a month thereafter. Initial hindlimb paralysis was paralleled by a loss of descending inputs to lumbar motoneurons. Within 4 days of SCC and progressively thereafter, hindlimb motility began to be restored and descending inputs reappeared, but with examples of atypical synaptic connections indicating a reorganization of circuitry. One to two weeks after SCC, hindlimb motility approached sham control levels, and weight-bearing locomotion was virtually indistinguishable in SCC and sham control mice. Genetically labeled human fetal neural progenitor cells injected into the injured spinal cord survived for at least a month, integrated into the host tissue and began to differentiate morphologically. This integrative neonatal mouse model provides opportunities to explore early adaptive plasticity mechanisms underlying functional recovery as well as the capacity for human stem cell-derived neurons to integrate functionally into spinal circuits. PMID:23990976

Zuchner, Mark; Strom, Susanne; Glover, Joel C.

2013-01-01

325

Enhanced regeneration in spinal cord injury by concomitant treatment with granulocyte colony-stimulating factor and neuronal stem cells  

Microsoft Academic Search

Granulocyte colony-stimulating factor (G-CSF) inhibits programmed cell death and stimulates neuronal progenitor differentiation. Neuronal stem cells transplanted into injured spinal cord can survive, differentiating into astroglia and oligodendroglia, and supporting axon growth and myelination. Herein, we evaluate the combined effects of G-CSF and neuronal stem cells on spinal cord injury. For 40 Sprague-Dawley rats (n=10 in each group) transverse spinal

Hung-Chuan Pan; Fu-Chou Cheng; Shu-Zhen Lai; Dar-Yu Yang; Yeou-Chih Wang; Maw-Sheng Lee

2008-01-01

326

Effect of the NMDA receptor antagonist MK-801 on recovery from spinal cord injury in rats given uncontrollable stimulation  

E-print Network

adopted me for the summer and continued to be happy to help throughout the year. Stephanie Washburn was a significant source of aid, teaching me to section spinal cords, patiently helping me with my research poster, and more. In addition, I must thank... plasticity. After spinal cord injury in either a cat or a human, behavioral training can reestablish stepping on a treadmill, and the spinal circuitry that underlies stepping can ?learn? or adapt to new environmental relations (Carrier et al., 1997; Edgerton...

Petrich, Christine

2006-08-16

327

Cotransplant of neural stem cells and NT3 gene modified Schwann cells promote the recovery of transected spinal cord injury  

Microsoft Academic Search

Study design:An animal model of transected spinal cord injury (SCI) was used to test the hypothesis that cografted neural stem cells (NSCs) and NT-3-SCs promote morphologic and functional recoveries of injured spinal cord.Objective:To explore whether cotransplant of NSCs and NT-3-SCs could promote the injured spinal cord repair.Setting:Zhongshan Medical College, Sun Yat-sen University, PR China.Methods:Female Sprague–Dawley (SD) rats weighing on 200–220

J-S Guo; Y-S Zeng; H-B Li; W-L Huang; R-Y Liu; X-B Li; Y Ding; L-Z Wu; D-Z Cai

2007-01-01

328

Function of microglia and macrophages in secondary damage after spinal cord injury  

PubMed Central

Spinal cord injury (SCI) is a devastating type of neurological trauma with limited therapeutic opportunities. The pathophysiology of SCI involves primary and secondary mechanisms of injury. Among all the secondary injury mechanisms, the inflammatory response is the major contributor and results in expansion of the lesion and further loss of neurologic function. Meanwhile, the inflammation directly and indirectly dominates the outcomes of SCI, including not only pain and motor dysfunction, but also preventingneuronal regeneration. Microglia and macrophages play very important roles in secondary injury. Microglia reside in spinal parenchyma and survey the microenvironment through the signals of injury or infection. Macrophages are derived from monocytes recruited to injured sites from the peripheral circulation. Activated resident microglia and monocyte-derived macrophages induce and magnify immune and inflammatory responses not only by means of their secretory moleculesand phagocytosis, but also through their influence on astrocytes, oligodendrocytes and demyelination. In this review, we focus on the roles of microglia and macrophages in secondary injury and how they contribute to the sequelae of SCI.

Zhou, Xiang; He, Xijing; Ren, Yi

2014-01-01

329

Spinal Cord Injury Enables Aromatic l-Amino Acid Decarboxylase Cells to Synthesize Monoamines.  

PubMed

Serotonin (5-HT), an important modulator of both sensory and motor functions in the mammalian spinal cord, originates mainly in the raphe nuclei of the brainstem. However, following complete transection of the spinal cord, small amounts of 5-HT remain detectable below the lesion. It has been suggested, but not proven, that this residual 5-HT is produced by intraspinal 5-HT neurons. Here, we show by immunohistochemical techniques that cells containing the enzyme aromatic l-amino acid decarboxylase (AADC) occur not only near the central canal, as reported by others, but also in the intermediate zone and dorsal horn of the spinal gray matter. We show that, following complete transection of the rat spinal cord at S2 level, AADC cells distal to the lesion acquire the ability to produce 5-HT from its immediate precursor, 5-hydroxytryptophan. Our results indicate that this phenotypic change in spinal AADC cells is initiated by the loss of descending 5-HT projections due to spinal cord injury (SCI). By in vivo and in vitro electrophysiology, we show that 5-HT produced by AADC cells increases the excitability of spinal motoneurons. The phenotypic change in AADC cells appears to result from a loss of inhibition by descending 5-HT neurons and to be mediated by 5-HT1B receptors expressed by AADC cells. These findings indicate that AADC cells are a potential source of 5-HT at spinal levels below an SCI. The production of 5-HT by AADC cells, together with an upregulation of 5-HT2 receptors, offers a partial explanation of hyperreflexia below a chronic SCI. PMID:25186745

Wienecke, Jacob; Ren, Li-Qun; Hultborn, Hans; Chen, Meng; Møller, Morten; Zhang, Yifan; Zhang, Mengliang

2014-09-01

330

Post-injury niches induce temporal shifts in progenitor fates to direct lesion repair after spinal cord injury  

PubMed Central

Progenitors that express NG2-proteoglycan are the predominant self-renewing cell within the CNS. NG2-progenitors replenish oligodendrocyte populations within the intact stem-cell niche, and cycling NG2-cells are among the first cells to react to CNS insults. We investigated the role of NG2-progenitors after spinal cord injury (SCI) and how bone morphogen protein (BMP) signals remodel the progressive post-injury niche. Progeny labeled by an NG2-specific reporter virus undergo a coordinated shift in differentiation profile. NG2-progeny born 24-hours post-injury (PI) produce scar-forming astrocytes and transient populations of novel phagocytic astrocytes shown to contain denatured myelin within cathepsin-D labeled endosomes, but NG2-progenitors born 7-days PI differentiate into oligodendrocytes and express myelin on processes that wrap axons. Analysis of spinal cord mRNA shows a temporal-shift in the niche-transcriptome of ligands that affect post-injury remodeling and direct progenitor differentiation. We conclude that NG2-progeny are diverse lineages that obey progressive-cues after trauma to replenish the injured niche. PMID:19458241

Sellers, Drew L.; Maris, Don O.; Horner, Philip J.

2009-01-01

331

Transplantation of neurotrophin-3-transfected bone marrow mesenchymal stem cells for the repair of spinal cord injury  

PubMed Central

Bone marrow mesenchymal stem cell transplantation has been shown to be therapeutic in the repair of spinal cord injury. However, the low survival rate of transplanted bone marrow mesenchymal stem cells in vivo remains a problem. Neurotrophin-3 promotes motor neuron survival and it is hypothesized that its transfection can enhance the therapeutic effect. We show that in vitro transfection of neurotrophin-3 gene increases the number of bone marrow mesenchymal stem cells in the region of spinal cord injury. These results indicate that neurotrophin-3 can promote the survival of bone marrow mesenchymal stem cells transplanted into the region of spinal cord injury and potentially enhance the therapeutic effect in the repair of spinal cord injury. PMID:25317169

Dong, Yuzhen; Yang, Libin; Yang, Lin; Zhao, Hongxing; Zhang, Chao; Wu, Dapeng

2014-01-01

332

Electrical Stimulation Therapy Increases Rate of Healing of Pressure Ulcers in Community-Dwelling People With Spinal Cord Injury  

Microsoft Academic Search

Houghton PE, Campbell KE, Fraser CH, Harris C, Keast DH, Potter PJ, Hayes KC, Woodbury MG. Electrical stimulation therapy increases rate of healing of pressure ulcers in community-dwelling people with spinal cord injury.

Pamela E. Houghton; Karen E. Campbell; Christine H. Fraser; Connie Harris; David H. Keast; Patrick J. Potter; Keith C. Hayes; M. Gail Woodbury

2010-01-01

333

Role of Secretory Phospholipase A2 in CNS Inflammation: Implications in Traumatic Spinal Cord Injury  

PubMed Central

Secretory phospholipases A2 (sPLA2s) are a subfamily of lipolytic enzymes which hydrolyze the acyl bond at the sn-2 position of glycerophospholipids to produce free fatty acids and lysophospholipids. These products are precursors of bioactive eicosanoids and platelet-activating factor (PAF). The hydrolysis of membrane phospholipids by PLA2 is a rate-limiting step for generation of eicosanoids and PAF. To date, more than 10 isozymes of sPLA2 have been found in the mammalian central nervous system (CNS). Under physiological conditions, sPLA2s are involved in diverse cellular responses, including host defense, phospholipid digestion and metabolism. However, under pathological situations, increased sPLA2 activity and excessive production of free fatty acids and their metabolites may lead to inflammation, loss of membrane integrity, oxidative stress, and subsequent tissue injury. Emerging evidence suggests that sPLA2 plays a role in the secondary injury process after traumatic or ischemic injuries in the brain and spinal cord. Importantly, sPLA2 may act as a convergence molecule that mediates multiple key mechanisms involved in the secondary injury since it can be induced by multiple toxic factors such as inflammatory cytokines, free radicals, and excitatory amino acids, and its activation and metabolites can exacerbate the secondary injury. Blocking sPLA2 action may represent a novel and efficient strategy to block multiple injury pathways associated with the CNS secondary injury. This review outlines the current knowledge of sPLA2 in the CNS with emphasis placed on the possible roles of sPLA2 in mediating CNS injuries, particularly the traumatic and ischemic injuries in the brain and spinal cord. PMID:18673210

Titsworth, W. Lee; Liu, Nai-Kui; Xu, Xiao-Ming

2009-01-01

334

Role of secretory phospholipase a(2) in CNS inflammation: implications in traumatic spinal cord injury.  

PubMed

Secretory phospholipases A(2) (sPLA(2)s) are a subfamily of lipolytic enzymes which hydrolyze the acyl bond at the sn-2 position of glycerophospholipids to produce free fatty acids and lysophospholipids. These products are precursors of bioactive eicosanoids and platelet-activating factor (PAF). The hydrolysis of membrane phospholipids by PLA(2) is a rate-limiting step for generation of eicosanoids and PAF. To date, more than 10 isozymes of sPLA(2) have been found in the mammalian central nervous system (CNS). Under physiological conditions, sPLA(2)s are involved in diverse cellular responses, including host defense, phospholipid digestion and metabolism. However, under pathological situations, increased sPLA(2) activity and excessive production of free fatty acids and their metabolites may lead to inflammation, loss of membrane integrity, oxidative stress, and subsequent tissue injury. Emerging evidence suggests that sPLA(2) plays a role in the secondary injury process after traumatic or ischemic injuries in the brain and spinal cord. Importantly, sPLA(2) may act as a convergence molecule that mediates multiple key mechanisms involved in the secondary injury since it can be induced by multiple toxic factors such as inflammatory cytokines, free radicals, and excitatory amino acids, and its activation and metabolites can exacerbate the secondary injury. Blocking sPLA(2) action may represent a novel and efficient strategy to block multiple injury pathways associated with the CNS secondary injury. This review outlines the current knowledge of sPLA(2) in the CNS with emphasis placed on the possible roles of sPLA(2) in mediating CNS injuries, particularly the traumatic and ischemic injuries in the brain and spinal cord. PMID:18673210

Titsworth, W Lee; Liu, Nai-Kui; Xu, Xiao-Ming

2008-06-01

335

Assessing the capacity of the sympathetic nervous system to respond to a cardiovascular challenge in human spinal cord injury  

Microsoft Academic Search

Study design:Measurement of haemodynamic responses and cutaneous blood flow during an inspiratory-capacity apnoea following spinal cord injury (SCI).Objective:To assess the capacity of the sympathetic nervous system to respond to a cardiovascular challenge following SCI.Setting:Prince of Wales Medical Research Institute, Australia.Subjects:Thirteen spinal cord injured subjects with injuries ranging from C5-T8 and eight able-bodied control subjects.Methods:Continuous blood pressure, an electrocardiogram, respiration and

R Brown; V G Macefield

2008-01-01

336

Oral creatine supplementation enhances upper extremity work capacity in persons with cervical-level spinal cord injury  

Microsoft Academic Search

Jacobs PL, Mahoney ET, Cohn KA, Sheradsky LF, Green BA. Oral creatine supplementation enhances upper extremity work capacity in persons with cervical-level spinal cord injury. Arch Phys Med Rehabil 2002;83:19-23. Objective: To examine the effects of short-term creatine monohydrate supplementation on the upper extremity work capacity of persons with cervical-level spinal cord injury (SCI). Design: Randomized, double-blind, placebo-controlled, crossover design

Patrick L. Jacobs; Edward T. Mahoney; Kelly A. Cohn; Laurey F. Sheradsky; Barth A. Green

2002-01-01

337

The effect of football helmet energy absorption mechanisms on the mitigation of cervical spinal injuries: a mathematical model  

E-print Network

of the requirements for the degree ol' MASTER OF SCIENCF August 1995 Major Subject: Bioengineering EFFECT OF FOOTBALL HELMET ENERGY ABSORPTION MECHANISMS ON THE MITIGATION OF CERVICAL SPINAL INJURIES: A MATHEMATICAL MODEL A Thesis by ADELINO YUNG Submitted... of Department) August 1995 Major Subject: Bioengineering ABSTRACT The Effect of Football Helmet Energy Absorption Mechanisms on the Mitigation of Cervical Spinal Injuries: AMathematical Model. (August 1995) Adelino Yung, B. S. , Michigan State University...

Yung, Adelino

2012-06-07

338

An exploratory study of pressure ulcers after spinal cord injury: Relationship to protective behaviors and risk factors  

Microsoft Academic Search

Krause JS, Vines CL, Farley TL, Sniezek J, Coker J. An exploratory study of pressure ulcers after spinal cord injury: relationship to protective behaviors and risk factors. Arch Phys Med Rehabil 2001;82:107-13. Objectives: To identify protective behaviors and risk factors associated with the development of pressure ulcers (PUs) after spinal cord injury (SCI). Design: A cross-sectional study to evaluate the

J. Stuart Krause; Cheryl L. Vines; Thomas L. Farley; Joseph Sniezek; Jennifer Coker

2001-01-01

339

Medical rehabilitation length of stay and outcomes for persons with traumatic spinal cord injury—1990–1997  

Microsoft Academic Search

Objectives: To describe changes in acute and rehabilitation length of stay (LOS) for persons with traumatic spinal cord injury (SCI), describe predictors of LOS, and explore year-1 anniversary medical and social outcomes.Design: Longitudinal, exploratory study of patients with SCI.Setting: Eighteen Model Spinal Cord Injury Centers across the United States.Sample: A total of 3,904 persons discharged from the Model Systems between

Elizabeth A. Eastwood; Kristofer J. Hagglund; Kristjan T. Ragnarsson; Wayne A. Gordon; Ralph J. Marino

1999-01-01

340

Therapeutic groups for patients with spinal cord injuries.  

PubMed

A preliminary study was conducted to determine the effectiveness of therapeutic patient groups in a rehabilitation setting. A spinal cord knowledge "Inventory" test was designed to evaluate the success of the group method in disseminating information to patients. The first part of this test assesses the patient's knowledge about body physiology and functioning, health care, and community resources. The second part attempts to evaluate the patient's feelings regarding his body image, sexual attractiveness, and family relationships. The test was administered to 31 spinal cord injured patients upon admission and again just prior to discharge. Eighteen patients participated in a therapeutic patient group, which met twice a week for a month. The other group did not participate in such sessions. The purpose of the meetings was to help the patient adjust to his disability by exchanging commonly needed information and discussing experiences and feelings. Initial results suggest that therapeutic groups can provide an effective means for imparting information to patients. The test also indicates that many patients experience changes in their attitudes and feelings around such sensitive areas as personal worth and self-esteem. PMID:1119921

Miller, D K; Wolfe, M; Spiegel, M H

1975-03-01

341

Radiographic assessment of hips in patients with spinal cord injury  

PubMed Central

Objective: The spinal cord-injured patients begin to present a new configuration of forces on the joints. The hip joint is one of the most affected, because these patients generally use a wheelchair as a means of locomotion. Osteoarticular changes, such as heterotopic ossification, can be found in these patients, as evidenced by radiographic studies. This study aims to identify radiographic changes in hips of spinal cord-injured patients. Methods 15 patients (30 hips) were evaluated and followed up at the Laboratory of Biomechanical Rehabilitation of the Musculoskeletal System of HC-Unicamp, through the analysis of radiographs of the pelvis in anterior-posterior and Lowenstein lateral positions. Results Of the total hips, only seven (23%) had no evidence of articular damage. The prevalence of heterotopic ossification found (16.6%) was similar to the literature. Conclusion The radiographic assessment of these patient's hips is justified by the prevalence of joint changes found. Level of Evidence II, Development of diagnostic criteria in consecutive patients (with universally applied reference "gold" standard). PMID:24453577

Grynwald, Jean; Bastos, Juliana de Melo Lafaiete; Costa, Vinicius Basanez Aleluia; Rimkus, Carolina de Medeiros; Junior, Alberto Cliquet

2012-01-01

342

Spinal Expression of Hippo Signaling Components YAP and TAZ Following Peripheral Nerve Injury in Rats  

PubMed Central

Previous studies have shown that the morphology and number of cells in the spinal cord dorsal horn could change following peripheral nerve injury and that the Hippo signaling pathway plays an important role in cell growth, proliferation, apoptosis, and dendritic remolding. In the present study, we examined whether the expression of YAP and TAZ, two critical components regulated by Hippo signaling, in the spinal cord dorsal horn would be altered by chronic constriction sciatic nerve injury (CCI). We found that 1) YAP was mainly expressed on CGRP- and IB4-immunoreactive primary afferent nerve terminals without noticeable expression on glial cells, whereas TAZ was mainly expressed on spinal cord second order neurons as well as microglia; 2) upregulation of YAP and TAZ expression followed two distinct temporal patterns after CCI, such that the highest expression of YAP and TAZ was on day 14 and day 1 after CCI, respectively; 3) there were also unique topographic patterns of YAP and TAZ distribution in the spinal cord dorsal horn consistent with their distinctive association with primary afferents and second order neurons; 4) changes in the YAP expression were selectively induced by CCI but not CFA-induced hindpaw inflammation; and 5) the number of nuclear profiles of TAZ expression was significantly increased after CCI, indicating translocation of TAZ from the cytoplasma to nucleus. These findings indicate that peripheral nerve injury induced time-dependent and region-specific changes in the spinal YAP and TAZ expression. A role for Hippo signaling in synaptic and structural plasticity is discussed in relation to the cellular mechanism of neuropathic pain. PMID:23998984

Li, Na; Lim, Grewo; Chen, Lucy; McCabe, Michael F.; Kim, Hyangin; Zhang, Shuzhuo; Mao, Jianren

2013-01-01

343

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning  

Microsoft Academic Search

Study Design:Cross-sectional study with repeated measurements.Objectives:To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL).Setting:Australia.Methods:A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients’ subjective evaluation of pre- and post-injury

R F Murray; A Asghari; D D Egorov; S B Rutkowski; P J Siddall; R J Soden; R Ruff

2007-01-01

344

Guanosine reduces apoptosis and inflammation associated with restoration of function in rats with acute spinal cord injury  

Microsoft Academic Search

Spinal cord injury results in progressive waves of secondary injuries, cascades of noxious pathological mechanisms that substantially\\u000a exacerbate the primary injury and the resultant permanent functional deficits. Secondary injuries are associated with inflammation,\\u000a excessive cytokine release, and cell apoptosis. The purine nucleoside guanosine has significant trophic effects and is neuroprotective,\\u000a antiapoptotic in vitro, and stimulates nerve regeneration. Therefore, we determined

Shucui Jiang; Farid Bendjelloul; Patrizia Ballerini; Iolanda D’Alimonte; Elenora Nargi; Cai Jiang; Xinjie Huang; Michel P. Rathbone

2007-01-01

345

In vivo tracking of neuronal-like cells by magnetic resonance in rabbit models of spinal cord injury.  

PubMed

In vitro experiments have demonstrated that neuronal-like cells derived from bone marrow mesenchymal stem cells can survive, migrate, integrate and help to restore the function and behaviors of spinal cord injury models, and that they may serve as a suitable approach to treating spinal cord injury. However, it is very difficult to track transplanted cells in vivo. In this study, we injected superparamagnetic iron oxide-labeled neuronal-like cells into the subarachnoid space in a rabbit model of spinal cord injury. At 7 days after cell transplantation, a small number of dot-shaped low signal intensity shadows were observed in the spinal cord injury region, and at 14 days, the number of these shadows increased on T2-weighted imaging. Perl's Prussian blue staining detected dot-shaped low signal intensity shadows in the spinal cord injury region, indicative of superparamagnetic iron oxide nanoparticle-labeled cells. These findings suggest that transplanted neuronal-like cells derived from bone marrow mesenchymal stem cells can migrate to the spinal cord injury region and can be tracked by magnetic resonance in vivo. Magnetic resonance imaging represents an efficient noninvasive technique for visually tracking transplanted cells in vivo. PMID:25206659

Zhang, Ruiping; Zhang, Kun; Li, Jianding; Liu, Qiang; Xie, Jun

2013-12-25

346

[Long-term follow-up in patients with spinal cord injury - prevention and comprehensive care].  

PubMed

Patients with spinal cord injuries suffer not only from sensory and motor deficits, but from failure of the autonomic nerve system which in consequence involves many organs and metabolic pathways. These deficits lead to a different approach to these patients and their medical, psychological and social problems. Three examples will illustrate the different approaches to typical medical problems of these patients. Regularly ambulatory long term follow up visits in specialized centres in close collaboration with general practitioners help to diminish complications and rehospitalisations. Facing the now ageing population with a spinal cord injury we need evidence based guidelines in follow up and preventive strategies for these patients. We updated these recommendations recently. The brochure is available on the webside oft he swiss society of paraplegia www.ssop.ch. PMID:24425548

Spreyermann, Regula; Michel, Franz

2014-01-15

347

Donald Munro Lecture. Spinal cord injury--past, present, and future.  

PubMed

This special report traces the path of spinal cord injury (SCI) from ancient times through the present and provides an optimistic overview of promising clinical trials and avenues of basic research. The spinal cord injuries of Lord Admiral Sir Horatio Nelson, President James A. Garfield, and General George Patton provide an interesting perspective on the evolution of the standard of care for SCI. The author details the contributions of a wide spectrum of professionals in the United States, Europe, and Australia, as well as the roles of various government and professional organizations, legislation, and overall advances in surgery, anesthesia, trauma care, imaging, pharmacology, and infection control, in the advancement of care for the individual with SCI. PMID:17591221

Donovan, William H

2007-01-01

348

Spinal cord injury in Parkour sport (free running): a rare case report.  

PubMed

A 24-year-old male was transferred to the emergency department while being in the state of quadriplegia with a history of performing Parkour sport, which is also called double front flip. Neurological examination revealed that the patient's muscle power was 0/5 at all extremities. The patient did not show any sense of light touch or pain in his extremities. In radiological studies, cervical spine X-ray and CT scan images showed C4-C5 subluxation with bilateral locked facets and spinal cord injury. The results of this very rare case study revealed that exercising Parkour sport without taking into account safety standards could result in irreversible injuries to the cervical spinal cord with fatal outcome. PMID:24889984

Derakhshan, Nima; Zarei, Mohammad Reza; Malekmohammady, Zahed; Rahimi-Movaghar, Vafa

2014-06-01

349

Comprehensive renal scintillation procedures in spinal cord injury: comparison with excretory urography  

SciTech Connect

A /sup 131/iodine orthoiodohippurate comprehensive renal scintillation procedure was performed and compared to results of excretory urography in 200 spinal cord injury patients. No severe urographic abnormalities were undetected by the comprehensive renal scintillation procedure. Only 1.4 per cent of renal units had greater than minimal pyelocaliectasis or ureterectasis in the presence of a normal radionuclide examination. A relatively large number of abnormalities were detected on the renal scintillation procedure when the excretory urogram was normal. Serial followup will be required to determine the significance of these findings but present data suggest that a comprehensive renal scintillation procedure and a plain film of the kidneys, ureters and bladder may be used for screening upper urinary tract abnormalities in lieu of an excretory urogram. This is particularly advantageous for the spinal cord injury population, since there have been no toxic or allergic reactions reported, no bowel preparation or dehydration is required and there is relatively low radiation exposure.

Lloyd, L.K.; Dubovsky, E.V.; Bueschen, A.J.; Witten, D.M.; Scott, J.W.; Kuhlemeier, K.; Stover, S.L.

1981-07-01

350

Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends  

PubMed Central

Pressure ulcers in spinal cord injury represent a challenging problem for patients, their caregivers, and their physicians. They often lead to recurrent hospitalizations, multiple surgeries, and potentially devastating complications. They present a significant cost to the healthcare system, they require a multidisciplinary team approach to manage well, and outcomes directly depend on patients' education, prevention, and compliance with conservative and surgical protocols. With so many factors involved in the successful treatment of pressure ulcers, an update on their comprehensive management in spinal cord injury is warranted. Current concepts of local wound care, surgical options, as well as future trends from the latest wound healing research are reviewed to aid medical professionals in treating patients with this difficult problem. PMID:24090179

Kruger, Erwin A.; Pires, Marilyn; Ngann, Yvette; Sterling, Michelle; Rubayi, Salah

2013-01-01

351

Cytokine pathways regulating glial and leukocyte function after spinal cord and peripheral nerve injury.  

PubMed

Injury to the nervous system causes the almost immediate release of cytokines by glial cells and neurons. These cytokines orchestrate a complex array of responses leading to microgliosis, immune cell recruitment, astrogliosis, scarring, and the clearance of cellular debris, all steps that affect neuronal survival and repair. This review will focus on cytokines released after spinal cord and peripheral nerve injury and the primary signalling pathways triggered by these inflammatory mediators. Notably, the following cytokine families will be covered: IL-1, TNF, IL-6-like, TGF-?, and IL-10. Whether interfering with cytokine signalling could lead to novel therapies will also be discussed. Finally, the review will address whether manipulating the above-mentioned cytokine families and signalling pathways could exert distinct effects in the injured spinal cord versus peripheral nerve. PMID:25017888

Bastien, Dominic; Lacroix, Steve

2014-08-01

352

Axonal regeneration after spinal cord injury in zebrafish and mammals: differences, similarities, translation.  

PubMed

Spinal cord injury (SCI) in mammals results in functional deficits that are mostly permanent due in part to the inability of severed axons to regenerate. Several types of growth-inhibitory molecules expressed at the injury site contribute to this regeneration failure. The responses of axons to these inhibitors vary greatly within and between organisms, reflecting axons' characteristic intrinsic propensity for regeneration. In the zebrafish (Danio rerio) many but not all axons exhibit successful regeneration after SCI. This review presents and compares the intrinsic and extrinsic determinants of axonal regeneration in the injured spinal cord in mammals and zebrafish. A better understanding of the molecules and molecular pathways underlying the remarkable individualism among neurons in mature zebrafish may support the development of therapies for SCI and their translation to the clinic. PMID:23893428

Vajn, Katarina; Plunkett, Jeffery A; Tapanes-Castillo, Alexis; Oudega, Martin

2013-08-01

353

Thinking through every step: how people with spinal cord injuries relearn to walk.  

PubMed

In this article we explore how people with incomplete spinal cord injury (iSCI) create meaning out of their changing bodies as they undergo a therapeutic intervention called locomotor training (LT). Therapeutic interventions like LT are used to promote the recovery of walking ability among individuals with iSCI. The chronological nature of this study--interviews at three points throughout the 12-week intervention--enhances understanding of the recovering self after spinal cord injury. Drawing on a constructivist theoretical framework, we organize data according to three narrative frames. Participants interpreted LT as (a) a physical change that was meaningful because of its social significance, (b) a coping strategy for dealing with the uncertainty of long-term recovery, and (c) a moral strategy to reconstitute the self. We offer findings that lay the conceptual groundwork for generating new knowledge about what is important to people with iSCI as they relearn how to walk. PMID:23774628

Jordan, Meggan M; Berkowitz, Dana; Hannold, Elizabeth; Velozo, Craig A; Behrman, Andrea L

2013-08-01

354

Physical activity, quality of life, and functional autonomy of adults with spinal cord injuries.  

PubMed

This study aimed to perform a systematic review of studies that address the influence of physical activity on the quality of life and functional independence of adult individuals with spinal cord injury. The review was performed using data obtained from the MEDLINE, CINAHL, SciELO, LILACS, SPORTDiscus, Web of Science, Academic Search Premier, and PEDro databases using the following keywords: quality of life; functional independence; autonomy; independence; physical activity; activities of daily living; physical exercise; tetraplegia; paraplegia; spinal cord injury; physical disabilities; and wheelchair. Eleven studies met the inclusion criteria. Although there was a lack of consensus among the selected studies, the majority of them presented a strong correlation between physical activity and variables of quality of life and/or functional independence. Thus, physical activity appears to have an important influence on social relationships, functional independence, psychological factors, and physical aspects, which can enhance quality of life and independence in the performance of daily activities. PMID:24197622

Kawanishi, Camilla Yuri; Greguol, Márcia

2013-10-01

355

Reorganization of the Intact Somatosensory Cortex Immediately after Spinal Cord Injury  

PubMed Central

Sensory deafferentation produces extensive reorganization of the corresponding deafferented cortex. Little is known, however, about the role of the adjacent intact cortex in this reorganization. Here we show that a complete thoracic transection of the spinal cord immediately increases the responses of the intact forepaw cortex to forepaw stimuli (above the level of the lesion) in anesthetized rats. These increased forepaw responses were independent of the global changes in cortical state induced by the spinal cord transection described in our previous work (Aguilar et al., J Neurosci 2010), as the responses increased both when the cortex was in a silent state (down-state) or in an active state (up-state). The increased responses in the intact forepaw cortex correlated with increased responses in the deafferented hindpaw cortex, suggesting that they could represent different points of view of the same immediate state-independent functional reorganization of the primary somatosensory cortex after spinal cord injury. Collectively, the results of the present study and of our previous study suggest that both state-dependent and state-independent mechanisms can jointly contribute to cortical reorganization immediately after spinal cord injury. PMID:23922771

Humanes-Valera, Desire; Aguilar, Juan; Foffani, Guglielmo

2013-01-01

356

Oral mucosa stem cells alleviates spinal cord injury-induced neurogenic bladder symptoms in rats  

PubMed Central

Background Spinal cord injury (SCI) deteriorates various physical functions, in particular, bladder problems occur as a result of damage to the spinal cord. Stem cell therapy for SCI has been focused as the new strategy to treat the injuries and to restore the lost functions. The oral mucosa cells are considered as the stem cells-like progenitor cells. In the present study, we investigated the effects of oral mucosa stem cells on the SCI-induced neurogenic bladder in relation with apoptotic neuronal cell death and cell proliferation. Results The contraction pressure and the contraction time in the urinary bladder were increased after induction of SCI, in contrast, transplantation of the oral mucosa stem cells decreased the contraction pressure and the contraction time in the SCI-induced rats. Induction of SCI initiated apoptosis in the spinal cord tissues, whereas treatment with the oral mucosa stem cells suppressed the SCI-induced apoptosis. Disrupted spinal cord by SCI was improved by transplantation of the oral mucosa stem cells, and new tissues were increased around the damaged tissues. In addition, transplantation of the oral mucosa stem cells suppressed SCI-induced neuronal activation in the voiding centers. Conclusions Transplantation of oral mucosa stem cells ameliorates the SCI-induced neurogenic bladder symptoms by inhibiting apoptosis and by enhancing cell proliferation. As the results, SCI-induced neuronal activation in the neuronal voiding centers was suppressed, showing the normalization of voiding function. PMID:24884998

2014-01-01

357

An occupational therapist as a sexual health clinician in the management of spinal cord injuries.  

PubMed

The Sexual Health Clinician is a health care specialist who is able to assess the sexual potential of physically disabled persons and assist them in the development of acceptable alternatives in sexual practices. This specialty role was first developed at the Spinal Cord Injury Unit, Shaughnessy Hospital in Vancouver, B.C., Canada, to answer a need of spinal cord injured patients, their partners and family. The opportunity to join the Service arose in May, 1981 following one year as the Senior Occupational Therapist on the Spinal Cord Injury Unit. This paper, which describes the experience of an occupational therapist as a member of the Sexual Health Service, is presented in five brief parts: 1. a background history; 2. a description of the sexual problems of the spinal cord injured and the goals of rehabilitation in this area; 3. the role of the Sexual Health Clinician; 4. the strengths and limitations of Occupational Therapy in this new role; 5. a brief discussion of the the need for a sex-related role and curriculum for students of Occupational Therapy. PMID:10268922

Miller, W T

1984-10-01

358

Transplantation of oligodendrocyte precursor cells improves locomotion deficits in rats with spinal cord irradiation injury.  

PubMed

Demyelination contributes to the functional impairment of irradiation injured spinal cord. One potential therapeutic strategy involves replacing the myelin-forming cells. Here, we asked whether transplantation of Olig2(+)-GFP(+)-oligodendrocyte precursor cells (OPCs), which are derived from Olig2-GFP-mouse embryonic stem cells (mESCs), could enhance remyelination and functional recovery after spinal cord irradiation injury. We differentiated Olig2-GFP-mESCs into purified Olig2(+)-GFP(+)-OPCs and transplanted them into the rats' cervical 4-5 dorsal spinal cord level at 4 months after irradiation injury. Eight weeks after transplantation, the Olig2(+)-GFP(+)-OPCs survived and integrated into the injured spinal cord. Immunofluorescence analysis showed that the grafted Olig2(+)-GFP(+)-OPCs primarily differentiated into adenomatous polyposis coli (APC(+)) oligodendrocytes (54.6±10.5%). The staining with luxol fast blue, hematoxylin & eosin (LFB/H&E) and electron microscopy demonstrated that the engrafted Olig2(+)-GFP(+)-OPCs attenuated the demyelination resulted from the irradiation. More importantly, the recovery of forelimb locomotor function was enhanced in animals receiving grafts of Olig2(+)-GFP(+)-OPCs. We concluded that OPC transplantation is a feasible therapy to repair the irradiated lesions in the central nervous system (CNS). PMID:23460872

Sun, Yan; Xu, Chong-Chong; Li, Jin; Guan, Xi-Yin; Gao, Lu; Ma, Li-Xiang; Li, Rui-Xi; Peng, Yu-Wen; Zhu, Guo-Pei

2013-01-01

359

Local and remote growth factor effects after primate spinal cord injury.  

PubMed

Primate models of spinal cord injury differ from rodent models in several respects, including the relative size and functional neuroanatomy of spinal projections. Fundamental differences in scale raise the possibility that retrograde injury signals, and treatments applied at the level of the spinal cord that exhibit efficacy in rodents, may fail to influence neurons at the far greater distances of primate systems. Thus, we examined both local and remote neuronal responses to neurotrophic factor-secreting cell grafts placed within sites of right C7 hemisection lesions in the rhesus macaque. Six months after gene delivery of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) into C7 lesion sites, we found both local effects of growth factors on axonal growth, and remote effects of growth factors reflected in significant reductions in axotomy-induced atrophy of large pyramidal neurons within the primary motor cortex. Additional examination in a rodent model suggested that BDNF, rather than NT-3, mediated remote protection of corticospinal neurons in the brain. Thus, injured neural systems retain the ability to respond to growth signals over the extended distances of the primate CNS, promoting local axonal growth and preventing lesion-induced neuronal degeneration at a distance. Remote cortical effects of spinally administered growth factors could "prime" the neuron to respond to experimental therapies that promote axonal plasticity or regeneration. PMID:20660255

Brock, John H; Rosenzweig, Ephron S; Blesch, Armin; Moseanko, Rod; Havton, Leif A; Edgerton, V Reggie; Tuszynski, Mark H

2010-07-21

360

Emerging approaches to the surgical management of acute traumatic spinal cord injury.  

PubMed

Traumatic, spinal cord injury (SCI) is a potentially catastrophic event causing major impact at both a personal and societal level. To date, virtually all therapies that have shown promise at the preclinical stage of study have failed to translate into clinically effective treatments. Surgery is performed in the setting of SCI, with the goals of decompressing the spinal cord and restoring spinal stability. Although a consensus regarding the optimal timing of surgical decompression for SCI has not been reached, much of the preclinical and clinical evidence, as well as a recent international survey of spine surgeons, support performing early surgery (<24 hours). Results of the multicenter, Surgical Trial in Acute Spinal Cord Injury Study (STASCIS), expected later this year, should further clarify this important management issue. The overall goal of this review is to provide an update regarding the current status of surgical therapy for traumatic SCI by reviewing relevant pathophysiology, laboratory, and clinical evidence, as well as to introduce radiologic and clinical tools that aid in the surgical decision-making process. PMID:21373951

Wilson, Jefferson R; Fehlings, Michael G

2011-04-01

361

Acrolein as a novel therapeutic target for motor and sensory deficits in spinal cord injury  

PubMed Central

In the hours to weeks following traumatic spinal cord injuries (SCI), biochemical processes are initiated that further damage the tissue within and surrounding the initial injury site: a process termed secondary injury. Acrolein, a highly reactive unsaturated aldehyde, has been shown to play a major role in the secondary injury by contributing significantly to both motor and sensory deficits. In particular, efforts have been made to elucidate the mechanisms of acrolein-mediated damage at the cellular level and the resulting paralysis and neuropathic pain. In this review, we will highlight the recent developments in the understanding of the mechanisms of acrolein in motor and sensory dysfunction in animal models of SCI. We will also discuss the therapeutic benefits of using acrolein scavengers to attenuate acrolein-mediated neuronal damage following SCI. PMID:25206871

Park, Jonghyuck; Muratori, Breanne; Shi, Riyi

2014-01-01

362

Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury  

Microsoft Academic Search

Study Design:Cross-sectional study.Objective:(1) To quantify intramyocellular lipid (IMCL) content of the soleus muscle. (2) To assess the T2 relaxation rates in the lower extremity skeletal muscles in persons with incomplete spinal cord injury (SCI).Setting:Academic Institution, Florida.Methods:Eight subjects (42±10 years old; 70±12 kg; 176±10 cm) with chronic (17±9 months post injury) motor SCI (C4-T12; ASIA C or D) and eight matched

P K Shah; C M Gregory; J E Stevens; N C Pathare; A Jayaraman; A L Behrman; G A Walter; K Vandenborne

2008-01-01

363

Pharmacological evidence for a role of peroxynitrite in the pathophysiology of spinal cord injury  

PubMed Central

Evidence suggests that the reactive oxygen species peroxynitrite (PN) is an important player in the pathophysiology of acute spinal cord injury (SCI). In the present study, we examined the ability of tempol, a catalytic scavenger of PN-derived free radicals, to alleviate oxidative damage, mitochondrial dysfunction and cytoskeletal degradation following a severe contusion (200 kdyn force) SCI in female Sprague–Dawley rats. PN-mediated oxidative damage in spinal cord tissue, including protein nitration, protein oxidation and lipid peroxidation was significantly reduced by acute tempol treatment (300 mg/kg, i.p. within 5 min post-injury). Injury-induced mitochondrial respiratory dysfunction, measured after 24 h in isolated mitochondria, was partially reversed by tempol along with an attenuation of oxidative damage to mitochondrial proteins. Mitochondrial dysfunction disrupts intracellular Ca2+ homeostasis contributing to calpain-mediated axonal cytoskeletal protein (?-spectrin, 280 kD) degradation. Increased levels of ?-spectrin breakdown proteins (SBDP 145 kD and 150 kD) were significantly decreased at 24 h in tempol-treated rats indicative of spinal axonal protection. However, a therapeutic window analysis showed that the axonal cytoskeletal protective effects require tempol dosing within the first hour after injury. Nevertheless, these findings are the first to support the concept that PN is an important neuroprotective target in early secondary SCI, and that there is a mechanistic link between PN-mediated oxidative compromise of spinal cord mitochondrial function, loss of intracellular Ca2+ homeostasis and calpain-mediated proteolytic axonal damage. PMID:19111721

Xiong, Yiqin; Hall, Edward D.

2009-01-01

364

Transplantation of Predifferentiated Adipose-Derived Stromal Cells for the Treatment of Spinal Cord Injury  

Microsoft Academic Search

Adipose-derived stromal cells (ASCs) are an alternative source of stem cells for cell-based therapies of neurological disorders\\u000a such as spinal cord injury (SCI). In the present study, we predifferentiated ASCs (pASCs) and compared their behavior with\\u000a naïve ASCs in vitro and after transplantation into rats with a balloon-induced compression lesion. ASCs were predifferentiated\\u000a into spheres before transplantation, then pASCs or

David Arboleda; Serhiy Forostyak; Pavla Jendelova; Dana Marekova; Takashi Amemori; Helena Pivonkova; Katarina Masinova; Eva Sykova

365

Nanoparticle-mediated local delivery of methylprednisolone after spinal cord injury  

Microsoft Academic Search

Systemic administration of a high-dose of Methylprednisolone (MP) can reduce neurological deficits after acute spinal cord injury (SCI). However, the use of high-dose MP in treating acute SCI is controversial due to significant dose related side effects and relatively modest improvements in neurological function. Here, using a rat model of SCI, we compare the efficacy of controlled, nanoparticle-enabled local delivery

Young-tae Kim; Jon-Michael Caldwell; Ravi V. Bellamkonda

2009-01-01

366

Clonus after human spinal cord injury cannot be attributed solely to recurrent muscle-tendon stretch  

Microsoft Academic Search

  \\u000a Clonus, presented behaviorally as rhythmic distal joint oscillation, is a common pathology that occurs secondary to spinal\\u000a cord injury (SCI) and other neurological disabilities. There are two predominant theories as to the underlying mechanism of\\u000a clonus. The prevailing one is that clonus results from recurrent activation of stretch reflexes. An alternative hypothesis\\u000a is that clonus results from the action

Janell A. Beres-Jones; Timothy D. Johnson; Susan J. Harkema

2003-01-01

367

Rehabilitation and future participation of youth following spinal cord injury: caregiver perspectives  

Microsoft Academic Search

Study design:Cross-sectional survey.Objectives:To examine caregivers’ perspectives on the effectiveness of rehabilitative support experienced by youth with spinal cord injury (SCI) during acute rehabilitation and after community reintegration in terms of their community participation.Setting:Data collection took place at the three Shriners SCI hospitals: Chicago, Philadelphia, and Northern California.Methods:A total of 132 primary caregivers of youth with SCI completed a survey on

L A House; H F Russell; E H Kelly; A Gerson; L C Vogel

2009-01-01

368

Sexual rehabilitation in women with spinal cord injury: a critical review of the literature  

Microsoft Academic Search

Study design:Review article.Objectives:Critical review of literature on the multiple aspects of sexual rehabilitation in women with spinal cord injury (SCI) from initial recovery to long-term follow-up.Setting:Neuro-urology Department.Methods:Studies on sexuality selected from PubMed from 1993 to 2009.Results:Literature supported by significant statistical analyses reports that females with complete tetraglegia deserved special attention immediately at initial recovery; sexual intercourse is much more difficult

G Lombardi; G Del Popolo; A Macchiarella; M Mencarini; M Celso

2010-01-01

369

Comparison of skin perfusion response with alternating and constant pressures in people with spinal cord injury  

Microsoft Academic Search

Study design:Two-way factorial mixed design, the between-subjects factor as the spinal cord injury (SCI) status (SCI and non-SCI) and the within-subjects factor as the pressure pattern (alternating and constant pressures).Objectives:To compare the effects of alternating and constant pressures on weight-bearing tissue perfusion in people with SCI, with application for improving alternating pressure support surface usage.Setting:University research laboratory.Subjects:A total of 28

Y-K Jan; D M Brienza; M L Boninger; G Brenes

2011-01-01

370

Sexual Desire and Depression Following Spinal Cord Injury: Masculine Sexual Prowess as a Moderator  

Microsoft Academic Search

Men’s adherence to masculine norms stressing sexual prowess may contribute to their adjustment to changes in sexual functioning\\u000a following spinal cord injury. The authors test this hypothesis by examining the moderating role of men’s conformity to gender\\u000a norms for sexual prowess on the relationship between sexual desire and depression. One hundred and sixteen male citizens of\\u000a the United States with

Shaun Michael Burns; Sigmund Hough; Briana L. Boyd; Justin Hill

2009-01-01

371

Use of Platelet Rich Plasma for the Treatment of Bicipital Tendinopathy in Spinal Cord Injury:  

PubMed Central

The purpose of study is to explore the efficacy and safety of platelet rich plasma (PRP) in the nonoperative management of shoulder tendinopathy amongst individuals with spinal cord injury. This objective was met by completing a pilot study on the effectiveness and safety of a PRP injection into the biceps tendon demonstrating clinical and ultrasonagraphic pathology. Recent analysis of the preliminary pilot data has demonstrated remarkably convincing results demonstrating both the safety and efficacy of this novel intervention. PMID:23459023

Ibrahim, Victor M.; Groah, Suzanne L.; Libin, Alexander; Ljungberg, Inger H.

2012-01-01

372

Efficacy of Intraspinal Microstimulation in Restoring Stepping after Spinal Cord Injury  

Microsoft Academic Search

The goal of this project was to test the efficacy of intraspinal microstimulation (ISMS) in restoring leg movements after spinal cord injury (SCI). Three aspects of ISMS-generated movements were tested: 1) kinematics and kinetics of evoked stepping, 2) fatigue resistance and muscle fiber-type recruitment, and 3) long-term stability of stimulation parameters and elicited responses. Studies were conducted in cats with

Mushahwar VK; Saigal R; Bamford J; Guevremont LG; Norton JA

373

Are current back protectors suitable to prevent spinal injury in recreational snowboarders?  

Microsoft Academic Search

ObjectiveBack protectors for snowboarders were analysed with respect to their potential to prevent spinal injury.DesignIn 20 Swiss skiing resorts, athletes were interviewed on the slope. In addition, an online survey was conducted. The performance of 12 commercially available back protectors was investigated by means of mechanical testing. A currently used drop test according to standard EN1621 (motorcycle protectors), testing energy

Kai-Uwe Schmitt; Bendicht Liechti; Frank I Michel; Rolf Stämpfli; Paul A Brühwiler

2010-01-01

374

Quality of life after spinal cord injury: a meta-synthesis of qualitative findings  

Microsoft Academic Search

Study design:Meta-synthesis of qualitative research.Objectives:To identify, compare and synthesize the factors found to contribute to, or detract from the experience of a life worth living following spinal cord injury (SCI).Methods:Published articles were identified from the Medline, CINAHL and Sociological Abstracts databases, a hand search through selected journals published since 1990, and from reference lists. These were assessed for their relevance

K Whalley Hammell

2007-01-01

375

Methylprednisolone neutralizes the beneficial effects of erythropoietin in experimental spinal cord injury  

PubMed Central

Inflammation plays a major pathological role in spinal cord injury (SCI). Although antiinflammatory treatment using the glucocorticoid methyprednisolone sodium succinate (MPSS) improved outcomes in several multicenter clinical trials, additional clinical experience suggests that MPSS is only modestly beneficial in SCI and poses a risk for serious complications. Recent work has shown that erythropoietin (EPO) moderates CNS tissue injury, in part by reducing inflammation, limiting neuronal apoptosis, and restoring vascular autoregulation. We determined whether EPO and MPSS act synergistically in SCI. Using a rat model of contusive SCI, we compared the effects of EPO [500-5,000 units/kg of body weight (kg-bw)] with MPSS (30 mg/kg-bw) for proinflammatory cytokine production, histological damage, and motor function at 1 month after a compression injury. Although high-dose EPO and MPSS suppressed proinflammatory cytokines within the injured spinal cord, only EPO was associated with reduced microglial infiltration, attenuated scar formation, and sustained neurological improvement. Unexpectedly, coadministration of MPSS antagonized the protective effects of EPO, even though the EPO receptor was up-regulated normally after injury. These data illustrate that the suppression of proinflammatory cytokines alone does not necessarily prevent secondary injury and suggest that glucocorticoids should not be coadministered in clinical trials evaluating the use of EPO for treatment of SCI. PMID:16260722

Gorio, Alfredo; Madaschi, Laura; Di Stefano, Barbara; Carelli, Stephana; Di Giulio, Anna Maria; De Biasi, Silvia; Coleman, Thomas; Cerami, Anthony; Brines, Michael

2005-01-01

376

Wheel running following spinal cord injury improves locomotor recovery and stimulates serotonergic fiber growth.  

PubMed

Exercise, through manual step training, robotic step training or voluntary wheel running, is emerging as a promising therapy after spinal cord injury (SCI). Animal models provide a tool to investigate the mechanisms by which physical activity influences recovery from SCI. In the present study, we extend previous experiments showing improved recovery after SCI with both pre- and post-injury running in a flat-surface running wheel and investigate mechanisms of recovery. We tested a clinically relevant model using post-injury wheel running, in which we provided mice with access to wheels either 3 days or 7 days/week. Open field behavior, observed for 15 weeks following moderate T9 contusion injury, showed a significant linear increase in locomotor improvements across groups, sedentary, 3-day runners and 7-day runners. Kinematic analysis of treadmill walking revealed that both wheel-running groups, 3 and 7 days/week, improved stepping ability compared with sedentary controls. Stereological quantification of neuron number in the injured segment of the spinal cord revealed no differences between the groups. However, stereological quantification of serotonin immunostaining using isotropic virtual planes showed increases in serotonin fiber length caudal to the lesion in the running groups. These observations suggest that improvement in function may be related to changes in serotonin fibers immediately caudal to the injury epicenter. PMID:17439482

Engesser-Cesar, Christie; Ichiyama, Ronaldo M; Nefas, Amber L; Hill, Mary Ann; Edgerton, V Reggie; Cotman, Carl W; Anderson, Aileen J

2007-04-01

377

Usability assessment of ASIBOT: a portable robot to aid patients with spinal cord injury.  

PubMed

The usability concept refers to aspects related to the use of products that are closely linked to the user's degree of satisfaction. Our goal is to present a functional evaluation methodology for assessing the usability of sophisticated technical aids, such as a portable robot for helping disabled patients with severe spinal cord injuries. The specific manipulator used for this task is ASIBOT, a personal assistance robot totally developed by RoboticsLab at the University Carlos III of Madrid. Our purpose is also to improve some aspects of the manipulator according to the user's perception. For our case study, a population of six patients with spinal cord injury is considered. These patients have been suffering spinal cord injuries for a period of time longer than 1 year before the tests are carried out. The methodology followed for the information gathering is based on the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Different daily functions, such as drinking, brushing one's teeth and washing one's face, are considered to assess the user's perception when using ASIBOT as a technical aid. The human factor in this procedure is the main base to establish the specific needs and tools to make the end product more suitable and usable. PMID:20969432

Jardón, Alberto; Gil, Ángel M; de la Peña, Ana I; Monje, Concepción A; Balaguer, Carlos

2011-01-01

378

Does diffusion tensor data reflect pathological changes in the spinal cord with chronic injury  

PubMed Central

Magnetic resonance diffusion tensor imaging has been shown to quantitatively measure the early pathological changes in chronic cervical spondylotic myelopathy. In this study, a novel spongy polyurethane material was implanted in the rat C3–5 epidural space to establish a rat model of chronic cervical spondylotic myelopathy. Diffusion tensor data were used to predict pathological changes. Results revealed that the fractional anisotropy value gradually decreased at 4, 24, and 72 hours and 1 week after injury in rat spinal cord, showing a time-dependent manner. Average diffusion coefficient increased at 72 hours and 1 week after implantation. Hematoxylin-eosin staining and Luxol-fast-blue staining exhibited that the number of neurons in the anterior horn of the spinal cord gray matter and the nerve fiber density of the white matter gradually reduced with prolonged compression time. Neuronal loss was most significant at 1 week after injury. Results verified that the fractional anisotropy value and average diffusion coefficient reflected the degree of pathological change in the site of compression in rat models at various time points after chronic spinal cord compression injury, which potentially has a reference value in the early diagnosis of chronic cervical spondylotic myelopathy.

Lin, Erjian; Long, Houqing; Li, Guangsheng; Lei, Wanlong

2013-01-01

379

A multimedia guide to spinal cord injury: empowerment through self instruction.  

PubMed

The Spinal Cord Injury (SCI) Project is developing a series of instructional modules on SCI that will be distributed via CD-ROM for patient and family education. The modules are based on an instructional program and patient manual distributed by the Paralyzed Veterans of America. The program includes topics ranging from the anatomy and physiology of spinal cord injuries to legal rights established under the Americans With Disabilities Act. The SCI project expands on the instructional manual by combining digital multimedia techniques with motivational features such as games and personal guides. The user selects a personal guide from among a selection of individuals with spinal cord injuries to guide them through tutorials that include accounts of personal experiences. The guides appear in small video windows at various points throughout the tutorials and give personal insight into the topic at hand. The user can also query the other guides to hear their views on a topic. The user interface incorporates 'seamless access' features, which enable persons with a wide range of disabilities to use the program. Innovative features of these modules are the use of personal instructional guides, motivational games and activities, incorporation of alternative input or access strategies, and the use of high quality, low cost, multimedia production strategies. PMID:8591558

Van Biervliet, A; Gest, T R

1995-01-01

380

Phospholipase A2 and its molecular mechanism after spinal cord injury.  

PubMed

Phospholipases A(2) (PLA(2)s) are a diverse family of lipolytic enzymes which hydrolyze the acyl bond at the sn-2 position of glycerophospholipids to produce free fatty acids and lysophospholipids. These products are precursors of bioactive eicosanoids and platelet-activating factor which have been implicated in pathological states of numerous acute and chronic neurological disorders. To date, more than 27 isoforms of PLA(2) have been found in the mammalian system which can be classified into four major categories: secretory PLA(2), cytosolic PLA(2), Ca(2+)-independent PLA(2), and platelet-activating factor acetylhydrolases. Multiple isoforms of PLA(2) are found in the mammalian spinal cord. Under physiological conditions, PLA(2)s are involved in diverse cellular responses, including phospholipid digestion and metabolism, host defense, and signal transduction. However, under pathological situations, increased PLA(2) activity, excessive production of free fatty acids and their metabolites may lead to the loss of membrane integrity, inflammation, oxidative stress, and subsequent neuronal injury. There is emerging evidence that PLA(2) plays a key role in the secondary injury process after traumatic spinal cord injury. This review outlines the current knowledge of the PLA(2) in the spinal cord with an emphasis being placed on the possible roles of PLA(2) in mediating the secondary SCI. PMID:20127525

Liu, Nai-Kui; Xu, Xiao-Ming

2010-06-01

381

Ethanol Extract of Chinese Propolis Facilitates Functional Recovery of Locomotor Activity after Spinal Cord Injury  

PubMed Central

An ethanol extract of Chinese propolis (EECP) was given intraperitoneally to rats suffering from hemitransection of half of their spinal cord (left side) at the level of the 10th thoracic vertebra to examine the effects of the EECP on the functional recovery of locomotor activity and expression of mRNAs of inducible nitric oxide (NO) synthase (iNOS) and neurotrophic factors in the injury site. Daily administration of EECP after the spinal cord injury ameliorated the locomotor function, which effect was accompanied by a reduced lesion size. Furthermore, the EECP suppressed iNOS gene expression, thus reducing NO generation, and also increased the expression level of brain-derived neurotrophic factor and neurotrophin-3 mRNAs in the lesion site, suggesting that the EECP reduced the inflammatory and apoptotic circumstances through attenuation of iNOS mRNA expression and facilitation of mRNA expression of neurotrophins in the injured spinal cord. These results suggest that Chinese propolis may become a promising tool for wide use in the nervous system for reducing the secondary neuronal damage following primary physical injury. PMID:20953390

Kasai, Masaki; Fukumitsu, Hidefumi; Soumiya, Hitomi; Furukawa, Shoei

2011-01-01

382

Ethanol extract of chinese propolis facilitates functional recovery of locomotor activity after spinal cord injury.  

PubMed

An ethanol extract of Chinese propolis (EECP) was given intraperitoneally to rats suffering from hemitransection of half of their spinal cord (left side) at the level of the 10th thoracic vertebra to examine the effects of the EECP on the functional recovery of locomotor activity and expression of mRNAs of inducible nitric oxide (NO) synthase (iNOS) and neurotrophic factors in the injury site. Daily administration of EECP after the spinal cord injury ameliorated the locomotor function, which effect was accompanied by a reduced lesion size. Furthermore, the EECP suppressed iNOS gene expression, thus reducing NO generation, and also increased the expression level of brain-derived neurotrophic factor and neurotrophin-3 mRNAs in the lesion site, suggesting that the EECP reduced the inflammatory and apoptotic circumstances through attenuation of iNOS mRNA expression and facilitation of mRNA expression of neurotrophins in the injured spinal cord. These results suggest that Chinese propolis may become a promising tool for wide use in the nervous system for reducing the secondary neuronal damage following primary physical injury. PMID:20953390

Kasai, Masaki; Fukumitsu, Hidefumi; Soumiya, Hitomi; Furukawa, Shoei

2011-01-01

383

Matrix metalloproteinases and their inhibitors in human traumatic spinal cord injury  

PubMed Central

Background Matrix metalloproteinases (MMPs) are a family of extracellular endopeptidases that degrade the extracellular matrix and other extracellular proteins. Studies in experimental animals demonstrate that MMPs play a number of roles in the detrimental as well as in the beneficial events after spinal cord injury (SCI). In the present correlative investigation, the expression pattern of several MMPs and their inhibitors has been investigated in the human spinal cord. Methods An immunohistochemical investigation in post mortem samples of control and lesioned human spinal cords was performed. All patients with traumatic SCI had been clinically diagnosed as having "complete" injuries and presented lesions of the maceration type. Results In the unlesioned human spinal cord, MMP and TIMP immunoreactivity was scarce. After traumatic SCI, a lesion-induced bi-phasic pattern of raised MMP-1 levels could be found with an early up-regulation in macrophages within the lesion epicentre and a later induction in peri-lesional activated astrocytes. There was an early and brief induction of MMP-2 at the lesion core in macrophages. MMP-9 and -12 expression peaked at 24 days after injury and both molecules were mostly expressed in macrophages at the lesion epicentre. Whereas MMP-9 levels rose progressively from 1 week to 3 weeks, there was an isolated peak of MMP-12 expression at 24 days. The post-traumatic distribution of the MMP inhibitors TIMP-1, -2 and -3 was limited. Only occasional TIMP immuno-positive macrophages could be detected at short survival times. The only clear induction was detected for TIMP-3 at survival times of 8 months and 1 year in peri-lesional activated astrocytes. Conclusion The involvement of MMP-1, -2, -9 and -12 has been demonstrated in the post-traumatic events after human SCI. With an expression pattern corresponding largely to prior experimental studies, they were mainly expressed during the first weeks after injury and were most likely involved in the destructive inflammatory events of protein breakdown and phagocytosis carried out by infiltrating neutrophils and macrophages, as well as being involved in enhanced permeability of the blood spinal cord barrier. Similar to animal investigations, the strong induction of MMPs was not accompanied by an expression of their inhibitors, allowing these proteins to exert their effects in the lesioned spinal cord. PMID:17594482

Buss, Armin; Pech, Katrin; Kakulas, Byron A; Martin, Didier; Schoenen, Jean; Noth, Johannes; Brook, Gary A

2007-01-01

384

A characterization of white matter pathology following spinal cord compression injury in the rat.  

PubMed

Our laboratory has previously described the characteristics of neuronal injury in a rat compression model of spinal cord injury (SCI), focussing on the impact of this injury on the gray matter. However, white matter damage is known to play a critical role in functional outcome following injury. Therefore, in the present study, we used immunohistochemistry and electron microscopy to examine the alterations to the white matter that are initiated by compression SCI applied at T12 vertebral level. A significant loss of axonal and dendritic cytoskeletal proteins was observed at the injury epicenter within 1day of injury. This was accompanied by axonal dysfunction, as demonstrated by the accumulation of ?-amyloid precursor protein (?-APP), with a peak at 3days post-SCI. A similar, acute loss of cytoskeletal proteins was observed up to 5mm away from the injury epicenter and was particularly evident rostral to the lesion site, whereas ?-APP accumulation was prominent in tracts proximal to the injury. Early myelin loss was confirmed by myelin basic protein (MBP) immunostaining and by electron microscopy, which also highlighted the infiltration of inflammatory and red blood cells. However, 6weeks after injury, areas of new Schwann cell and oligodendrocyte myelination were observed. This study demonstrates that substantial white matter damage occurs following compression SCI in the rat. Moreover, the loss of cytoskeletal proteins and accumulation of ?-APP up to 5mm away from the lesion site within 1day of injury indicates the rapid manner in which the axonal damage extends in the rostro-caudal axis. This is likely due to both Wallerian degeneration and spread of secondary cell death, with the latter affecting axons both proximal and distal to the injury. PMID:24361176

Ward, R E; Huang, W; Kostusiak, M; Pallier, P N; Michael-Titus, A T; Priestley, J V

2014-02-28

385

Dropped-head syndrome resulting from injury to the central spinal cord at the upper cervical level.  

PubMed

There are many causes of paraspinal muscle weakness which give rise to the dropped-head syndrome. In the upper cervical spine the central portion of the spinal cord innervates the cervical paraspinal muscles. Dropped-head syndrome resulting from injury to the central spinal cord at this level has not previously been described. We report two patients who were treated acutely for this condition. Both presented with weakness in the upper limbs and paraspinal cervical musculature after a fracture of C2. Despite improvement in the strength of the upper limbs, the paraspinal muscle weakness persisted in both patients. One ultimately underwent cervicothoracic fusion to treat her dropped-head syndrome. While the cause of the dropped-head syndrome cannot be definitively ascribed to the injuries to the spinal cord, this pattern is consistent with the known patho-anatomical mechanisms of both injury to the central spinal cord and dropped-head syndrome. PMID:21464490

Rust, C L; Ching, A C; Hart, R A

2011-04-01

386

Phosphorylation of ezrin/radixin/moesin (ERM) protein in spinal microglia following peripheral nerve injury and lysophosphatidic acid administration.  

PubMed

Peripheral nerve injury activates spinal glial cells, which may contribute to the development of pain behavioral hypersensitivity. There is growing evidence that activated microglia show dynamic changes in cell morphology; however, the molecular mechanisms that underlie the modification of the membrane and cytoskeleton of microglia are not known. Here, we investigated the phosphorylation of ezrin, radixin, and moesin (ERM) proteins in the spinal cord after peripheral nerve injury. ERM is known to function as membrane-cytoskeletal linkers and be localized at filopodia- and microvilli-like structures. ERM proteins must be phosphorylated at a specific C-terminal threonine residue to be in the active state. The nature of ERM proteins in the spinal cord of animals in a neuropathic pain model has not been investigated and characterized. In the present study, we observed an increase in the phosphorylated ERM in the spinal microglia following spared nerve injury. The intrathecal administration of lysophosphatidic acid induced the phosphorylation of ERM proteins in microglia along with the development of mechanical pain hypersensitivity. Intrathecal administration of ERM antisense locked nucleic acid suppressed nerve injury-induced tactile allodynia and decreased the phosphorylation of ERM, but not the Iba1 staining pattern, in spinal glial cells. These findings suggest that lysophosphatidic acid induced the phosphorylation of ERM proteins in spinal microglia and may be involved in the emergence of neuropathic pain. These findings may underlie the pathological mechanisms of nerve injury-induced neuropathic pain. PMID:23065679

Kashimoto, Ryosuke; Yamanaka, Hiroki; Kobayashi, Kimiko; Okubo, Masamichi; Yagi, Hideshi; Mimura, Osamu; Noguchi, Koichi

2013-03-01

387

The Impact of Mild Traumatic Brain Injury on Cognitive Functioning Following Co-occurring Spinal Cord Injury  

PubMed Central

Meta-analytic studies have shown that mild traumatic brain injury (MTBI) has relatively negligible effects on cognitive functioning at 90 or more days post-injury. Few studies have prospectively examined the effects of MTBI in acute physical trauma populations. This prospective, cohort study compared the cognitive performance of persons who sustained a spinal cord injury (SCI) and a co-occurring MTBI (N = 53) to persons who sustained an SCI alone (N = 64) between 26 and 76 days (mean = 46) post-injury. The presence of MTBI was determined based on acute medical record review using a standardized algorithm. Primary outcome measures were seven neuropsychological tests that evaluated visual, verbal, and working memory, perceptual reasoning, and processing speed that controlled for potential upper extremity impairment. Persons who sustained SCI with or without MTBI had lower than expected performance across all neuropsychological tests, on average about 1 SD below the mean. Analysis of covariance indicated that persons with MTBI did not evidence greater impairment on any neuropsychological test. The aggregated effect size (Cohen's d) was ?0.16. The strongest predictors of neuropsychological test scores were education, race, history of learning problems, and days from injury to rehabilitation admission. MTBI did not predict performance on any neuropsychological test. These findings are consistent with other controlled studies that indicate a single MTBI has negligible long-term impacts on cognition. PMID:24055885

Macciocchi, Stephen N.; Seel, Ronald T.; Thompson, Nicole

2013-01-01

388

The impact of mild traumatic brain injury on cognitive functioning following co-occurring spinal cord injury.  

PubMed

Meta-analytic studies have shown that mild traumatic brain injury (MTBI) has relatively negligible effects on cognitive functioning at 90 or more days post-injury. Few studies have prospectively examined the effects of MTBI in acute physical trauma populations. This prospective, cohort study compared the cognitive performance of persons who sustained a spinal cord injury (SCI) and a co-occurring MTBI (N = 53) to persons who sustained an SCI alone (N = 64) between 26 and 76 days (mean = 46) post-injury. The presence of MTBI was determined based on acute medical record review using a standardized algorithm. Primary outcome measures were seven neuropsychological tests that evaluated visual, verbal, and working memory, perceptual reasoning, and processing speed that controlled for potential upper extremity impairment. Persons who sustained SCI with or without MTBI had lower than expected performance across all neuropsychological tests, on average about 1 SD below the mean. Analysis of covariance indicated that persons with MTBI did not evidence greater impairment on any neuropsychological test. The aggregated effect size (Cohen's d) was -0.16. The strongest predictors of neuropsychological test scores were education, race, history of learning problems, and days from injury to rehabilitation admission. MTBI did not predict performance on any neuropsychological test. These findings are consistent with other controlled studies that indicate a single MTBI has negligible long-term impacts on cognition. PMID:24055885

Macciocchi, Stephen N; Seel, Ronald T; Thompson, Nicole

2013-11-01

389

Delayed anti-nogo-a antibody application after spinal cord injury shows progressive loss of responsiveness.  

PubMed

Blocking the function of the myelin protein Nogo-A or its signaling pathway is a promising method to overcome an important neurite growth inhibitory factor of the adult central nervous system (CNS), and to enhance axonal regeneration and plasticity after brain or spinal cord injuries. Several studies have shown increased axonal regeneration and enhanced compensatory sprouting, along with substantially improved functional recovery after treatment with anti-Nogo-A antibodies, Nogo-receptor antagonists, or inhibition of the downstream mediator RhoA/ROCK in adult rodents. Proof-of-concept studies in spinal cord-injured macaque monkeys with anti-Nogo-A antibodies have replicated these findings; recently, clinical trials in spinal cord-injured patients have begun. However, the optimal time window for successful Nogo-A function blocking treatments has not yet been determined. We studied the effect of acute as well as 1- or 2-weeks delayed intrathecal anti-Nogo-A antibody infusions on the regeneration of corticospinal tract (CST) axons and the recovery of motor function after large but anatomically incomplete thoracic spinal cord injuries in adult rats. We found that lesioned CST fibers regenerated over several millimeters after acute or 1-week-delayed treatments, but not when the antibody treatment was started with a delay of 2 weeks. Swimming and narrow beam crossing recovered well in rats treated acutely or with a 1-week delay with anti-Nogo-A antibodies, but not in the 2-week-delayed group. These results show that the time frame for treatment of spinal cord lesions with anti-Nogo-A antibodies is restricted to less than 2 weeks in adult rodents. PMID:21815784

Gonzenbach, Roman R; Zoerner, Bjoern; Schnell, Lisa; Weinmann, Oliver; Mir, Anis K; Schwab, Martin E

2012-02-10

390

Traumatic spinal cord injury complicated by AIDS related complex.  

PubMed

It is estimated that one to two million people in the US have antibodies to the human T-lymphotropic virus Type III/lymphadenopathy-associated virus (HTLV-III/LAV) and are consequently at risk for developing acquired immunodeficiency syndrome (AIDS). As the number of carriers of this infection increases, so does the expected incidence of this population for acquiring disabilities that require rehabilitative services. We report a traumatic spinal cord injured patient with resultant quadriplegia who has HTLV-III/LAV infection. Presented are the difficulties in classifying the manifestations of the HTLV-III/LAV infection in such a patient. Many of the symptoms of AIDS may be attributed to complications of recently acquired quadriplegia. This is added to the psychologic and social strains on a patient who has already lost permanent function due to quadriplegia. Implementation of educational programs to meet staff, family, and patient needs regarding their concerns and questions significantly reduced anxiety on the rehabilitation unit. Because the possible life expectancy can still be quite long, AIDS patients warrant rehabilitation programs. This necessitates that health care professionals in rehabilitation become familiar with AIDS, as they are likely to be involved in the care of patients with AIDS in the future. PMID:3348725

Meythaler, J M; Cross, L L

1988-03-01

391

ICF Based Comprehensive Evaluation for Post-Acute Spinal Cord Injury  

PubMed Central

Objective To evaluate the feasibility of the ICF for initial comprehensive evaluation of early post-acute spinal cord injury. Method A comprehensive evaluation of 62 early post-acute spinal cord injury (SCI) patients was conducted by rehabilitation team members, such as physicians, physical therapists, occupational therapists, nutritionists, medical social-workers, and nurses. They recorded each of their evaluation according to the ICF first level classification. The contents of the comprehensive evaluation were linked to the ICF second level categories, retrospectively. The linked codes were analyzed descriptively and were also compared with the brief ICF core set for early post-acute SCI. Results In the evaluation of early post-acute SCI patients based on the ICF first level categories, 19 items from the body functions domain, such as muscle power functions (b730) and urination functions (b620), 15 items from the body structures domain, including spinal cord and related structures (s120), 11 items from the activities and participation domain, such as transferring oneself (d420) and walking (d450), and 9 items from the environmental factors domain, e.g., health professionals (e355), were linked to the ICF second level categories. In total, 82.4% of all contents were linked to the brief ICF core set. Prognosis insight, a personal factor not linkable to an ICF code, was mentioned in 29.0% of all patients. Conclusion First level ICF categories can provide a structural base for a comprehensive evaluation in early post-acute spinal cord injury. However, frequently linked items, including the brief core set, as well as personal factors should be considered via a checklist in order to prevent the omission of significant contents. PMID:23342313

Nam, Hyung Seok; Kim, Kwang Dong

2012-01-01

392

Simvastatin Ameliorates Cauda Equina Compression Injury in a Rat Model of Lumbar Spinal Stenosis  

PubMed Central

Lumbar spinal stenosis (LSS) is the leading cause of morbidity and mortality worldwide. LSS pathology is associated with secondary injury caused by inflammation, oxidative damage and cell death. Apart from laminectomy, pharmacological therapy targeting secondary injury is limited. Statins are FDA-approved cholesterol-lowering drug. They also show pleiotropic anti-inflammatory, antioxidant and neuroprotective effects. To investigate the therapeutic efficacy of simvastatin in restoring normal locomotor function after cauda equina compression (CEC) in a rat model of LSS, CEC injury was induced in rats by implanting silicone gels into the epidural spaces of L4 and L6. Experimental group was treated with simvastatin (5 mg/kg body weight), while the injured (vehicle) and sham operated (sham) groups received vehicle solution. Locomotor function in terms of latency on rotarod was measured for 49 days and the threshold of pain was determined for 14 days. Rats were sacrificed on day 3 and 14 and the spinal cord and cauda equina fibers were extracted and studied by histology, immunofluorescence, electron microscopy (EM) and TUNEL assay. Simvastatin aided locomotor functional recovery and enhanced the threshold of pain after the CEC. Cellular Infiltration and demyelination decreased in the spinal cord from the simvastatin group. EM revealed enhanced myelination of cauda equina in the simvastatin group. TUNEL assay showed significantly decreased number of apoptotic neurons in spinal cord from the simvastatin group compared to the vehicle group. Simvastatin hastens the locomotor functional recovery and reduces pain after CEC. These outcomes are mediated through the neuroprotective and anti-inflammatory properties of simvastatin. The data indicate that simvastatin may be a promising drug candidate for LSS treatment in humans. PMID:23188522

Shunmugavel, Anandakumar; Martin, Marcus M.; Khan, Mushfiquddin; Copay, Anne G.; Subach, Brian R.; Schuler, Thomas C.

2012-01-01

393

Minocycline Treatment Reduces Delayed Oligodendrocyte Death, Attenuates Axonal Dieback, and Improves Functional Outcome after Spinal Cord Injury  

Microsoft Academic Search

Minocycline has been demonstrated to be neuroprotective after spinal cord injury (SCI). However, the cellular consequences of minocy- cline treatment on the secondary injury response are poorly understood. We examined the ability of minocycline to reduce oligodendro- cyte apoptosis, microglial\\/macrophage activation, corticospinal tract (CST) dieback, and lesion size and to improve functional outcome after SCI. Adult rats were subjected to

D. P. Stirling; Kourosh Khodarahmi; Jie Liu; Lowell T. Mcphail; Christopher B. Mcbride; John D. Steeves; Matt S. Ramer; Wolfram Tetzlaff

2004-01-01

394

The Initial Systolic Time Interval in patients with spinal cord injury measured with impedance cardiography  

NASA Astrophysics Data System (ADS)

The Initial Systolic Time Interval (ISTI), obtained from the electrocardiogram and impedance cardiogram, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart. This time delay is influenced by the sympathetic nerve system. Therefore, an observational study was performed in a group of patients (SCI) with spinal cord injuries. The relationship between the ISTI and the total heart cycle (RR-interval) was established by varying the RR-interval using an exercise stimulus to increase the heart rate. The slope of this relationship was observed to be significantly higher in the SCI-group as compared with a control group, although there was no difference in ISTI in the range of common heart rates during the test between the groups. This slope and the ISTI was observed to be significantly different in an acute patient having a recent spinal cord injury at a high level. Because of the variety in injury levels and incompleteness of the injuries further, more specific research is necessary to draw decisive conclusions with respect to the contribution of autonomic nervous control on the ISTI in SCI, although the present observations are notable.

Hoekstra, Femke; Martinsen, Ørjan G.; Verdaasdonk, Rudolf M.; Janssen, Thomas W. J.; Meijer, Jan H.

2012-12-01

395

Effects of rolipram on adult rat oligodendrocytes and functional recovery after contusive cervical spinal cord injury.  

PubMed

Traumatic human spinal cord injury (SCI) causes devastating and long-term hardships. These are due to the irreparable primary mechanical injury and secondary injury cascade. In particular, oligodendrocyte cell death, white matter axon damage, spared axon demyelination, and the ensuing dysfunction in action potential conduction lead to the initial deficits and impair functional recovery. For these reasons, and that oligodendrocyte and axon survival may be related, various neuroprotective strategies after spinal cord injury are being investigated. We previously demonstrated that oligodendrocytes in the adult rat epicenter ventrolateral funiculus (VLF) express 3'-5'-cyclic adenosine monophosphate-dependent phosphodiesterase 4 (PDE4) subtypes and that their death was attenuated up to 3 days after contusive cervical SCI when rolipram, a specific inhibitor of PDE4, was administered. Here, we report that (1) there are more oligodendrocyte somata in the adult rat epicenter VLF, (2) descending and ascending axonal conductivity in the VLF improves, and that (3) there are fewer hindlimb footfall errors during grid-walking at 5 weeks after contusive cervical SCI when rolipram is delivered for 2 weeks. This is the first demonstration of improved descending and ascending long-tract axonal conductivity across a SCI with this pharmacological approach. Since descending long-tract axonal conductivity did not return to normal, further evaluations of the pharmacokinetics and therapeutic window of rolipram as well as optimal combinations are necessary before consideration for neuroprotection in humans with SCI. PMID:19635528

Beaumont, E; Whitaker, C M; Burke, D A; Hetman, M; Onifer, S M

2009-11-10

396

A murine model of cervical spinal cord injury to study post-lesional respiratory neuroplasticity.  

PubMed

A cervical spinal cord injury induces permanent paralysis, and often leads to respiratory distress. To date, no efficient therapeutics have been developed to improve/ameliorate the respiratory failure following high cervical spinal cord injury (SCI). Here we propose a murine pre-clinical model of high SCI at the cervical 2 (C2) metameric level to study diverse post-lesional respiratory neuroplasticity. The technique consists of a surgical partial injury at the C2 level, which will induce a hemiparalysis of the diaphragm due to a deafferentation of the phrenic motoneurons from the respiratory centers located in the brainstem. The contralateral side of the injury remains intact and allows the animal recovery. Unlike other SCIs which affect the locomotor function (at the thoracic and lumbar level), the respiratory function does not require animal motivation and the quantification of the deficit/recovery can be easily performed (diaphragm and phrenic nerve recordings, whole body ventilation). This pre-clinical C2 SCI model is a powerful, useful, and reliable pre-clinical model to study various respiratory and non-respiratory neuroplasticity events at different levels (molecular to physiology) and to test diverse putative therapeutic strategies which might improve the respiration in SCI patients. PMID:24894020

Keomani, Emilie; Deramaudt, Thérèse B; Petitjean, Michel; Bonay, Marcel; Lofaso, Frédéric; Vinit, Stéphane

2014-01-01

397

The loss of antinociceptive efficacy of spinal morphine in rats with nerve ligation injury is prevented by reducing spinal afferent drive  

Microsoft Academic Search

Nerve ligation injury in rats may represent a useful model of some clinical neuropathic pains. Activation of N-methyl-d-aspartate (NMDA) receptors may maintain central sensitivity and contribute to neuropathic pain. Here, nerve injury was produced by unilateral ligation of the L5 and L6 spinal roots of the sciatic nerve of rats. Catheters were inserted for intrathecal (i.th.) or local delivery of

Michael H. Ossipov; Yvan Lopez; Michael L. Nichols; Di Bian; Frank Porreca

1995-01-01

398

Bone marrow mesenchymal stem cells repair spinal cord ischemia/reperfusion injury by promoting axonal growth and anti-autophagy  

PubMed Central

Bone marrow mesenchymal stem cells can differentiate into neurons and astrocytes after transplantation in the spinal cord of rats with ischemia/reperfusion injury. Although bone marrow mesenchymal stem cells are known to protect against spinal cord ischemia/reperfusion injury through anti-apoptotic effects, the precise mechanisms remain unclear. In the present study, bone marrow mesenchymal stem cells were cultured and proliferated, then transplanted into rats with ischemia/reperfusion injury via retro-orbital injection. Immunohistochemistry and immunofluorescence with subsequent quantification revealed that the expression of the axonal regeneration marker, growth associated protein-43, and the neuronal marker, microtubule-associated protein 2, significantly increased in rats with bone marrow mesenchymal stem cell transplantation compared with those in rats with spinal cord ischemia/reperfusion injury. Furthermore, the expression of the autophagy marker, microtubule-associated protein light chain 3B, and Beclin 1, was significantly reduced in rats with the bone marrow mesenchymal stem cell transplantation compared with those in rats with spinal cord ischemia/reperfusion injury. Western blot analysis showed that the expression of growth associated protein-43 and neurofilament-H increased but light chain 3B and Beclin 1 decreased in rats with the bone marrow mesenchymal stem cell transplantation. Our results therefore suggest that bone marrow mesenchymal stem cell transplantation promotes neurite growth and regeneration and prevents autophagy. These responses may likely be mechanisms underlying the protective effect of bone marrow mesenchymal stem cells against spinal cord ischemia/reperfusion injury. PMID:25374587

Yin, Fei; Meng, Chunyang; Lu, Rifeng; Li, Lei; Zhang, Ying; Chen, Hao; Qin, Yonggang; Guo, Li

2014-01-01

399

Ptena, but not Ptenb, reduces regeneration after spinal cord injury in adult zebrafish.  

PubMed

Based on the observation that the tumor suppressor gene PTEN (phosphatase and tensin homolog) reduces regeneration after spinal cord injury (SCI) as evidenced in the PTEN knockout mouse, we have investigated the function of Ptena and Ptenb, the two zebrafish homologs of mammalian PTEN, in adult zebrafish after spinal cord injury with the aim to assess the contribution of the two zebrafish genes to functional recovery in an animal species that spontaneously recovers from central nervous system injury. The inhibition of Ptena expression by antisense morpholino (MO) application improved spinal cord regeneration through 4 to 5weeks after injury. Retrograde tracing showed regrowth of axons from neurons of the regeneration-competent nucleus of the medial longitudinal fascicle in the brainstem in the Ptena MO-treated fish. Ptenb MO-treated fish recovered as well as control MO-treated fish at 4 and 5weeks after SCI, with their locomotion being similar to that of sham-injured and non-injured fish. The mRNA levels of Ptena were upregulated after SCI at the early stage after injury (12h and 6days) caudal to the lesion site, compared to the non-injured control, while the levels of Ptenb were upregulated only at 12h after injury. In situ hybridization experiments were in agreement with the qPCR measurements. At the protein level, Ptena was found to be expressed in spinal motoneurons and immature neurons. These results indicate that Ptena, but not Ptenb, inhibits regeneration in zebrafish, thus sharing this feature with PTEN in mammals. The fact that zebrafish regenerate better than mammals despite the inhibitory presence of Ptena is likely due to regeneration-conducive molecules that tip the balance from inhibition to enhancement. Interestingly, although Ptena and Ptenb have been shown to be functionally redundant in promoting the development of the fish larval central nervous system, they are not functionally redundant in the adult, suggesting that regeneration in fish is not predominantly due to the overall recapitulation of development. PMID:24929056

Liu, Dan; Yu, Yong; Schachner, Melitta

2014-11-01

400

Altered spinal arachidonic acid turnover after peripheral nerve injury regulates regional glutamate concentration and neuropathic pain behaviors in rats.  

PubMed

Spinal glutamate transporters (GT) have been implicated in the mechanisms of neuropathic pain; however, how spinal GT uptake activity is regulated remains unclear. Here we show that alteration of spinal arachidonic acid (AA) turnover after peripheral nerve injury regulated regional GT uptake activity and glutamate homeostasis. Chronic constriction nerve injury (CCI) in rats significantly reduced spinal GT uptake activity ((3)H-glutamate uptake) with an associated increase in extracellular AA and glutamate concentration from spinal microdialysates on postoperative day 8. AACOCF3 (a cytosolic phospholipase A2 inhibitor, 30mug) given intrathecally twice a day for postoperative day 1-7 reversed this CCI-induced spinal AA production, prevented the reduced spinal GT uptake activity and increased extracellular glutamate concentration. Conversely, alteration of spinal AA metabolism by diclofenac (a cyclooxygenase 1/2 inhibitor, 200mug) further reduced spinal GT uptake activity and increased extracellular glutamate concentration in CCI rats. GT uptake activity was also attenuated when AA (10 or 100nM) was directly added into spinal samples of naïve rats in an in vitro(3)H-glutamate uptake assay, indicating a direct inhibitory effect of AA on GT uptake activity. Consistent with these findings, AACOCF3 reduced the development of both thermal hyperalgesia and mechanical allodynia, whereas diclofenac exacerbated thermal hyperalgesia, in CCI rats. Thus, spinal AA turnover may serve as a regulator in CCI-induced changes in regional GT uptake activity, glutamate homeostasis, and neuropathic pain behaviors. These data suggest that regulating spinal AA turnover may be a useful approach to improving the clinical management of neuropathic pain. PMID:17267128

Sung, Backil; Wang, Shuxing; Zhou, Bei; Lim, Grewo; Yang, Liling; Zeng, Qing; Lim, Jeong-Ae; Wang, Jing Dong; Kang, Jing X; Mao, Jianren

2007-09-01

401

Return to work after spinal cord injury: a review of recent research.  

PubMed

This manuscript reviews recent research on return to work (RTW) for individuals who sustain spinal cord injury (SCI), including the effects of demographics variables, occupational characteristics, workplace accommodations, quality of life, physical functional limitations, and other variable. Demographic variables that influence RTW for persons with SCI include age at injury onset, chronological age, gender, education, ethnicity, marital status, and per-injury work intensity. Others include satisfaction, and adjustment to sustaining SCI. In an effort to enhance employment opportunities for individuals with disabilities including SCI, Ticket to Work Incentive Improvement Act of 1999 (TWILA) has been passed by Congress and some states have begun implementing targeted initiatives through the State Partnership Systems Change Initiatives (SPI). Future research directions are recommended in light of recent legislative initiatives. PMID:12237497

Yasuda, Satoko; Wehman, Paul; Targett, Pamela; Cifu, David X; West, Michael

2002-01-01

402

In vivo magnetization transfer measurements of experimental spinal cord injury in the rat.  

PubMed

Magnetization transfer (MT) imaging techniques were implemented to study a clip compression model of spinal cord injury (SCI) in the rat. The purpose of this study was to determine if the magnetization transfer ratio (MTR) could be used to classify the stage and severity of SCI. Two clip compression injuries were studied: mild SCI and severe SCI. MTRs were determined for gray matter (GM) and white matter (WM) regions and the GM-WM contrast was determined on days 1 and 7 following surgery. Despite differences in pathologic features of mild and severe SCI, the GM-WM contrast did not allow discrimination between the two degrees of severity of SCI. WM MTR allowed differentiation of mild and severe SCI on day 1. These preliminary results suggest that WM MTR may provide an indication of the severity of injury in SCI. Magn Reson Med 45:159-163, 2001. PMID:11146498

Gareau, P J; Weaver, L C; Dekaban, G A

2001-01-01

403

Acute cervical spinal cord injury secondary to air bag deployment without proper use of lap or shoulder harnesses.  

PubMed

The authors present a case report of a patient with cervical central spinal cord syndrome caused by a hyperextension injury after a motor vehicle collision in which the air bag deployed in the absence of shoulder or lap belt harnesses. The potential for cervical spine and spinal cord hyperextension injuries in passengers positioned in front of air bags without proper use of shoulder or lap belt harnesses is discussed. Cervical central spinal cord quadriplegia occurred with cervical spondylosis and kyphosis that was managed by early three-level cervical corpectomy in a 58-year-old patient. Early improvement in the patient's neurological status occurred but was incomplete at the time of this report. Cervical hyperextension injuries are possible in passengers positioned in the front seat of cars with air bags when shoulder or lap belt harnesses are not used properly. Previous biomechanical studies have documented the potential for these types of injuries. PMID:10710147

Hart, R A; Mayberry, J C; Herzberg, A M

2000-02-01

404

Matrix Metalloproteinase-1 (MMP-1) Expression in Rat Spinal Cord Injury Model.  

PubMed

Matrix metalloproteinase-1 (MMP-1), a member of the matrix metalloproteinases family, plays an integral role in extracellular matrix degradation and has been reportedly involved in the regulation of the brain or spinal cord traumatic neurovascular remodeling. Although the critical involvement of MMP-1 in the metastasis of tumors has been extensively documented, the role of MMP-1 in the pathology of neurological diseases remains largely elusive. In the present study, we established an adult rat spinal cord injury (SCI) model and investigated a potential role of MMP-1 in the pathological process of SCI. Using Western blot analysis, we identified notable expression change of MMP-1 after SCI. Immunohistochemistry showed that MMP-1 was distributed widely in rat spinal cord. Double immunofluorescence staining revealed that MMP-1 immunoreactivity was predominantly increased in neurons and astrocytes following SCI. Moreover, after injury, colocalization of MMP-1/active caspase-3 in neurons (NeuN-positive), and colocalization of MMP-1/PCNA in astrocytes (GFAP-positive) were clearly observed. We also examined the protein expression of PCNA, active caspase-3, Bcl-2, and Bax and found that the expression of the proteins was closely correlated with that of MMP-1. Taken together, our findings indicate that MMP-1 might play an important role in the regulation of neuronal apoptosis and astrocyte proliferation after SCI. PMID:25073870

Zhou, Ying; Cui, Zhiming; Xia, Xiaopeng; Liu, Chun; Zhu, Xinhui; Cao, Jianhua; Wu, Yuanyuan; Zhou, Li; Ben, Zhiyun; Song, Yan; Zhang, Haiyan; Zhang, Dongmei

2014-11-01

405

Brain sensorimotor system atrophy during the early stage of spinal cord injury in humans.  

PubMed

Spinal cord injury (SCI) usually leads to severe sensory and motor deficits below the spinal lesion. Previous animal models have shown significant atrophic changes in the neural sensorimotor system following SCI. However, specific anatomical changes in the human brain following SCI remain poorly understood. The purpose of the present study was to investigate structural changes during the early stage of SCI, and to investigate further the association between the structural changes and patients' sensorimotor functions. The study participants included 20 patients with SCI and 30 matched healthy controls. The mean period post-SCI was 8.9±2.7weeks (range 4-12weeks). Voxel-based morphometry was used to investigate the regions with gray and white matter volume changes. Compared to healthy controls, patients with SCI showed significant gray matter atrophy in the primary motor cortex (M1), primary somatosensory cortex (S1), supplementary motor area (SMA), and thalamus, as well as white matter atrophy in the corticospinal tracts at the level of the bilateral cerebral peduncles. In addition, gray matter volume in the primary motor cortex was positively correlated with the total American Spinal Injury Association motor score in patients with SCI. In conclusion, our findings suggest that SCI causes significant anatomical changes in the human sensorimotor system, and that these anatomical changes may occur in the early phase of SCI. Future treatments that aim to restore sensorimotor functions following SCI need to attend to these anatomical changes in the brain. PMID:24561217

Hou, J-M; Yan, R-B; Xiang, Z-M; Zhang, H; Liu, J; Wu, Y-T; Zhao, M; Pan, Q-Y; Song, L-H; Zhang, W; Li, H-T; Liu, H-L; Sun, T-S

2014-04-25

406

Spatiotemporal pattern of TRAF3 expression after rat spinal cord injury.  

PubMed

TNF receptor associated factor 3 (TRAF3), a member of the TRAF family of intracellular signaling proteins, can directly influence the phosphorylation status and activation of c-Jun N-terminal kinase, participating in CD40-induced apoptosis in carcinoma. However, its expression profile and function are still unclear in spinal cord injury (SCI). In this study, we performed an acute spinal cord contusion injury model in adult rats and detected the dynamic change patterns of TRAF3 expression in spinal cord. Western blot and immunohistochemistry revealed a striking upregulation of TRAF3 after SCI. Double immunofluorescence staining prompted that TRAF3 immunoreactivity was found in neurons rather than astrocytes. Moreover, co-localization of TRAF3/active caspase-3 was detected in neuronal nuclei. To further investigate the function of TRAF3, a neuronal cell line PC12 was employed to establish an apoptosis model in vitro. We analyzed the association of TRAF3 with active caspase-3 on PC12 cells by western blot and immunofluorescent labeling, which was parallel with the data in vivo. Additionally, knocking TRAF3 down with siRNA demonstrated the probable pro-apoptotic role of TRAF3 in the process of neuronal apoptosis. To summarize, we firstly uncover the temporal and spatial expression changes of TRAF3 in SCI. Our data suggest that TRAF3 might be implicated in central nervous system pathophysiology after SCI. PMID:24803166

Wu, Ya; Zheng, Minqian; Wang, Siqing; Song, Changzhi; Wang, Chuanbin; Xiao, Yueping; Xu, Lei; Xu, Xiaozu

2014-10-01

407

Mesenchymal stem cells in the treatment of spinal cord injuries: A review  

PubMed Central

With technological advances in basic research, the intricate mechanism of secondary delayed spinal cord injury (SCI) continues to unravel at a rapid pace. However, despite our deeper understanding of the molecular changes occurring after initial insult to the spinal cord, the cure for paralysis remains elusive. Current treatment of SCI is limited to early administration of high dose steroids to mitigate the harmful effect of cord edema that occurs after SCI and to reduce the cascade of secondary delayed SCI. Recent evident-based clinical studies have cast doubt on the clinical benefit of steroids in SCI and intense focus on stem cell-based therapy has yielded some encouraging results. An array of mesenchymal stem cells (MSCs) from various sources with novel and promising strategies are being developed to improve function after SCI. In this review, we briefly discuss the pathophysiology of spinal cord injuries and characteristics and the potential sources of MSCs that can be used in the treatment of SCI. We will discuss the progress of MSCs application in research, focusing on the neuroprotective properties of MSCs. Finally, we will discuss the results from preclinical and clinical trials involving stem cell-based therapy in SCI. PMID:24772239

Dasari, Venkata Ramesh; Veeravalli, Krishna Kumar; Dinh, Dzung H

2014-01-01

408

Comprehensive Locomotor Outcomes Correlate to Hyperacute Diffusion Tensor Measures After Spinal Cord Injury in the Adult Rat  

PubMed Central

In adult rats, locomotor deficits following a contusive thoracic spinal cord injury (SCI) are caused primarily by white matter loss/dysfunction at the epicenter. This loss/dysfunction decreases descending input from the brain and cervical spinal cord, and decreases ascending signals in long propriospinal, spinocerebellar and somatosensory pathways, among many others. Predicting the long-term functional consequences of a contusive injury acutely, without knowledge of the injury severity is difficult due to the temporary flaccid paralysis and loss of reflexes that accompanies spinal shock. It is now well known that recovery of high quality hindlimb stepping requires only 12-15% spared white matter at the epicenter, but that forelimb-hindlimb coordination and precision stepping (grid or horizontal ladder) requires substantially more trans-contusion communication. In order to translate our understanding of the neural substrates for functional recovery in the rat to the clinical arena, common outcome measures and imaging modalities are required. In the current study we furthered the exploration of one of these approaches, diffusion tensor magnetic resonance imaging (DTI), a technique now used commonly to image the brain in clinical research but rarely used diagnostically or prognostically for spinal cord injury. In the adult rat model of SCI, we found that hyper-acute (<3 hours post-injury) DTI of the lateral and ventral white matter at the injury epicenter was predictive of both electrophysiological and behavioral (locomotor) recovery at 4 weeks post-injury, despite the presence of flaccid paralysis/spinal shock. Regions of white matter with a minimum axial diffusivity of 1.5?m2/ms at 3 hours were able to conduct action potentials at 4 weeks, and axial diffusivity within the lateral funiculus was highly predictive of locomotor function at 4 weeks. These observations suggest that acute DTI should be useful to provide functional predictions for spared white matter following contusive spinal cord injuries clinically. PMID:22119625

Kim, Joong; Song, Sheng-Kwei; Burke, Darlene A.; Magnuson, David S. K.

2012-01-01

409

Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation  

Microsoft Academic Search

Fifty patients with thoracolumbar fractures were treated operatively between July 2000 and December 2001. The average age\\u000a of the patients was 33.6 years (range: 20–50 years), 36 were males and 14 were females and the follow-up averaged 59 months\\u000a (range: 49–68 months). A fall from a height, usually a tree, was the most common cause of injury. Twenty six patients had\\u000a unstable burst fractures

Mohammad F. Butt; Munir Farooq; Bashir Mir; Ahmad Shabir Dhar; Anwar Hussain; Mohammad Mumtaz

2007-01-01

410

Neural stem cells in models of spinal cord injury.  

PubMed

Replication of published studies is an important and respected aspect of the conduct of science. Most would argue that the interpretation of "negative" outcomes is still more challenging than the interpretation of "positive" findings, however, due to uncertainty in knowing precisely why a hypothesized outcome was not observed: in particular, are "negative" findings in replication studies a result of invalidity of the original experimental hypothesis, or due to a methodological failure, insensitivity of the applied instruments of analysis, or other factors? These points must be carefully considered. Steward and colleagues report findings of a study in which multipotent neural progenitor cells were grafted to sites of T3 complete transection. Unlike our study, cells failed to fill the lesion site, leaving collagenous rifts between rostral and caudal graft components. This "anatomical" failure precluded formation of neural relays across the lesion site, and was predictably associated with a failure to detect functional improvement. In summarizing outcomes of the study, Steward and colleagues did not clearly link the failure to achieve graft continuity in the lesion cavity with functional outcomes, despite the central role of this observation in cogently interpreting results of the replication study. In addition, the authors stated that they failed to replicate our report of "extensive" host axonal regeneration into grafts, but we did not report "extensive" host anatomical regeneration; moreover, underexposed images may have contributed to Steward's underestimation of host axonal penetration. The authors also stated that our original study excluded some animals from functional analysis, and this is incorrect. While replication studies are important and necessary, this particular report contained several errors, and the failure to form a continuous neural progenitor cell bridge across the lesion site limited the ability to conclude whether continuous grafts can restore function. In subsequent experiments we too have observed rift formation in animals grafted at long delays (>2weeks) after SCI, and we confirm that animals with rifts do not exhibit functional improvement; we are developing methods to remove or prevent rift formation. The replication study confirmed the cardinal finding of our original report: that early-stage neural precursors extend very large numbers of axons over remarkably long distances through the lesioned adult spinal cord. PMID:25079369

Tuszynski, Mark H; Wang, Yaozhi; Graham, Lori; McHale, Karla; Gao, Mingyong; Wu, Di; Brock, John; Blesch, Armin; Rosenzweig, Ephron S; Havton, Leif A; Zheng, Binhai; Conner, James M; Marsala, Martin; Lu, Paul

2014-11-01

411

A case report of spinal cord injury patient from a high velocity gunshot wound to the lumbar spine.  

PubMed

We report on operational and rehabilitation management, as well as the outcome, of a patient who with sustained spinal cord injury from a high velocity gunshot wound to the lumbar spine. More specifically, a patient with a gunshot wound to the spine is more likely to sustain a complete injury and have a poor prognosis. As such, there should be concerns regarding associated and extended injuries related to bullet fragmentation as well as the possibility of long-term sequelae. PMID:23526072

Kim, Juyong; Kim, Je Ho; Bang, Moon Suk

2013-02-01