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1

Spinal Cord Injury Map  

MedlinePLUS

Spinal Cord Injury Map Loss of function depends on what part of the spinal cord is damaged, as well ... control. Learn more about spinal cord injuries. A spinal cord injury affects the entire family FacingDisability is designed to ...

2

Spinal injury - resources  

MedlinePLUS

Resources - spinal injury ... The following organizations are a good resource for information on spinal injury : National Institute of Neurological Disorders and Stroke - www.ninds.nih.gov The National Spinal Cord Injury Association - ...

3

Spinal Cord Injury  

MedlinePLUS

... Types of illnesses and disabilities Spinal cord injury Spinal cord injury Read advice from Dr. Jeffrey Rabin , a pediatric ... your health on a daily basis. Living with spinal cord injury — your questions answered top What are pediatric rehabilitation ...

4

Spinal Cord Injury  

MedlinePLUS

NINDS Spinal Cord Injury Information Page Condensed from Spinal Cord Injury: Hope Through Research Table of Contents (click to jump to ... Trials Organizations Additional resources from MedlinePlus What is Spinal Cord Injury? A spinal cord injury usually begins with a ...

5

Spinal Cord Injuries  

MedlinePLUS

... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... down on the nerve parts that carry signals. Spinal cord injuries can be complete or incomplete. With a complete ...

6

Depression and Spinal Cord Injury  

MedlinePLUS

... Urinary Tract Infections: Indwelling (Foley) Catheter Depression and Spinal Cord Injury [ Download this pamphlet: “Depression and Spinal Cord Injury” (PDF - 477KB)] Depression is a common illness that ...

7

Spinal injuries in sports.  

PubMed

Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:19084763

Boden, Barry P; Jarvis, Christopher G

2009-02-01

8

Spinal injuries in sports.  

PubMed

Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:18295084

Boden, Barry P; Jarvis, Christopher G

2008-02-01

9

Living with Spinal Cord Injury  

MedlinePLUS

... techniques that may prevent injury and disease. A spinal cord injury (SCI) can result from trauma, such as a ... with daily living skills. What can persons with spinal cord injuries and their friends and families do? ? Get involved ...

10

Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

... is "Braingate" research? What is the status of stem-cell research? How would stem-cell therapies work in the treatment of spinal cord injuries? What does stem-cell research on animals tell us? When can we ...

11

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

12

What Is Spinal Cord Injury?  

MedlinePLUS

... NICHD Research Information Clinical Trials Resources and Publications Spinal Cord Injury (SCI): Condition Information Skip sharing on social media ... 3 National Institute of Neurological Disorders and Stroke. Spinal cord injury: Hope through research. Retrieved June 19 , 2013 , from ...

13

Spinal Cord Injury  

NSDL National Science Digital Library

This patient education program discusses how spinal cord injuries are caused and their treatment options. It also includes tips on how to prevent spinal cord injuries. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

14

Spinal Cord Injury Prevention Tips  

MedlinePLUS

Spinal Cord Injury Prevention Tips Preventing SCI Biking prevention tips While many cycling injuries are head injuries, the proper ... NeurosurgeryToday.org Every year, an estimated 11,000 spinal cord injury (SCI) accidents occur in the United States. Motor ...

15

Pediatric Spinal Cord Injury 101  

MedlinePLUS Videos and Cool Tools

... Pressure Sores Transition from Hospital to Home Spasticity, Physical Therapy-Lokomat Sex and Fertility After Spinal Cord ... How do spinal cord injuries before puberty affect physical growth and development? Can scoliosis be slowed or ...

16

Spinal cord injury in the rat  

Microsoft Academic Search

Only limited therapeutic measures are currently available for the treatment of spinal cord injury. This review describes the pathologic mechanisms of trauma-induced spinal cord injury in rats, which will contribute to new understanding of the pathologic process leading to spinal cord injury and to further development of new therapeutic strategies. Spinal cord injury induced by trauma is a consequence of

Yuji Taoka; Kenji Okajima

1998-01-01

17

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

18

Role of commercial drivers in motor vehicle related injuries in Ghana  

PubMed Central

Introduction—In many low income countries, commercial vehicles are the major source of motorized transport. Drivers of such vehicles may be an important focus for road safety efforts. Aims—An estimation of the percentage of motor vehicle related injuries that involved commercial vehicles in Ghana was sought. The knowledge, attitude, and practices of commercial drivers with regards to road safety was then evaluated. Methods—A community based survey was carried out, involving 21 105 persons. As well, focus group discussions were held with 30 commercial drivers. Results—In the survey, 122 motor vehicle related injuries were reported for the preceding year. The majority (81%) of these involved commercial vehicles, principally buses (40%) and taxis (24%). The involvement of commercial vehicles was the same for both motor vehicle crashes (81%) and pedestrian injuries (82%). However, motor vehicle related injuries in children were especially likely to involve commercial vehicles (95%), in comparison with adults (79%). The focus groups indicated that commercial drivers had a good general attitude towards road safety. Most believed that actions could be taken that would lower the risk of crashes and injuries, including vision examinations, using seat belts, and avoiding alcohol. However, this knowledge was not fully implemented. For example, few drivers had ever had their vision checked and most used seat belts only for long journeys. Conclusions—In Ghana, commercial drivers are an important group to target in road safety programs. They are also a potentially useful group to include in building coalitions to implement such road safety measures. PMID:10628914

Mock, C.; Amegashie, J.; Darteh, K.

1999-01-01

19

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 ...

20

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

21

Spinal Cord Injury (SCI)  

MedlinePLUS

... page: About CDC.gov . Injury Prevention & Control : Traumatic Brain Injury CDC's Injury Center Share Compartir This Page has ... redirected to a new page on the Traumatic Brain Injury website. If you have this page book marked, ...

22

Evaluation of spinal cord injury animal models  

PubMed Central

Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies. PMID:25598784

Zhang, Ning; Fang, Marong; Chen, Haohao; Gou, Fangming; Ding, Mingxing

2014-01-01

23

Motorcycle-related spinal injury: crash characteristics.  

PubMed

This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury. PMID:23036400

Zulkipli, Zarir Hafiz; Abdul Rahmat, Abdul Manap; Mohd Faudzi, Siti Atiqah; Paiman, Noor Faradila; Wong, Shaw Voon; Hassan, Ahamedali

2012-11-01

24

Erythropoietin in spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) is a devastating condition for individual patients and costly for health care systems requiring significant\\u000a long-term expenditures. Cytokine erythropoietin (EPO) is a glycoprotein mediating cytoprotection in a variety of tissues,\\u000a including spinal cord, through activation of multiple signaling pathways. It has been reported that EPO exerts its beneficial\\u000a effects by apoptosis blockage, reduction of inflammation, and

Georgios K. Matis; Theodossios A. Birbilis

2009-01-01

25

Vehicle Related Factors that Influence Injury Outcome in Head-On Collisions  

PubMed Central

This study specifically investigated a range of vehicle-related factors that are associated with a lower risk of serious or fatal injury to a belted driver in a head-on collision. This analysis investigated a range of structural characteristics, quantities that describes the physical features of a passenger vehicle, e.g., stiffness or frontal geometry. The study used a data-mining approach (classification tree algorithm) to find the most significant relationships between injury outcome and the structural variables. The algorithm was applied to 120,000 real-world, head-on collisions, from the National Highway Traffic Safety Administration’s (NHTSA’s) State Crash data files, that were linked to structural attributes derived from frontal crash tests performed as part of the USA New Car Assessment Program. As with previous literature, the analysis found that the heavier vehicles were correlated with lower injury risk to their drivers. This analysis also found a new and significant correlation between the vehicle’s stiffness and injury risk. When an airbag deployed, the vehicle’s stiffness has the most statistically significant correlation with injury risk. These results suggest that in severe collisions, lower intrusion in the occupant cabin associated with higher stiffness is at least as important to occupant protection as vehicle weight for self-protection of the occupant. Consequently, the safety community might better improve self-protection by a renewed focus on increasing vehicle stiffness in order to improve crashworthiness in head-on collisions. PMID:19026230

Blum, Jeremy J.; Scullion, Paul; Morgan, Richard M.; Digges, Kennerly; Kan, Cing-Dao; Park, Shinhee; Bae, Hanil

2008-01-01

26

Classification of pain following spinal cord injury  

Microsoft Academic Search

Pain continues to be a significant management problem in people with spinal cord injuries. Despite this there is little consensus regarding the nature, terminology and definitions of the various types of pain that occur following spinal cord injury. This has led to large variations in the reported incidence and prevalence of pain following spinal cord injury. Treatment studies have been

P J Siddall; D A Taylor; M J Cousins

1997-01-01

27

Pain following spinal cord injury  

Microsoft Academic Search

Chronic pain is an important problem following spinal cord injury (SCI) and is a major impediment to effective rehabilitation. The reported prevalence of chronic SCI pain is variable but averages 65% with around one third of these people rating their pain as severe. The mechanisms responsible for the presence of pain are poorly understood. However, evidence from clinical observations and

PJ Siddall; JD Loeser

2001-01-01

28

SPINAL CORD INJURY (SCI) DATABASE  

EPA Science Inventory

The National Spinal Cord Injury Database has been in existence since 1973 and captures data from SCI cases in the United States. Since its inception, 24 federally funded Model SCI Care Systems have contributed data to the National SCI Database. Statistics are derived from this da...

29

Rehabilitation of spinal cord injuries.  

PubMed

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye

2015-01-18

30

Psychological Aspects of Spinal Cord Injury  

ERIC Educational Resources Information Center

Reviewing literature on the psychological impact of spinal cord injury suggests: (a) depression may not be a precondition for injury adjustment; (b) many persons sustaining cord injury may have experienced psychological disruption prior to injury; and (c) indexes of rehabilitation success need to be developed for the spinal cord injured. (Author)

Cook, Daniel W.

1976-01-01

31

Bridging spinal cord injuries  

E-print Network

] describe a particular type of immature astrocyte that seems to provide a very successful bridging material. The idea of using embryonic CNS tissue and embryonic astrocytes for repairing the spinal cord has a long history. Axons grow in the embryonic CNS, so... at various mechanisms, including neutrali- zation of inhibitory molecules, promotion of plasticity, direct stimulation of axon regeneration, bridging and control of inflammation. A combination of two or more of these approaches will be needed to achieve...

2008-10-15

32

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 Fogaça; de Barros Filho, Tarcísio Eloy Pessoa; Marcon, Raphael Martus; Letaif, Olavo Biraghi; da Rocha, Ivan Dias

2012-01-01

33

Sexuality for women with spinal cord injury.  

PubMed

The authors conducted a review of the literature on women's sexuality after spinal cord injury, including studies from 1990 to 2011 retrieved from PubMed. Several facets of a woman's sexuality are negatively affected by after spinal cord injury, and consequently, sexual satisfaction has been shown to decrease, which also negatively affects quality of life. Neurogenic bladder is common after spinal cord injury, and the resulting urinary incontinence is a top therapeutic priority of this population. To improve sexual satisfaction and quality of life for women with spinal cord injury, future research needs to explore the effects of urinary incontinence on various aspects of sexuality. PMID:24325679

Cramp, Jackie D; Courtois, Frédérique J; Ditor, David S

2015-01-01

34

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

2015-03-11

35

Erythropoietin in spinal cord injury  

PubMed Central

Spinal cord injury (SCI) is a devastating condition for individual patients and costly for health care systems requiring significant long-term expenditures. Cytokine erythropoietin (EPO) is a glycoprotein mediating cytoprotection in a variety of tissues, including spinal cord, through activation of multiple signaling pathways. It has been reported that EPO exerts its beneficial effects by apoptosis blockage, reduction of inflammation, and restoration of vascular integrity. Neuronal regeneration has been also suggested. In the present review, the pathophysiology of SCI and the properties of endogenous or exogenously administered EPO are briefly described. Moreover, an attempt to present the current traumatic, ischemic and inflammatory animal models that mimic SCI is made. Currently, a clearly effective pharmacological treatment is lacking. It is highlighted that administration of EPO or other recently generated EPO analogues such as asialo-EPO and carbamylated-EPO demonstrate exceptional preclinical characteristics, rendering the evaluation of these tissue-protective agents imperative in human clinical trials. PMID:19030901

Birbilis, Theodossios A.

2008-01-01

36

Melatonin lowers edema after spinal cord injury  

PubMed Central

Melatonin has been shown to diminish edema in rats. Melatonin can be used to treat spinal cord injury. This study presumed that melatonin could relieve spinal cord edema and examined how it might act. Our experiments found that melatonin (100 mg/kg, i.p.) could reduce the water content of the spinal cord, and suppress the expression of aquaporin-4 and glial fibrillary acidic protein after spinal cord injury. This suggests that the mechanism by which melatonin alleviates the damage to the spinal cord by edema might be related to the expression of aquaporin-4 and glial fibrillary acidic protein. PMID:25657743

Li, Cheng; Chen, Xiao; Qiao, Suchi; Liu, Xinwei; Liu, Chang; Zhu, Degang; Su, Jiacan; Wang, Zhiwei

2014-01-01

37

How Is Spinal Cord Injury (SCI) Diagnosed?  

MedlinePLUS

... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved June 26, 2012, from ... sci.htm [top] University Specialty Clinics. (n.d.). Spinal cord injury . Retrieved June 26, 2012, from http://neurosurgery.med. ...

38

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

39

Nanomedicine for Treating Spinal Cord Injury  

PubMed Central

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

2015-01-01

40

Nanomedicine for treating spinal cord injury  

NASA Astrophysics Data System (ADS)

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.

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

2013-09-01

41

Spinal Cord Injury Medicine. 3. Rehabilitation Phase After Acute Spinal Cord Injury  

Microsoft Academic Search

Kirshblum SC, Priebe MM, Ho CH, Scelza WM, Chiodo AE, Wuermser LA. Spinal cord injury medicine. 3. Rehabilitation phase after acute spinal cord injury.This self-directed learning module highlights the rehabilitation aspects of care for people with traumatic spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees

Steven C. Kirshblum; Michael M. Priebe; Chester H. Ho; William M. Scelza; Anthony E. Chiodo; Lisa-Ann Wuermser

2007-01-01

42

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

43

Weight Management Following SCI (Spinal Cord Injury)  

MedlinePLUS

... changes, participation in physical activities, and long-term planning. As a person with spinal cord injury (SCI), you can benefit in many ways from a healthy weight management program. You may help... ... lower your risk for ...

44

Nutrition of People with Spinal Cord Injuries  

Technology Transfer Automated Retrieval System (TEKTRAN)

This conference proceeding summarizes current knowledge about the nutritional status and needs of the spinal cord injured patient. Topics covered include the aspects of spinal cord injury that influence nutrient intakes and status, and the nutrients most likely to be problematic in this diverse gro...

45

Depression following Traumatic Spinal Cord Injury  

Microsoft Academic Search

Objectives: To describe the epidemiology of depression following traumatic spinal cord injury (SCI) and identify risk factors associated with depression. Methods: This population-based cohort study followed individuals from date of SCI to 6 years after injury. Administrative data from a Canadian province with a universal publicly funded health care system and centralized databases were used. A Cox proportional hazards model

Donna M. Dryden; L. Duncan Saunders; Brian H. Rowe; Laura A. May; Niko Yiannakoulias; Lawrence W. Svenson; Donald P. Schopflocher; Donald C. Voaklander

2005-01-01

46

Employment Outcomes Following Spinal Cord Injury.  

ERIC Educational Resources Information Center

A study of 83 Australian adults with spinal cord injuries found that at least 56% had worked at some time post-injury and those who were working when surveyed had done so for an average of close to 10 years. Clerical, office, and administrative occupations proved to be the most suitable. (Author/CR)

Engel, S.; Murphy, G. S.; Athanasou, J. A.; Hickey, L.

1998-01-01

47

Pediatric motor vehicle related injuries in the Navajo Nation: the impact of the 1988 child occupant restraint laws  

PubMed Central

Background: Navajo motor vehicle mortality is the highest among the 12 Indian Health Service (IHS) administrative areas. In July 1988, the Navajo Nation enacted a primary enforcement safety belt use and a child restraint law. Objective: Assess the impact of the laws on the rate and severity of pediatric (0–19 years) motor vehicle injury resulting in hospitalizations in the Navajo Nation. Methods: Hospitalizations associated with motor vehicle related injury discharges were identified by International Classification of Diseases, 9th revision, CM E codes, 810–825 (.0,.1) from the Navajo IHS hospital discharge database. Age specific rates for the period before the law, 1983–88, were compared with those after enactment and enforcement, 1991–95. Severity of injury, measured by the abbreviated injury scale (AIS) score and new injury severity score (NISS), was determined with ICDMAP-90 software. Wilcoxon rank sum and ?2 tests were used for analysis. Results: Discharge rates (SE) for motor vehicle injury (per 100 000) decreased significantly in all age groups: 0–4 years (62 (7) to 28 (4)), 5–11 years (55.3 (6) to 26 (4)), and 15–19 years (139 (14) to 68 (7)); p=0.0001. In children 0–4 years, the median AIS score decreased from 1.5 (1,3) (25th, 75th centile) to 1 (1,2), p=0.06, and the median NISS decreased from 3.5 (1,9) to 2 (1,5), p=0.07. The proportion of children with NISS scores >4 decreased significantly for the 0–4 year age group (p=0.03). Conclusions: Concurrent with enactment of the Navajo Nation occupant and child restraint laws there was a reduction in the rate of motor vehicle related hospital discharges for children. Severity of injury declined in very young Navajo children. The effect of enactment and enforcement of this Native American child occupant restraint law may serve as an example of an effective injury control effort directed at Native American children. PMID:12226119

Phelan, K; Khoury, J; Grossman, D; Hu, D; Wallace, L; Bill, N; Kalkwarf, H

2002-01-01

48

Cell Cycle Activation and Spinal Cord Injury  

Microsoft Academic Search

Summary  Traumatic spinal cord injury (SCI) evokes a complex cascade of events with initial mechanical damage leading to secondary\\u000a injury processes that contribute to further tissue loss and functional impairment. Growing evidence suggests that the cell\\u000a cycle is activated following SCI. Up-regulation of cell cycle proteins after injury appears to contribute not only to apoptotic\\u000a cell death of postmitotic cells, including

Junfang Wu; Bogdan A. Stoica; Alan I. Faden

2011-01-01

49

Spinal Cord Injury: Facts and Figures at a Glance  

MedlinePLUS

Spinal Cord Injury Facts and Figures at a Glance https: / / www. nscisc. uab. edu February 2012 This is a ... derived from the National SCI Database. The National Spinal Cord Injury Database has been in existence since 1973 and ...

50

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 ...

51

Bowel management in spinal cord injury patients.  

PubMed

Spinal cord injuries are common in the United States, affecting approximately 12,000 people per year. Most of these patients lack normal bowel function. The pattern of dysfunction varies with the spinal level involved. Most patients use a bowel management program, and elements of successful programs are discussed. Surgical treatment, when indicated, could include sacral nerve stimulation, Malone antegrade continence enema, and colostomy. PMID:25320571

Hughes, Matthew

2014-09-01

52

Restoring walking after spinal cord injury.  

PubMed

One of the most obvious deficits following a spinal cord injury is the difficulty in walking, forcing many patients to use wheelchairs for locomotion. Over the past decade considerable effort has been directed at promoting the recovery of walking and to find effective treatments for spinal cord injury. Advances in our knowledge of the neuronal control of walking have led to the development of a promising rehabilitative strategy in patients with partial spinal cord injury, namely treadmill training with partial weight support. The current focus is on developing more efficient training protocols and automating the training to reduce the physical demand for the therapists. Mechanisms underlying training-induced improvements in walking have been revealed to some extent in animal studies. Another strategy for improving the walking in spinal cord injured patients is the use of functional electric stimulation of nerves and muscles to assist stepping movements. This field has advanced significantly over the past decade as a result of developments in computer technology and the miniaturization of electronics. Finally, basic research on animals with damaged spinal cords has focused on enhancing walking and other motor functions by promoting growth and regeneration of damaged axons. Numerous important findings have been reported yielding optimism that techniques for repairing the injured spinal cord will be developed in the near future. However, at present no strategy involving direct treatment of the injured spinal cord has been established for routine use in spinal cord injured patients. It now seems likely that any successful protocol in humans will require a combination of a treatment to promote re-establishing functional connections to neuronal networks in the spinal cord and specialized rehabilitation training to shape the motor patterns generated by these networks for specific behavioral tasks. PMID:15201036

Fouad, Karim; Pearson, Keir

2004-06-01

53

Chronic cervical spinal cord injury and autonomic hyperreflexia in rats  

E-print Network

Chronic cervical spinal cord injury and autonomic hyperreflexia in rats JOHN W. OSBORN, ROBERT F cervical spinal cord injury and autonomic hyperreflexia in rats. Am. J. Physiol. 258(Regulatory Integra spinal cord injury are proneto acute, marked,hypertensive episodes,i.e., autonomic hyperreflexia

Schramm, Lawrence P.

54

Sexuality Counseling with Clients Who Have Spinal Cord Injuries.  

ERIC Educational Resources Information Center

Examines effects of spinal cord injury on sexuality. Discusses areas of sexual concern. Provides suggestions for treating clients with spinal cord injuries experiencing sexual difficulties. Concludes that major goal in working with clients with spinal cord injuries who have sexual difficulties should be the facilitation of a creative and…

Farrow, Jeff

1990-01-01

55

Inflammation & apoptosis in spinal cord injury  

PubMed Central

Spinal cord injury (SCI) consists of a two-steps process involving a primary mechanical injury followed by an inflammatory process and apoptosis. Secondary insult is characterized by further destruction of neuronal and glial cells, and leads to expansion of the damage, so that the paralysis can extend to higher segments. With the identification of mechanisms that either promote or prevent neuronal inflammation and apoptosis come new approaches for preventing and treating neurodegenerative disorders. From a clinical perspective, this article discusses novel targets for the development of therapeutic agents that have the potential to protect the spinal cord from irreversible damage and promote functional recovery. PMID:22561613

Zhang, Ning; Yin, Ying; Xu, Sheng-Jie; Wu, Yong-Ping; Chen, Wei-Shan

2012-01-01

56

Urodynamic patterns after traumatic spinal cord injury.  

PubMed

Objectives To study the correlation between neurological level of spinal injury and bladder functions as detected by urodynamic study. Study design Analytical study. Setting and participants Seventy individuals with traumatic spinal cord injury (SCI) admitted to the Department of Physical Medicine and Rehabilitation, S.M.S. Medical College and Hospital, Jaipur. Detailed clinical, neurological evaluation as per American Spinal Injury Association Classification and radiological assessment were done along with clinical examination of bladder and urodynamic study. Results Out of 65 patients with suprasacral injuries, 53 (81.5%) demonstrated hyperreflexia with or without detrusor sphincter dyssynergia, 6 (9.2%) detrusor areflexia, and 6 (9.2%) had normal bladders, 41 (59.4%) low compliance (<20 ml/cmH2O), and 47 (72.30%) had high detrusor leak pint pressures (>40 cmH2O). Of the five patients with sacral injuries, one (20%) showed detrusor hyperreflexia, four (80%) detrusor areflexia, and one (20%) had low bladder compliance; all five (100%) had high detrusor leak point pressures. Conclusions The correlation between somatic neurologic findings, spinal imaging studies, and urodynamic findings in patients with SCI is not exact. Therefore, bladder management should not completely rely only on clinical bladder evaluation or neurological examination alone, but should always include urodynamic studies. PMID:24090106

Agrawal, Mahima; Joshi, Mrinal

2015-03-01

57

Neurologic recovery after traumatic spinal cord injury: data from the model spinal cord injury systems  

Microsoft Academic Search

Objective: To present data on neurologic recovery gathered by the Model Spinal Cord Injury (SCI) Systems over a 10-year period.Design: Case series.Setting: Twenty-one Model SCI Systems.Patients: A total of 3,585 individuals with traumatic SCI admitted between January 1, 1988 and December 31, 1997.Main Outcome Measures: Neurologic impairment category; Frankel grade; American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade; motor

Ralph J. Marino; John F. Ditunno; William H. Donovan; Frederick Maynard

1999-01-01

58

Upper extremity pain after spinal cord injury  

Microsoft Academic Search

Objective: Patients with spinal cord injury (SCI) may complain of upper extremity (UE) pain. The purpose of this study was to determine the frequency and severity of UE pain as well as its association with functional activities. Types of treatments that SCI patients received for UE pain and the benefits of these treatments were also identified. Study design and methods:

M Dalyan; DD Cardenas; B Gerard

1999-01-01

59

Spinal cord injury (SCI)—Prehospital management  

Microsoft Academic Search

Up to 20,000 patients annually suffer from spinal cord injury (SCI) and 20% of these die before being admitted to the hospital in the United States as well as in the European Union. Prehospital management of SCI is of critical importance since 25% of SCI damage may occur or be aggravated after the initial event. Prehospital management includes examination of

Michael Bernhard; Andr ´ e Gries; Paul Kremer

2005-01-01

60

Accommodating Workers with Spinal Cord Injury.  

ERIC Educational Resources Information Center

Examination of over 1,000 calls to the Job Accommodation Network involving workers with spinal cord injury identified the nature of the industry, job, career progression, and accessibility solutions. The number of calls increased dramatically after passage of the Americans with Disabilities Act. (SK)

Dowler, Denetta; Batiste, Linda; Whidden, Eddie

1998-01-01

61

Cardiac dysfunctions following spinal cord injury  

PubMed Central

The aim of this article is to analyze cardiac dysfunctions occurring after spinal cord injury (SCI). Cardiac dysfunctions are common complications following SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. We reviewed epidemiology of cardiac disturbances after SCI, and neuroanatomy and pathophysiology of autonomic nervous system, sympathetic and parasympathetic. SCI causes disruption of descendent pathways from central control centers to spinal sympathetic neurons, originating into intermediolateral nuclei of T1–L2 spinal cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant cardiac dysfunction. Impairment of autonomic nervous control system, mostly in patients with cervical or high thoracic SCI, causes cardiac dysrrhythmias, especially bradycardia and, rarely, cardiac arrest, or tachyarrhytmias and hypotension. Specific complication dependent on the period of time after trauma like spinal shock and autonomic dysreflexia are also reviewed. Spinal shock occurs during the acute phase following SCI and is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe bradycardia and hypotension. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a life–threatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5–T6). Besides all this, additional cardiac complications, such as cardiac deconditioning and coronary heart disease may also occur. Proper prophylaxis, including nonpharmacologic and pharmacological strategies and cardiac rehabilitation diminish occurrence of the cardiac dysfunction following SCI. Each type of cardiac disturbance requires specific treatment. PMID:20108532

Sandu, AM; Popescu, M; Iacobini, MA; Stoian, R; Neascu, C; Popa, F

2009-01-01

62

Endogenous Repair after Spinal Cord Contusion Injuries in the Rat  

Microsoft Academic Search

Contusion injuries of the rat thoracic spinal cord were made using a standardized device developed for the Multicenter Animal Spinal Cord Injury Study (MASCIS). Lesions of different severity were studied for signs of endogenous repair at times up to 6 weeks following injury. Contusion injuries produced a typical picture of secondary damage resulting in the destruction of the cord center

M. S. Beattie; J. C. Bresnahan; J. Komon; C. A. Tovar; M. Van Meter; D. K. Anderson; A. I. Faden; C. Y. Hsu; L. J. Noble; S. Salzman; W. Young

1997-01-01

63

Vascular dysfunctions following spinal cord injury  

PubMed Central

The aim of this article is to analyze the vascular dysfunctions occurring after spinal cord injury (SCI). Vascular dysfunctions are common complications of SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. Neuroanatomy and physiology of autonomic nervous system, sympathetic and parasympathetic, is reviewed. SCI implies disruption of descendent pathways from central centers to spinal sympathetic neurons, originating in intermediolateral nuclei of T1–L2 cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant vascular dysfunction. Spinal shock occurs during the acute phase following SCI and it is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe arterial hypotension and bradycardia. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a life–threatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5–T6). Arterial hypotension with orthostatic hypotension occurs in both acute and chronic phases. The etiology is multifactorial. We described a few factors influencing the orthostatic hypotension occurrence in SCI: sympathetic nervous system dysfunction, low plasma catecholamine levels, rennin–angiotensin–aldosterone activity, peripheral alpha–adrenoceptor hyperresponsiveness, impaired function of baroreceptors, hyponatremia and low plasmatic volume, cardiovascular deconditioning, morphologic changes in sympathetic neurons, plasticity within spinal circuits, and motor deficit leading to loss of skeletal muscle pumping activity. Additional associated cardiovascular concerns in SCI, such as deep vein thrombosis and long–term risk for coronary heart disease and systemic atherosclerosis are also described. Proper prophylaxis, including non–pharmacologic and pharmacological strategies, diminishes the occurrence of the vascular dysfunction following SCI. Each vascular disturbance requires a specific treatment. PMID:20945818

Popa, F; Grigorean, VT; Onose, G; Sandu, AM; Popescu, M; Burnei, G; Strambu, V; Sinescu, C

2010-01-01

64

Neural plasticity after spinal cord injury?  

PubMed Central

Plasticity changes of uninjured nerves can result in a novel neural circuit after spinal cord injury, which can restore sensory and motor functions to different degrees. Although processes of neural plasticity have been studied, the mechanism and treatment to effectively improve neural plasticity changes remain controversial. The present study reviewed studies regarding plasticity of the central nervous system and methods for promoting plasticity to improve repair of injured central nerves. The results showed that synaptic reorganization, axonal sprouting, and neurogenesis are critical factors for neural circuit reconstruction. Directed functional exercise, neurotrophic factor and transplantation of nerve-derived and non-nerve-derived tissues and cells can effectively ameliorate functional disturbances caused by spinal cord injury and improve quality of life for patients.

Liu, Jian; Yang, Xiaoyu; Jiang, Lianying; Wang, Chunxin; Yang, Maoguang

2012-01-01

65

Pediatric spinal cord injury: a review by organ system.  

PubMed

In this article, an overview is provided of pediatric spinal cord injury, organized by effects of this injury on various organ systems. Specific management differences between children and adults with spinal cord injury are highlighted. A detailed management approach is offered for particularly complex topics, such as spasticity and upper extremity reconstruction. PMID:25479784

Powell, Aaron; Davidson, Loren

2015-02-01

66

Role of neutrophils in spinal cord injury in the rat  

Microsoft Academic Search

Activated neutrophils are thought to be involved in tissue injury through the release of various inflammatory mediators. To understand the role of neutrophils in spinal cord injury, the effects of nitrogen mustard-induced leukocyte depletion and the administration of an anti-P-selectin monoclonal antibody on motor disturbances observed following spinal cord compression were examined in rats. Spinal cord injury was induced by

Y Taoka; K Okajima; M Uchiba; K Murakami; S Kushimoto; M Johno; M Naruo; H Okabe; K Takatsuki

1997-01-01

67

Recent demographic and injury trends in people served by the model spinal cord injury care systems  

Microsoft Academic Search

Objective: To identify trends in the demographic and injury data of persons with spinal cord injury (SCI).Design: Consecutive case series.Settings: Model Spinal Cord Injury Care Systems throughout the United States.Patients: A total of 25,054 persons admitted to a Model Spinal Cord Injury Care System within 365 days of injury between 1973 and 1998.Results: Many trends and changes have been noted

Austin I. Nobunaga; Bette K. Go; Rosalie B. Karunas

1999-01-01

68

Spinal Column and Spinal Cord Injuries in Mountain BikersA 13Year Review  

Microsoft Academic Search

Background: Multiple studies have described in general the injuries associated with mountain biking, and detailed accounts of spine injuries sustained in hockey, gymnastics, skiing, snowboarding, rugby, and paragliding have previously been published. However, no large-scale detailed assessment of mountain biking associated spinal fractures and spinal cord injuries has previously been published.Purpose: This study was undertaken to describe the patient demographics,

Emily R. Dodwell; Brian K. Kwon; Barbara Hughes; David Koo; Andrea Townson; Allan Aludino; Richard K. Simons; Charles G. Fisher; Marcel F. Dvorak; Vanessa K. Noonan

2010-01-01

69

Spinal cord injury, immunodepression, and antigenic challenge.  

PubMed

The inability to effectively control microbial infection is a leading cause of morbidity and mortality in individuals affected by spinal cord injury (SCI). Available evidence from clinical studies as well as animal models of SCI demonstrate that increased susceptibility to infection is derived from disruption of central nervous system (CNS) communication with the host immune system that ultimately leads to immunodepression. Understanding the molecular and cellular mechanisms governing muted cellular and humoral responses that occur post-injury resulting in impaired host defense following infection is critical for improving the overall quality of life of individuals with SCI. This review focuses on studies performed using preclinical animal models of SCI to evaluate how injury impacts T and B lymphocyte responses following either viral infection or antigenic challenge. PMID:24747011

Held, Katherine S; Lane, Thomas E

2014-10-01

70

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

71

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

72

Current therapeutic strategies for inflammation following traumatic spinal cord injury?  

PubMed Central

Damage from spinal cord injury occurs in two phases – the trauma of the initial mechanical insult and a secondary injury to nervous tissue spared by the primary insult. Apart from damage sustained as a result of direct trauma to the spinal cord, the post-traumatic inflammatory response contributes significantly to functional motor deficits exacerbated by the secondary injury. Attenuating the detrimental aspects of the inflammatory response is a promising strategy to potentially ameliorate the secondary injury, and promote significant functional recovery. This review details how the inflammatory component of secondary injury to the spinal cord can be treated currently and in the foreseeable future. PMID:25624806

Singh, Priyanka L.; Agarwal, Nitin; Barrese, James C.; Heary, Robert F.

2012-01-01

73

Pregabalin as a neuroprotector after spinal cord injury in rats  

Microsoft Academic Search

The over-expression of excitotoxic neurotransmitter, such as glutamate, is an important mechanism of secondary injury after\\u000a spinal cord injury. The authors examined the neuroprotective effect of pregabalin (GP) which is known as to reduce glutamate\\u000a secretion, in a rat model of spinal cord injury. Thirty-two male Sprague–Dawley rats were randomly allocated to four groups;\\u000a the control group (contusion injury only),

Kee-Yong Ha; Young-Hoon Kim; Kee-Won Rhyu; Soon-Eok Kwon

2008-01-01

74

Spinal cord injury medicine and rehabilitation.  

PubMed

The rehabilitation of spinal cord injury (SCI) is a complicated process, but one in which new research is developing novel and increasingly promising methods of restorative neurology. Spinal cord injury medicine addresses not only the neurologic injury, but all the secondary complications in other organ systems whose regulation is disrupted after SCI. To some degree, the rehabilitation of SCI is focused on return to the community and functional goals are paramount, regardless of whether they can be achieved through some mechanism of compensation or due to a growing effort at engendering neurologic plasticity and recovery. The authors present a typical case of cervical incomplete SCI and discuss the medical complications and considerations for care during acute rehabilitation. They also review current methods of planning and executing rehabilitation, along with emerging methods that are leading to, in varying degrees, greater neurologic recovery. Finally, new approaches in SCI rehabilitation, namely neuromodulation, are discussed as efforts are made to further augment neural plasticity and recovery in SCI. PMID:25520024

Stampas, Argyrios; Tansey, Keith E

2014-11-01

75

Spinal Cord Injury Reveals Multilineage Differentiation of Ependymal Cells  

Microsoft Academic Search

Spinal cord injury often results in permanent functional impairment. Neural stem cells present in the adult spinal cord can be expanded in vitro and improve recovery when transplanted to the injured spinal cord, demonstrating the presence of cells that can promote regeneration but that normally fail to do so efficiently. Using genetic fate mapping, we show that close to all

Konstantinos Meletis; Fanie Barnabé-Heider; Marie Carlén; Emma Evergren; Nikolay Tomilin; Oleg Shupliakov; Jonas Frisén

2008-01-01

76

Autonomic consequences of spinal cord injury.  

PubMed

Spinal cord injury (SCI) results not only in motor and sensory deficits but also in autonomic dysfunctions. The disruption of connections between higher brain centers and the spinal cord, or the impaired autonomic nervous system itself, manifests a broad range of autonomic abnormalities. This includes compromised cardiovascular, respiratory, urinary, gastrointestinal, thermoregulatory, and sexual activities. These disabilities evoke potentially life-threatening symptoms that severely interfere with the daily living of those with SCI. In particular, high thoracic or cervical SCI often causes disordered hemodynamics due to deregulated sympathetic outflow. Episodic hypertension associated with autonomic dysreflexia develops as a result of massive sympathetic discharge often triggered by unpleasant visceral or sensory stimuli below the injury level. In the pelvic floor, bladder and urethral dysfunctions are classified according to upper motor neuron versus lower motor neuron injuries; this is dependent on the level of lesion. Most impairments of the lower urinary tract manifest in two interrelated complications: bladder storage and emptying. Inadequate or excessive detrusor and sphincter functions as well as detrusor-sphincter dyssynergia are examples of micturition abnormalities stemming from SCI. Gastrointestinal motility disorders in spinal cord injured-individuals are comprised of gastric dilation, delayed gastric emptying, and diminished propulsive transit along the entire gastrointestinal tract. As a critical consequence of SCI, neurogenic bowel dysfunction exhibits constipation and/or incontinence. Thus, it is essential to recognize neural mechanisms and pathophysiology underlying various complications of autonomic dysfunctions after SCI. This overview provides both vital information for better understanding these disorders and guides to pursue novel therapeutic approaches to alleviate secondary complications. PMID:25428850

Hou, Shaoping; Rabchevsky, Alexander G

2014-10-01

77

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

78

Natural Polyphenols and Spinal Cord Injury  

PubMed Central

Polyphenols have been shown to have some of the neuroprotective effects against neurodegenerative diseases. These effects are attributed to a variety of biological activities, including free radical scavenging/antioxidant and anti-inflammatory and anti-apoptotic activities. In this regard, many efforts have been made to study the effects of various well-known dietary polyphenols on spinal cord injury (SCI) and to explore the mechanisms behind the neuroprotective effects. The aim of this paper is to present the mechanisms of neuroprotection of natural polyphenols used in animal models of SCI. PMID:24842137

Khalatbary, Ali Reza

2014-01-01

79

Diaphragmatic pacing in spinal cord injury.  

PubMed

After cervical spinal cord injuries, many patients are unable to sustain independent ventilation because of a disruption of diaphragm innervation and respiratory functioning. If phrenic nerve function is preserved, the patient may be able to tolerate exogenous pacing of the diaphragm via electrical stimulation. Previously this was accomplished by stimulation directly to the phrenic nerves, but may be accomplished less invasively by percutaneously stimulating the diaphragm itself. The benefits, when compared with mechanical ventilation, include a lower rate of pulmonary complications, improved venous return, more normal breathing and speech, facilitation of eating, cost-effectiveness, and increased patient mobility. PMID:25064791

Dalal, Kevin; DiMarco, Anthony F

2014-08-01

80

Writing Nutrition Practice Guidelines for Spinal Cord Injury  

Microsoft Academic Search

A task force has been developed under the direction of Dietetics Practice Group-Dietetics in Physical Medicine and Rehabilitation to develop and publish through the ADA, nutrition practice guidelines for spinal cord injury (SCI). Spinal cord injury affects over 10,000 persons in the United States each year. High costs associated with problems that result when medical nutrition therapy (MNT) is not

A. Paison; Erin DeDecker; Carolyn Wyly

1999-01-01

81

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

82

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

83

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

84

Shriners Hospital Spinal Cord Injury Self Care Manual.  

ERIC Educational Resources Information Center

This manual is intended for young people with spinal cord injuries who are receiving rehabilitation services within the Spinal Cord Injury Unit at Shriners Hospital (San Francisco, California). An introduction describes the rehabilitation program, which includes family conferences, an individualized program, an independent living program,…

Fox, Carol

85

International bowel function basic spinal cord injury data set  

Microsoft Academic Search

Study design:International expert working group.Objective:To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research.Setting:Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).Methods:A

K Krogh; I Perkash; S A Stiens; F Biering-Sørensen

2009-01-01

86

International bowel function extended spinal cord injury data set  

Microsoft Academic Search

Study design:International expert working group.Objective:To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function.Setting:Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).Methods:A draft prepared by the working group

K Krogh; I Perkash; S A Stiens; F Biering-Sørensen

2009-01-01

87

Cellular therapies for treating pain associated with spinal cord injury  

PubMed Central

Spinal cord injury leads to immense disability and loss of quality of life in human with no satisfactory clinical cure. Cell-based or cell-related therapies have emerged as promising therapeutic potentials both in regeneration of spinal cord and mitigation of neuropathic pain due to spinal cord injury. This article reviews the various options and their latest developments with an update on their therapeutic potentials and clinical trialing. PMID:22394650

2012-01-01

88

Epidemiology of spinal cord injuries in the 2005 Pakistan earthquake  

Microsoft Academic Search

Study design:Prospective observational study.Objectives:To identify the epidemiological features specific to spinal injuries as a result of an earthquake.Settings:Rawalpindi, Pakistan in the months after the 8 October 2005 earthquake.Methods:In the month after the earthquake, the one established rehabilitation center was augmented with two makeshift spinal cord centers. Information on mechanism of injury, mode of evacuation, associated injuries was gathered, and a

M F A Rathore; P Rashid; A W Butt; A A Malik; Z A Gill; A J Haig; MFA Rathore

2007-01-01

89

76 FR 71623 - Agency Information Collection (Spinal Cord Injury Patient Care Survey) Under OMB Review  

Federal Register 2010, 2011, 2012, 2013, 2014

...Agency Information Collection (Spinal Cord Injury Patient Care Survey) Under OMB...SUPPLEMENTARY INFORMATION: Title: Spinal Cord Injury Patient Care Survey, VA Form...10-0515 will be used to determine spinal cord patients' satisfaction...

2011-11-18

90

76 FR 56504 - Proposed Information Collection (Spinal Cord Injury Patient Care Survey) Activity: Comment Request  

Federal Register 2010, 2011, 2012, 2013, 2014

...Proposed Information Collection (Spinal Cord Injury Patient Care Survey) Activity...information technology. Title: Spinal Cord Injury Patient Care Survey, VA Form...10-0515 will be used to determine spinal cord patients' satisfaction...

2011-09-13

91

Polyethylene glycol immediately repairs neuronal membranes and inhibits free radical production after acute spinal cord injury  

E-print Network

after acute spinal cord injury Jian Luo, Richard Borgens and Riyi Shi Department of Basic Medical and their processes after traumatic spinal cord injury. Using an in vitro guinea pig spinal cord injury model, we have an important causal effect of membrane disruption in generating ROS in spinal cord injury, suggesting membrane

Shi, Riyi

92

Autonomic dysreflexia in a mouse model of spinal cord injury.  

PubMed

Most experimental studies of spinal cord injury have centered on the rat as an experimental model. A shift toward a mouse model has occurred in recent years because of its usefulness as a genetic tool. While many studies have concentrated on motor function and the inflammatory response following spinal cord injury in the mouse, the development of autonomic dysreflexia after injury has yet to be described. Autonomic dysreflexia is a condition in which episodic hypertension develops after injuries above the mid-thoracic segment of the spinal cord. In this study 129Sv mice received a spinal cord transection at the second thoracic segment. The presence of autonomic dysreflexia was assessed 2 weeks later. Blood pressure responses to stimulation were as follows: moderate cutaneous pinch caudal to the injury (35+/-6 mm Hg), tail pinch (25+/-7 mm Hg), and a 0.3 ml balloon distension of the colon (37+/-4 mm Hg). Previous reports have suggested that small diameter primary afferent fiber sprouting after spinal cord injury may be responsible for the development of autonomic dysreflexia. In order to determine whether autonomic dysreflexia in the mouse may be caused by a similar mechanism, the size of the small diameter primary afferent arbor in spinal cord-injured and sham-operated animals was assessed by measuring the area occupied by calcitonin gene-related peptide-immunoreactive fibers. The percentage increase in the area of the small diameter primary afferent arbor in transected over sham-operated spinal cords was 46%, 45% and 80% at spinal segments thoracic T5-8, thoracic T9-12 and thoracic T13-lumbar L2 respectively. This study demonstrates the development of autonomic dysfunction in a mouse model of spinal cord injury that is associated with sprouting of calcitonin gene-related peptide fibers. These results provide strong support for the use of this mouse model of spinal cord injury in the study of autonomic dysreflexia. PMID:11738503

Jacob, J E; Pniak, A; Weaver, L C; Brown, A

2001-01-01

93

Optical measurement of blood flow changes in spinal cord injury  

NASA Astrophysics Data System (ADS)

Little is known about cell death in spinal cord tissue following compression injury, despite compression being a key component of spinal injuries. Currently models are used to mimic compression injury in animals and the effects of the compression evaluated by observing the extent and duration of recovery of normal motor function in the days and weeks following the injury. A fibreoptic photoplethysmography system was used to investigate whether pulsation of the small arteries in the spinal cord occurred before, during and after compressive loads were applied to the tissue. It was found that the signal amplitudes were reduced and this reduction persisted for at least five minutes after the compression ceased. It is hoped that results from this preliminary study may improve knowledge of the mechanism of spinal cord injury.

Phillips, J. P.; Kyriacou, P. A.; George, K. J.; Langford, R. M.

2010-07-01

94

Degenerative and regenerative mechanisms governing spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) is a major cause of disability, and at present, there is no universally accepted treatment. The functional decline following SCI is contributed to both direct mechanical injury and secondary pathophysiological mechanisms that are induced by the initial trauma. These mechanisms initially involve widespread haemorrhage at the site of injury and necrosis of central nervous system (CNS)

Christos Profyris; Surindar S Cheema; DaWei Zang; Michael F Azari; Kristy Boyle; Steven Petratos

2004-01-01

95

Rehabilitation of a child with a spinal cord injury  

Microsoft Academic Search

The incidence and sex distribution of spinal cord injury (SCI) changes with age. Motor vehicle accidents, bicycle accidents, sports accidents, and violence are major causes in the pediatric population. Pulmonary complications may be severe and life-threatening in the acute phase. Chronically, the degree of ventilatory support needed depends on the level of the injury, with high cervical injuries typically requiring

Kathryn Zidek; Rajashree Srinivasan

2003-01-01

96

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

97

Self-Esteem Differences among Persons with Spinal Cord Injury.  

ERIC Educational Resources Information Center

Surveyed 63 people with spinal cord injury (SCI) in either their first, second, or fifth year post-injury. Results indicated that perceived levels of self-esteem decreased following the SCI. Found that self-esteem was lowest in the second year of injury. Self-esteem may be connected to loss of employment. (RJM)

Marini, Irmo; And Others

1995-01-01

98

Optogenetics Applications for Treating Spinal Cord Injury  

PubMed Central

Cases of spinal cord injury (SCI) are increasing all over the world; and in USA alone, there are 273,000 patients, which not only leads to morbidity and mortality but also results in a great economic burden. Many approaches are being used at the pre-clinical and clinical level to treat SCI including therapeutic agents, surgical decompression, stem cell therapy etc. Recently, a new approach called optogenetics has emerged in which light sensitive proteins are used to switch neurons on and off, and this approach has great potential to be used as therapy due to its specificity and rapid response in milliseconds. Few animal studies have been performed so far in which the respiratory and bladder function of rats was restored through the use of optogenetics. On the basis of promising results obtained, in the future, this approach can prove to be a valuable tool to treat patients with SCI.

Ashraf, Sadia; Komai, Shoji

2015-01-01

99

Current and future surgery strategies for spinal cord injuries.  

PubMed

Spinal cord trauma is a prominent cause of mortality and morbidity. In developed countries a spinal cord injury (SCI) occurs every 16 min. SCI occurs due to tissue destruction, primarily by mechanical and secondarily ischemic. Primary damage occurs at the time of the injury. It cannot be improved. Following the primary injury, secondary harm mechanisms gradually result in neuronal death. One of the prominent causes of secondary harm is energy deficit, emerging from ischemia, whose main cause in the early stage, is impaired perfusion. Due to the advanced techniques in spinal surgery, SCI is still challenging for surgeons. Spinal cord doesn't have a self-repair property. The main damage occurs at the time of the injury primarily by mechanical factors that cannot be improved. Secondarily mechanisms take part in the following sections. Spinal compression and neurological deficit are two major factors used to decide on surgery. According to advanced imaging techniques the classifications systems for spinal injury has been changed in time. Aim of the surgery is to decompress the spinal channel and to restore the spinal alinement and mobilize the patient as soon as possible. Use of neuroprotective agents as well as methods to achieve cell regeneration in addition to surgery would contribute to the solution. PMID:25621209

Dalbayrak, Sedat; Yaman, Onur; Y?lmaz, Tevfik

2015-01-18

100

Outcome Measures in Spinal Cord Injury  

PubMed Central

Study Design review by the Spinal Cord Outcomes Partnership Endeavor (SCOPE), which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. Objectives assessment of current and evolving tools for evaluating human spinal cord injury (SCI) outcomes for both clinical diagnosis and clinical research studies. Methods a framework for the appraisal of evidence of metric properties was used to examine outcome tools or tests for accuracy, sensitivity, reliability and validity for human SCI. Results imaging, neurological, functional, autonomic, sexual health, bladder/bowel, pain, and psycho-social tools were evaluated. Several specific tools for human SCI studies have or are being developed to allow the more accurate determination for a clinically meaningful benefit (improvement in functional outcome or quality of life) being achieved as a result of a therapeutic intervention. Conclusion significant progress has been made, but further validation studies are required to identify the most appropriate tools for specific targets in a human SCI study or clinical trial. PMID:19381157

Alexander, Marcalee S.; Anderson, Kim; Biering-Sorensen, Fin; Blight, Andrew R.; Brannon, Ruth; Bryce, Thomas; Creasey, Graham; Catz, Amiram; Curt, Armin; Donovan, William; Ditunno, John; Ellaway, Peter; Finnerup, Nanna B.; Graves, Daniel E.; Haynes, Beth Ann; Heinemann, Allen W.; Jackson, Amie B.; Johnston, Mark; Kalpakjian, Claire Z.; Kleitman, Naomi; Krassioukov, Andrei; Krogh, Klaus; Lammertse, Daniel; Magasi, Susan; Mulcahey, MJ; Schurch, Brigitte; Sherwood, Arthur; Steeves, John D.; Stiens, Steven; Tulsky, David S.; van Hedel, Hubertus J.A.; Whiteneck, Gale

2009-01-01

101

Neuroprotection and its molecular mechanism following spinal cord injury?  

PubMed Central

Acute spinal cord injury initiates a complex cascade of molecular events termed ‘secondary injury’, which leads to progressive degeneration ranging from early neuronal apoptosis at the lesion site to delayed degeneration of intact white matter tracts, and, ultimately, expansion of the initial injury. These secondary injury processes include, but are not limited to, inflammation, free radical-induced cell death, glutamate excitotoxicity, phospholipase A2 activation, and induction of extrinsic and intrinsic apoptotic pathways, which are important targets in developing neuroprotective strategies for treatment of spinal cord injury. Recently, a number of studies have shown promising results on neuroprotection and recovery of function in rodent models of spinal cord injury using treatments that target secondary injury processes including inflammation, phospholipase A2 activation, and manipulation of the PTEN-Akt/mTOR signaling pathway. The present review outlines our ongoing research on the molecular mechanisms of neuroprotection in experimental spinal cord injury and briefly summarizes our earlier findings on the therapeutic potential of pharmacological treatments in spinal cord injury. PMID:25624837

Liu, Nai-Kui; Xu, Xiao-Ming

2012-01-01

102

Radionuclide assessment of heterotopic ossification in spinal cord injury patients  

SciTech Connect

Whole body /sup 99m/T-pyrophosphate bone scans were obtained and correlated with skeletal radiographs for detection of heterotopic ossification in 135 spinal injury patients. There were 40 patients with recent injury (less than 6 months) and 95 with injury of over 6 months duration. Heterotopic new bone was detected on the bone scan in 33.7% of 95 patients with spinal cord injuries of more than 6 months duration and 30% of 40 patients with injuries of less than 6 months. The radionuclide scan was found to be useful in detection of heterotopic ossification at its early stage and in its differentiation from other complications in spinal cord injury patients.

Prakash, V.

1983-01-01

103

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, Björn; Dierks, Thomas; Schachner, Melitta

2013-01-01

104

Acute complications of spinal cord injuries.  

PubMed

The aim of this paper is to give an overview of acute complications of spinal cord injury (SCI). Along with motor and sensory deficits, instabilities of the cardiovascular, thermoregulatory and broncho-pulmonary system are common after a SCI. Disturbances of the urinary and gastrointestinal systems are typical as well as sexual dysfunction. Frequent complications of cervical and high thoracic SCI are neurogenic shock, bradyarrhythmias, hypotension, ectopic beats, abnormal temperature control and disturbance of sweating, vasodilatation and autonomic dysreflexia. Autonomic dysreflexia is an abrupt, uncontrolled sympathetic response, elicited by stimuli below the level of injury. The symptoms may be mild like skin rash or slight headache, but can cause severe hypertension, cerebral haemorrhage and death. All personnel caring for the patient should be able to recognize the symptoms and be able to intervene promptly. Disturbance of respiratory function are frequent in tetraplegia and a primary cause of both short and long-term morbidity and mortality is pulmonary complications. Due to physical inactivity and altered haemostasis, patients with SCI have a higher risk of venous thromboembolism and pressure ulcers. Spasticity and pain are frequent complications which need to be addressed. The psychological stress associated with SCI may lead to anxiety and depression. Knowledge of possible complications during the acute phase is important because they may be life threatening and/ or may lead to prolonged rehabilitation. PMID:25621207

Hagen, Ellen Merete

2015-01-18

105

Acute complications of spinal cord injuries  

PubMed Central

The aim of this paper is to give an overview of acute complications of spinal cord injury (SCI). Along with motor and sensory deficits, instabilities of the cardiovascular, thermoregulatory and broncho-pulmonary system are common after a SCI. Disturbances of the urinary and gastrointestinal systems are typical as well as sexual dysfunction. Frequent complications of cervical and high thoracic SCI are neurogenic shock, bradyarrhythmias, hypotension, ectopic beats, abnormal temperature control and disturbance of sweating, vasodilatation and autonomic dysreflexia. Autonomic dysreflexia is an abrupt, uncontrolled sympathetic response, elicited by stimuli below the level of injury. The symptoms may be mild like skin rash or slight headache, but can cause severe hypertension, cerebral haemorrhage and death. All personnel caring for the patient should be able to recognize the symptoms and be able to intervene promptly. Disturbance of respiratory function are frequent in tetraplegia and a primary cause of both short and long-term morbidity and mortality is pulmonary complications. Due to physical inactivity and altered haemostasis, patients with SCI have a higher risk of venous thromboembolism and pressure ulcers. Spasticity and pain are frequent complications which need to be addressed. The psychological stress associated with SCI may lead to anxiety and depression. Knowledge of possible complications during the acute phase is important because they may be life threatening and/ or may lead to prolonged rehabilitation. PMID:25621207

Hagen, Ellen Merete

2015-01-01

106

Molecular basis of vascular events following spinal cord injury  

PubMed Central

The aim of this article is to analyze the effects of the molecular basis of vascular events following spinal cord injury and their contribution in pathogenesis. First of all, we reviewed the anatomy of spinal cord vessels. The pathophysiology of spinal cord injuries revealed two types of pathogenic mechanisms. The primary event, the mechanic trauma, results in a disruption of neural and vascular structures into the spinal cord. It is followed by secondary pathogenesis that leads to the progression of the initial lesion. We reviewed vascular responses following spinal cord injury, focusing on both primary and secondary events. The intraparenchymal hemorrhage is a direct consequence of trauma; it has a typical pattern of distribution into the contused spinal cord, inside the gray matter and, it is radially extended into the white matter. The intraparenchymal hemorrhage is restricted to the dorsal columns, into adjacent rostral and caudal spinal segments. Distribution of chronic lesions overlaps the pattern of the early intraparenchymal hemorrhage. We described the mechanisms of action, role, induction and distribution of the heme oxygenase isoenzymes 1 and 2. Posttraumatic inflammatory response contributes to secondary pathogenesis. We analyzed the types of cells participating in the inflammatory response, the moment of appearance after the injury, the decrease in number, and the nature of their actions. The disruption of the blood–spinal cord barrier is biphasic. It exposes the spinal cord to inflammatory cells and to toxic effects of other molecules. Endothelin 1 mediates oxidative stress into the spinal cord through the modulation of spinal cord blood flow. The role of matrix metalloproteinases in blood–spinal cord barrier disruption, inflammation, and angiogenesis are reviewed. PMID:20945816

Popa, F; Grigorean, VT; Onose, G; Sandu, A; Popescu, M; Burnei, G; Strambu, V; Popa, C

2010-01-01

107

Characterization of Morphine Self-Administration Following Spinal Cord Injury  

E-print Network

Approximately two-thirds of patients will experience pain following spinal cord injury (SCI). This pain can arise as an immediate consequence of SCI, or can develop over time into chronic, neuropathic pain. Individuals are frequently prescribed...

Woller, Sarah Ann

2013-07-16

108

Chronic pain associated with spinal cord injuries: A community survey  

Microsoft Academic Search

Objective:To investigate, in a community sample of people with spinal cord injuries (SCIs), chronic pain prevalence, associated factors, sites, characteristics, interference with daily functioning, treatments received, and treatment helpfulness.

Judith A. Turner; Diana D. Cardenas; Catherine A. Warms; Catherine B. McClellan

2001-01-01

109

Nanomedicine strategies for treatment of secondary spinal cord injury  

PubMed Central

Neurological injury, such as spinal cord injury, has a secondary injury associated with it. The secondary injury results from the biological cascade after the primary injury and affects previous uninjured, healthy tissue. Therefore, the mitigation of such a cascade would benefit patients suffering a primary injury and allow the body to recover more quickly. Unfortunately, the delivery of effective therapeutics is quite limited. Due to the inefficient delivery of therapeutic drugs, nanoparticles have become a major field of exploration for medical applications. Based on their material properties, they can help treat disease by delivering drugs to specific tissues, enhancing detection methods, or a mixture of both. Incorporating nanomedicine into the treatment of neuronal injury and disease would likely push nanomedicine into a new light. This review highlights the various pathological issues involved in secondary spinal cord injury, current treatment options, and the improvements that could be made using a nanomedical approach. PMID:25673988

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

2015-01-01

110

LP: Spinal sympathetic interneurons: Their identification and roles after spinal cord injury  

E-print Network

Abstract: Primary afferent neurons rarely, if ever, synapse on the sympathetic preganglionic neurons that regulate the cardiovascular system, nor do sympathetic preganglionic neurons normally exhibit spontaneous activity in the absence of excitatory inputs. Therefore, after serious spinal cord injury ‘‘spinal sympathetic interneurons’ ’ provide the sole excitatory and inhibitory inputs to sympathetic preganglionic neurons. Few studies have addressed the anatomy and physiology of spinal sympathetic interneurons, to a great extent because they are difficult to identify. Therefore, this chapter begins with descriptions of both neurophysiological and neuroanatomical criteria for identifying spinal sympathetic interneurons, and it discusses the advantages and disadvantages of each. Spinal sympathetic interneurons also have been little studied because their importance in intact animals has been unknown, whereas the roles of direct projections from the brain to sympathetic preganglionic neurons are better known. This chapter presents evidence that spinal sympathetic interneurons play only a minor role in sympathetic regulation when the spinal cord is intact. However, they play an important role after spinal cord injury, both in generating ongoing activity in sympathetic nerves and in mediating segmental and intersegmental sympathetic reflexes. The spinal sympathetic interneurons that most directly influence the activity of sympathetic preganglionic neurons after spinal cord injury are located close to their associated sympathetic preganglionic neurons,

111

Walking after spinal cord injury: Evaluation, treatment, and functional recovery  

Microsoft Academic Search

Objective: To present some recent developments and concepts emerging from both animal and human studies aimed at enhancing recovery of walking after spinal cord injury (SCI).Data Sources: Researchers in the field of restoration of walking after SCI, as well as references extracted from searches in the Medline computerized database.Study Selection: Studies that reported outcome measures of walking for spinal cord

Hugues Barbeau; Michel Ladouceur; Kathleen E. Norman; André Pépin; Alain Leroux

1999-01-01

112

Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury  

PubMed Central

Clinical studies have shown that hyperbaric oxygen therapy improves motor function in patients with spinal cord injury. In the present study, we explored the mechanisms associated with the recovery of neurological function after hyperbaric oxygen therapy in a rat model of spinal cord injury. We established an acute spinal cord injury model using a modification of the free-falling object method, and treated the animals with oxygen at 0.2 MPa for 45 minutes, 4 hours after injury. The treatment was administered four times per day, for 3 days. Compared with model rats that did not receive the treatment, rats exposed to hyperbaric oxygen had fewer apoptotic cells in spinal cord tissue, lower expression levels of aquaporin 4/9 mRNA and protein, and more NF-200 positive nerve fibers. Furthermore, they had smaller spinal cord cavities, rapid recovery of somatosensory and motor evoked potentials, and notably better recovery of hindlimb motor function than model rats. Our findings indicate that hyperbaric oxygen therapy reduces apoptosis, downregulates aquaporin 4/9 mRNA and protein expression in injured spinal cord tissue, improves the local microenvironment for nerve regeneration, and protects and repairs the spinal cord after injury. PMID:25657740

Wang, Yang; Zhang, Shuquan; Luo, Min; Li, Yajun

2014-01-01

113

Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury.  

PubMed

Clinical studies have shown that hyperbaric oxygen therapy improves motor function in patients with spinal cord injury. In the present study, we explored the mechanisms associated with the recovery of neurological function after hyperbaric oxygen therapy in a rat model of spinal cord injury. We established an acute spinal cord injury model using a modification of the free-falling object method, and treated the animals with oxygen at 0.2 MPa for 45 minutes, 4 hours after injury. The treatment was administered four times per day, for 3 days. Compared with model rats that did not receive the treatment, rats exposed to hyperbaric oxygen had fewer apoptotic cells in spinal cord tissue, lower expression levels of aquaporin 4/9 mRNA and protein, and more NF-200 positive nerve fibers. Furthermore, they had smaller spinal cord cavities, rapid recovery of somatosensory and motor evoked potentials, and notably better recovery of hindlimb motor function than model rats. Our findings indicate that hyperbaric oxygen therapy reduces apoptosis, downregulates aquaporin 4/9 mRNA and protein expression in injured spinal cord tissue, improves the local microenvironment for nerve regeneration, and protects and repairs the spinal cord after injury. PMID:25657740

Wang, Yang; Zhang, Shuquan; Luo, Min; Li, Yajun

2014-12-15

114

Compliance with bladder management in spinal cord injury patients  

Microsoft Academic Search

Study design: Retrospective analysis of medical records on spinal cord injury (SCI) patients with neuropathic bladder.Objective: To determine SCI patients' compliance with the method of bladder management they used on discharge from inpatient rehabilitation.Setting: Ankara University Medical School, Department of Physical Medicine and Rehabilitation, Spinal Cord Injury Unit, which treats patients referred from throughout Turkey.Methods: The bladder management method of

G Yavuzer; H Gök; S Tuncer; T Soygür; N Arikan; T Arasil

2000-01-01

115

Paratracks, November 2000. Publication of Canadian Paraplegic Association (Manitoba) Inc. Spinal Cord Injury Clinical Research Report  

E-print Network

Spinal Cord Injury Clinical Research Report by Orpha Schryvers I believe a short explanation is needed towards understanding the spinal cord and investigating ways of curing an injury to the spinal cord, D Uebelhart. Intravenous Pamidronate Attenuates Bone Density Loss After Acute Spinal Cord Injury

Manitoba, University of

116

Functional and electrophysiological changes after graded traumatic spinal cord injury in adult rat  

E-print Network

Functional and electrophysiological changes after graded traumatic spinal cord injury in adult rat,b,d , Christopher B. Shieldsa,b,d , Scott R. Whittemorea,b,d,* a Kentucky Spinal Cord Injury Research Center spinal cord injury (SCI) was created in the adult rat spinal cord using the Infinite Horizons (IH

Harkema, Susan

117

Reshaping the chromatin landscape after spinal cord injury  

PubMed Central

The pathophysiology underlying spinal cord injury is complex. Mechanistic understanding of the adaptive responses to injury is critical for targeted therapy aimed at reestablishing lost connections between proximal and distal neurons. After injury, cell-type specific gene transcription programs govern distinct cellular behaviors, and chromatin regulators play a central role in shaping the chromatin landscape to adjust transcriptional profiles in a context-dependent manner. In this review, we summarize recent progress on the pleiotropic roles of chromatin regulators in mediating the diverse adaptive behaviors of neurons and glial cells after spinal cord injury, and wherever possible, discuss the underlying mechanisms and genomic targets. We specifically draw attention to the perspective that takes into consideration the impact of epigenetic modulation on axon growth potential, together with its effect on wound-healing properties of glial cells. Epigenetic modulation of chromatin state represents an emerging therapeutic direction to promote neural repair and axon regeneration after spinal cord injury. PMID:25554728

WONG, Jamie K.; ZOU, Hongyan

2014-01-01

118

Cooling athletes with a spinal cord injury.  

PubMed

Cooling strategies that help prevent a reduction in exercise capacity whilst exercising in the heat have received considerable research interest over the past 3 decades, especially in the lead up to a relatively hot Olympic and Paralympic Games. Progressing into the next Olympic/Paralympic cycle, the host, Rio de Janeiro, could again present an environmental challenge for competing athletes. Despite the interest and vast array of research into cooling strategies for the able-bodied athlete, less is known regarding the application of these cooling strategies in the thermoregulatory impaired spinal cord injured (SCI) athletic population. Individuals with a spinal cord injury (SCI) have a reduced afferent input to the thermoregulatory centre and a loss of both sweating capacity and vasomotor control below the level of the spinal cord lesion. The magnitude of this thermoregulatory impairment is proportional to the level of the lesion. For instance, individuals with high-level lesions (tetraplegia) are at a greater risk of heat illness than individuals with lower-level lesions (paraplegia) at a given exercise intensity. Therefore, cooling strategies may be highly beneficial in this population group, even in moderate ambient conditions (~21 °C). This review was undertaken to examine the scientific literature that addresses the application of cooling strategies in individuals with an SCI. Each method is discussed in regards to the practical issues associated with the method and the potential underlying mechanism. For instance, site-specific cooling would be more suitable for an athlete with an SCI than whole body water immersion, due to the practical difficulties of administering this method in this population group. From the studies reviewed, wearing an ice vest during intermittent sprint exercise has been shown to decrease thermal strain and improve performance. These garments have also been shown to be effective during exercise in the able-bodied. Drawing on additional findings from the able-bodied literature, the combination of methods used prior to and during exercise and/or during rest periods/half-time may increase the effectiveness of a strategy. However, due to the paucity of research involving athletes with an SCI, it is difficult to establish an optimal cooling strategy. Future studies are needed to ensure that research outcomes can be translated into meaningful performance enhancements by investigating cooling strategies under the constraints of actual competition. Cooling strategies that meet the demands of intermittent wheelchair sports need to be identified, with particular attention to the logistics of the sport. PMID:25119157

Griggs, Katy E; Price, Michael J; Goosey-Tolfrey, Victoria L

2015-01-01

119

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

Microsoft Academic Search

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

Subramanian Vaidyanathan; Bakul M Soni; Paul Mansour; Peter L Hughes; Gurpreet Singh; Tun Oo

2009-01-01

120

Intermittent hypoxia induces functional recovery following cervical spinal injury  

PubMed Central

Respiratory-related complications are the leading cause of death in spinal cord injury (SCI) patients. Few effective SCI treatments are available after therapeutic interventions are performed in the period shortly after injury (e.g. spine stabilization and prevention of further spinal damage). In this review we explore the capacity to harness endogenous spinal plasticity induced by intermittent hypoxia to optimize function of surviving (spared) neural pathways associated with breathing. Two primary questions are addressed: 1) does intermittent hypoxia induce plasticity in spinal synaptic pathways to respiratory motor neurons following experimental SCI? and 2) can this plasticity improve respiratory function? In normal rats, intermittent hypoxia induces serotonin-dependent plasticity in spinal pathways to respiratory motor neurons. Early experiments suggest that intermittent hypoxia also enhances respiratory motor output in experimental models of cervical SCI, (cervical hemisection) and that the capacity to induce functional recovery is greater with longer durations post-injury. Available evidence suggests that intermittent hypoxia-induced spinal plasticity has considerable therapeutic potential to treat respiratory insufficiency following chronic cervical spinal injury. PMID:19651247

Vinit, Stéphane; Lovett-Barr, Mary Rachael; Mitchell, Gordon S.

2009-01-01

121

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

122

Spinal fractures in recreational bobsledders: an unexpected mechanism of injury  

PubMed Central

Study design:?Retrospective case series and literature review. Objective:?To report and discuss spinal fractures occurring in recreational bobsledders. Summary of background data:?Spinal fractures have been commonly described following traumatic injury during a number of recreational sports. Reports have focused on younger patients and typically involved high-impact sports or significant injuries. With an aging population and a wider array of recreational sports, spinal injuries may be seen after seemingly benign activities and without a high-impact injury. Methods:?A retrospective review of two patients and review of the literature was performed. Results:?Two patients with spinal fractures after recreational bobsledding were identified. Both patients, aged 57 and 54 years, noticed a simultaneous onset of severe back pain during a routine turn on a bobsled track. Neither was involved in a high-impact injury during the event. Both patients were treated conservatively with resolution of symptoms. An analysis of the bobsled track revealed that potential forces imparted to the rider may be greater than the yield strength of vertebral bone. Conclusions:?Older athletes may be at greater risk for spinal fracture associated with routine recreational activities. Bobsledding imparts large amounts of force during routine events and may result in spinal trauma. Older patients, notably those with osteoporosis or metabolic bone disease, should be educated about the risks associated with seemingly benign recreational sports. PMID:23230417

Severson, Erik P.; Sofianos, Dmitri A.; Powell, Amy; Daubs, Michael; Patel, Rakesh; Patel, Alpesh A.

2012-01-01

123

Neurotrophic Factors Increase Axonal Growth after Spinal Cord Injury and Transplantation in the Adult Rat  

Microsoft Academic Search

The capacity of CNS neurons for axonal regrowth after injury decreases as the age of the animal at time of injury increases. After spinal cord lesions at birth, there is extensive regenerative growth into and beyond a transplant of fetal spinal cord tissue placed at the injury site. After injury in the adult, however, although host corticospinal and brainstem-spinal axons

Barbara S. Bregman; Marietta McAtee; Hai Ning Dai; Penelope L. Kuhn

1997-01-01

124

Plasticity of motor systems after incomplete spinal cord injury  

Microsoft Academic Search

Although spontaneous regeneration of lesioned fibres is limited in the adult central nervous system, many people that suffer from incomplete spinal cord injuries show significant functional recovery. This recovery process can go on for several years after the injury and probably depends on the reorganization of circuits that have been spared by the lesion. Synaptic plasticity in pre-existing pathways and

Olivier Raineteau; Martin E. Schwab

2001-01-01

125

Specific aspects of erectile dysfunction in spinal cord injury  

Microsoft Academic Search

According to preliminary studies, the overall incidence of spinal cord injury (SCI; traumatic and medical) in Spain is estimated to be between 12 and 20 per million inhabitants, and almost 80% of these injuries occur in young men. SCI causes organic changes in men leading to erectile dysfunction (ED), impaired ejaculation, and changes in genital orgasmic perception. A vast majority

A S Ramos; J V Samsó

2004-01-01

126

Substance Abuse and Medical Complications Following Spinal Cord Injury  

Microsoft Academic Search

This study examined relationships between medical complications resulting in hospital stays and alcohol and illicit substance use in 71 persons with recent spinal cord injury (SCI). At 5 intervals after injury, medical records were reviewed for pressure ulcers and urinary tract infections (UTIs). Abstainers with histories of drinking problems before SCI were at greater risk for UTIs from 7 to

Darlene A. Hawkins; Allen W. Heinemann

1998-01-01

127

Factors Affecting Employment Following Spinal Cord Injury: A Qualitative Study  

Microsoft Academic Search

ABSTRACT. Objective: To examine factors that differentiated persons with spinal cord injury (SCI) who returned to work from those who did not. Participants: Six employed persons with SCI matched with 6 unemployed persons with SCI on the basis of education, race, age, gender, time since injury, and level of function. Study Design: Semi-structured interviews 1 to 2 hr in length

Martha H. Chapin; Donald G. Kewman

2001-01-01

128

Substance Abuse and Medical Complications Following Spinal Cord Injury  

Microsoft Academic Search

Substance abuse results in health problems by contributing to impairment and injuries. Few studies have examined how post-spinal cord injury medical complications may be affected by substance use. This study examined the use of alcohol and other drugs and the relationship between use and two medical complications, pressure ulcers and urinary tract infections. A sample of 103 persons undergoing inpatient

Allen W. Heinemann; Darlene Hawkins

1995-01-01

129

Myelin Gene Expression after Experimental Contusive Spinal Cord Injury  

Microsoft Academic Search

After incomplete traumatic spinal cord injury (SCI), the spared tissue exhibits abnormal myelination that is associated with reduced or blocked axonal conductance. To examine the mo- lecular basis of the abnormal myelination, we used a standard- ized rat model of incomplete SCI and compared normal unin- jured tissue with that after contusion injury. We evaluated expression of mRNA for myelin

Jean R. Wrathall; Wen Li; Lynn D. Hudson

1998-01-01

130

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

131

Incidence of Secondary Complications in Spinal Cord Injury.  

ERIC Educational Resources Information Center

Data from 348 patients (mean age 37) with postacute spinal cord injury revealed that 95% reported at least 1 secondary problem, and 58% reported 3 or more. The number and severity of complications varied with time since the injury. Obesity, pain, spasticity, urinary tract infections, pressure sores, and lack of social integration were common…

Anson, C. A.; Shepherd, C.

1996-01-01

132

Osteoporosis in individuals with spinal cord injury.  

PubMed

The pathophysiology, clinical considerations, and relevant experimental findings with regard to osteoporosis in individuals with spinal cord injury (SCI) will be discussed. The bone loss that occurs acutely after more neurologically motor complete SCI is unique for its sublesional skeletal distribution and rate, at certain skeletal sites approaching 1% of bone mineral density per week, and its resistance to currently available treatments. The areas of high bone loss include the distal femur, proximal tibia, and more distal boney sites. Evidence from a study performed in monozygotic twins discordant for SCI indicates that sublesional bone loss in the twin with SCI increases for several decades, strongly suggesting that the heightened net bone loss after SCI may persist for an extended period of time. The increased frequency of fragility fracture after paralysis will be discussed, and a few risk factors for such fractures after SCI will be examined. Because vitamin D deficiency, regardless of disability, is a relevant consideration for bone health, as well as an easily reversible condition, the increased prevalence of and treatment target values for vitamin D in this deficiency state in the SCI population will be reviewed. Pharmacological and mechanical approaches to preserving bone integrity in persons with acute and chronic SCI will be reviewed, with emphasis placed on efficacy and practicality. Emerging osteoanabolic agents that improve functioning of WNT/?-catenin signaling after paralysis will be introduced as therapeutic interventions that may hold promise. PMID:25171878

Bauman, William A; Cardozo, Christopher P

2015-02-01

133

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

134

Central Neuropathic Pain in Spinal Cord Injury  

PubMed Central

Spinal cord injury (SCI) is a devastating medical condition affecting 1.2 million people in the United States. Central neuropathic pain is one of the most common medical complications of SCI. Current treatment options include opioids, antiepileptic agents such as gabapentin, antispastic agents such as baclofen or tizanidine, and tricyclic acid. Other options include complementary, nonpharmacological treatment such as exercise or acupuncture, interventional treatments, and psychological approaches. Although these treatment options exist, central neuropathic pain in patients with SCI is still extremely difficult to treat because of its complexity. To develop and provide more effective treatment options to these patients, proper assessment of and classification tools for central neuropathic pain, as well as a better understanding of the pathophysiology, are needed. A combination of approaches, from standard general pain assessments to medically specific questions unique to SCI pathophysiology, is essential for this population. A multidisciplinary approach to patient care, in addition with a better understanding of pathophysiology and diagnosis, will lead to improved management and treatment of patients with SCI displaying central neuropathic pain. Here we summarize the most recent classification tools, pathophysiology, and current treatment options for patients with SCI with central neuropathic pain.

Lee, Sujin; Zhao, Xing; Hatch, Maya; Chun, Sophia; Chang, Eric

2015-01-01

135

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2012 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 ...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2012-07-01

136

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2011 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 ...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2011-07-01

137

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2014 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 ...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2014-07-01

138

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2013 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 ...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2013-07-01

139

34 CFR 359.1 - What is the Special Projects and Demonstrations for Spinal Cord Injuries Program?  

Code of Federal Regulations, 2010 CFR

...Projects and Demonstrations for Spinal Cord Injuries Program? 359.1 Section...PROJECTS AND DEMONSTRATIONS FOR SPINAL CORD INJURIES General § 359.1 What...Projects and Demonstrations for Spinal Cord Injuries Program? This...

2010-07-01

140

Rehabilitation in spinal cord disorders. 4. Outcomes and issues of aging after spinal cord injury.  

PubMed

This self-directed learning module highlights current concepts in outcomes and issues of aging in spinal cord injury. It is part of the chapter on rehabilitation in spinal cord disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This article includes discussion of the measurement of impairment, disability, and handicap, and outcomes with respect to employment, long-term adjustment, aging, life expectancy, and causes of death in spinal cord injury. PMID:2003762

Lammertse, D P; Yarkony, G M

1991-03-01

141

Risk Factors for Chest Illness in Chronic Spinal Cord Injury  

PubMed Central

Objective Chest illnesses commonly cause morbidity in persons with chronic spinal cord injury. Risk factors remain poorly characterized because previous studies have not accounted for factors other than spinal cord injury. Design Between 1994 and 2005, 403 participants completed a respiratory questionnaire and underwent spirometry. Participants were contacted at a median of 1.7 yrs [interquartile range: 1.3–2.5 yrs] apart over a mean (SD) of 5.1 ± 3.0 yrs and asked to report chest illnesses that had resulted in time off work, spent indoors, or in bed since prior contact. Results In 97 participants, there were 247 chest illnesses (0.12/person-year) with 54 hospitalizations (22%). Spinal cord injury level, completeness of injury, and duration of injury were not associated with illness risk. Adjusting for age and smoking history, any wheeze (relative risk = 1.92; 95% confidence interval: 1.19, 3.08), pneumonia or bronchitis since spinal cord injury (relative risk = 2.29; 95% confidence interval: 1.40, 3.75), and physician-diagnosed chronic obstructive pulmonary disease (relative risk = 2.17; 95% confidence interval: 1.08, 4.37) were associated with a greater risk of chest illness. Each percent-predicted decrease in forced expiratory volume in 1 sec was associated with a 1.2% increase in risk of chest illness (P = 0.030). Conclusions In chronic spinal cord injury, chest illness resulting in time spent away from usual activities was not related to the level or completeness of spinal cord injury but was related to reduced pulmonary function, wheeze, chronic obstructive pulmonary disease, a history of pneumonia and bronchitis, and smoking. PMID:20463565

Stolzmann, Kelly L.; Gagnon, David R.; Brown, Robert; Tun, Carlos G.; Garshick, Eric

2011-01-01

142

Curcumin protects against ischemic spinal cord injury: The pathway effect  

PubMed Central

Inducible nitric oxide synthase and N-methyl-D-aspartate receptors have been shown to participate in nerve cell injury during spinal cord ischemia. This study observed a protective effect of curcumin on ischemic spinal cord injury. Models of spinal cord ischemia were established by ligating the lumbar artery from the left renal artery to the bifurcation of the abdominal aorta. At 24 hours after model establishment, the rats were intraperitoneally injected with curcumin. Reverse transcription-polymerase chain reaction and immunohistochemical results demonstrated that after spinal cord ischemia, inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression significantly increased. However, curcumin significantly decreased inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression in the ischemic spinal cord. Tarlov scale results showed that curcumin significantly improved motor function of the rat hind limb after spinal cord ischemia. The results demonstrate that curcumin exerts a neuroprotective fect against ischemic spinal cord injury by decreasing inducible nitric oxide synthase and N-methyl-D-aspartate receptor expression. PMID:25206661

Zhang, Jinhua; Wei, Hao; Lin, Meimei; Chen, Chunmei; Wang, Chunhua; Liu, Maobai

2013-01-01

143

An ADL measure for spinal cord injury.  

PubMed

Occupational therapists do not have a comprehensive, objective method for measuring how persons with tetraplegia perform activities of daily living (ADL) in their homes and communities, because SCI ADL performance is usually determined in rehabilitation. The ADL Habits Survey (ADLHS) is designed specifically to address this knowledge gap by surveying performance on relevant and meaningful activities in homes and communities. After a comprehensive task analysis and pilot development, 30 activities were selected that emphasize a broad range of hand and wrist, reaching, and grasping movements in compound activities. A sample of 49 persons with cervical spinal cord injuries responded to items. The sample was predominantly male, median age was 41 years, and ASIA motor classification levels ranged from C2 through C8/T1 with majority concentration in C4, C5, or C6 (68%). Each participant report was rated by an occupational therapist using a seven category rating scale, and the item by participant response matrix (30 X 49) was analyzed with a Rasch model for rating scales. Results showed excellent participant separation (>4) and very high reliability (>.95), and both item and participant fit values were adequate (STANDARDIZED INFIT less than absolute value of 3). With only two exceptions, all participants fit the Rasch rating scale model, and only one item "Light housekeeping" presented significant fit issues. Principal Components Analysis an analysis of item residuals did not reveal serious threats to unidimensionality. A between group fit comparison of participants with more versus less movement found invariant item calibrations, and ANOVA of participant measures found statistically significant differences across ASIA motor classification levels. These ADLHS results offer occupational therapists a new method for measuring ADL that is potentially more sensitive to functional changes in tetraplegia than most instruments in common use. Accommodation of step disorder with a three category rating scale did not diminish measurement properties. PMID:22357128

Bryden, Anne; Bezruczko, Nikolaus

2011-01-01

144

Disability, atrophy and cortical reorganization following spinal cord injury  

PubMed Central

The impact of traumatic spinal cord injury on structural integrity, cortical reorganization and ensuing disability is variable and may depend on a dynamic interaction between the severity of local damage and the capacity of the brain for plastic reorganization. We investigated trauma-induced anatomical changes in the spinal cord and brain, and explored their relationship to functional changes in sensorimotor cortex. Structural changes were assessed using cross-sectional cord area, voxel-based morphometry and voxel-based cortical thickness of T1-weighted images in 10 subjects with cervical spinal cord injury and 16 controls. Cortical activation in response to right-sided (i) handgrip; and (ii) median and tibial nerve stimulation were assessed using functional magnetic resonance imaging. Regression analyses explored associations between cord area, grey and white matter volume, cortical activations and thickness, and disability. Subjects with spinal cord injury had impaired upper and lower limb function bilaterally, a 30% reduced cord area, smaller white matter volume in the pyramids and left cerebellar peduncle, and smaller grey matter volume and cortical thinning in the leg area of the primary motor and sensory cortex compared with controls. Functional magnetic resonance imaging revealed increased activation in the left primary motor cortex leg area during handgrip and the left primary sensory cortex face area during median nerve stimulation in subjects with spinal cord injury compared with controls, but no increased activation following tibial nerve stimulation. A smaller cervical cord area was associated with impaired upper limb function and increased activations with handgrip and median nerve stimulation, but reduced activations with tibial nerve stimulation. Increased sensory deficits were associated with increased activations in the left primary sensory cortex face area due to median nerve stimulation. In conclusion, spinal cord injury leads to cord atrophy, cortical atrophy of primary motor and sensory cortex, and cortical reorganization of the sensorimotor system. The degree of cortical reorganization is predicted by spinal atrophy and is associated with significant disability. PMID:21586596

Weiskopf, Nikolaus; Ward, Nick S.; Hutton, Chloe; Gall, Angela; Ciccarelli, Olga; Craggs, Michael; Friston, Karl; Thompson, Alan J.

2011-01-01

145

History, implementation, and current status of the national spinal cord injury database  

Microsoft Academic Search

Objective: To summarize a 25-year history of the Model Spinal Cord Injury Program and the coexistent National Spinal Cord Injury Database and provide the status of the Database with a discussion of the strengths and weaknesses.Design: Inception cohort.Setting: Model spinal cord injury systems throughout the United States.Results: As of September 1998, the National Spinal Cord Injury Database included abbreviated registry

Samuel L. Stover; Michael J. De Vivo; Bette K. Go

1999-01-01

146

Functional outcome and discharge destination in elderly patients with spinal cord injuries  

Microsoft Academic Search

Study design:Retrospective cohort study.Objective:To describe functional outcome and discharge destination of elderly patients with traumatic spinal cord injuries.Setting:National Spinal Injuries Unit, Glasgow, UK.Methods:We collected data for 5 years on all patients >65 years old with a traumatic spinal cord injury treated at the National Spinal Injuries Unit.Results:We identified 39 patients. Of these, nine patients died during admission; all had cervical

A Gulati; C J Yeo; A D Cooney; A N McLean; M H Fraser; D B Allan

2011-01-01

147

Nogo-A expression dynamically varies after spinal cord injury  

PubMed Central

The mechanism involved in neural regeneration after spinal cord injury is unclear. The myelin-derived protein Nogo-A, which is specific to the central nervous system, has been identified to negatively affect the cytoskeleton and growth program of axotomized neurons. Studies have shown that Nogo-A exerts immediate and chronic inhibitory effects on neurite outgrowth. In vivo, inhibitors of Nogo-A have been shown to lead to a marked enhancement of regenerative axon extension. We established a spinal cord injury model in rats using a free-falling weight drop device to subsequently investigate Nogo-A expression. Nogo-A mRNA and protein expression and immunoreactivity were detected in spinal cord tissue using real-time quantitative PCR, immunohistochemistry and western blot analysis. At 24 hours after spinal cord injury, Nogo-A protein and mRNA expression was low in the injured group compared with control and sham-operated groups. The levels then continued to drop further and were at their lowest at 3 days, rapidly rose to a peak after 7 days, and then gradually declined again after 14 days. These changes were observed at both the mRNA and protein level. The transient decrease observed early after injury followed by high levels for a few days indicates Nogo-A expression is time dependent. This may contribute to the lack of regeneration in the central nervous system after spinal cord injury. The dynamic variation of Nogo-A should be taken into account in the treatment of spinal cord injury.

Wang, Jian-wei; Yang, Jun-feng; Ma, Yong; Hua, Zhen; Guo, Yang; Gu, Xiao-lin; Zhang, Ya-feng

2015-01-01

148

Continuous decoding of Motor Attempt and Motor Imagery from EEG Activity in Spinal Cord Injury Patients  

E-print Network

Continuous decoding of Motor Attempt and Motor Imagery from EEG Activity in Spinal Cord Injury-- Spinal cord injury (SCI) associates brain reor- ganization with a loss of cortical representation broader activation associated patterns that are easier to recognize. I. INTRODUCTION Spinal cord injury

Minguez, Javier

149

Development/Plasticity/Repair Functional Recovery in Traumatic Spinal Cord Injury after  

E-print Network

Development/Plasticity/Repair Functional Recovery in Traumatic Spinal Cord Injury after Bartlett Bunge,5,6,7 and Scott R. Whittemore1,2,3 1Kentucky Spinal Cord Injury Research Center at 9 d after injury. Expression of D15A in the injured spinal cord is five times higher in animals

Harkema, Susan

150

Reduced Functional Recovery by Delaying Motor Training After Spinal Cord Injury  

E-print Network

Reduced Functional Recovery by Delaying Motor Training After Spinal Cord Injury B. A. Norrie, J. M by delaying motor training after spinal cord injury. J Neurophysiol 94: 255­264, 2005. First published March in rehabilitative motor training after spinal cord injury affects functional motor recovery. We studied a skilled

Gorassini, Monica

151

Spastic Long-Lasting Reflexes in the Awake Rat After Sacral Spinal Cord Injury  

E-print Network

Spastic Long-Lasting Reflexes in the Awake Rat After Sacral Spinal Cord Injury D. J. Bennett, L in the awake rat after sacral spinal cord injury. J Neurophysiol 91: 2247­2258, 2004; 10.1152/jn.00946 The debilitating spasms that accompany spinal cord injury develop slowly are often not fully manifested for months

Gorassini, Monica

152

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

E-print Network

W. M. Keck Center for Collaborative Neuroscience THE SPINAL CORD INJURY PROJECT WORKSHOP INFORMATION Please save for your reference Spinal Cord Injury Research Methods Workshop. (Mark date of your of payment: Spinal Cord Injury Research Methods, $800. Refresher Course (for previous attendees), $425

Chen, Kuang-Yu

153

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

E-print Network

Original Article Functional electrical therapy: retraining grasping in spinal cord injury MR intervention-versus-control trial. Setting: Rehabilitation hospital for spinal cord injury in Toronto, Canada. Methods: A total of 21 people with new spinal cord injuries ranging from C3 to C7 were randomly assigned

Popovic, Milos R.

154

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

E-print Network

W. M. Keck Center for Collaborative Neuroscience THE SPINAL CORD INJURY PROJECT WORKSHOP REGISTRATION FORM Spinal Cord Injury Research Methods Workshop. (Please indicate 1st and 2nd choice.) ___ March. Registration is not final until payment has been received. ___ Spinal Cord Injury Research Methods, $800

Chen, Kuang-Yu

155

Hydralazine inhibits compression and acrolein-mediated injuries in ex vivo spinal cord  

E-print Network

Hydralazine inhibits compression and acrolein-mediated injuries in ex vivo spinal cord Kristin, slow down, and even reverse the development of various diseases. In the case of spinal cord injury that post-trauma oxidative stress plays a critical role in the pathogenesis of spinal cord injury

Duerstock, Bradley

156

Walking after spinal cord injury. Goal or wish?  

PubMed

Less than a third of patients walk again after a spinal cord injury, whereas every one of them wants to try. Residual function, energy expenditure, the extent of orthotic support needed, and patient motivation will determine the outcome. Functional electrical stimulation and other new orthotic designs have not notably increased the number of persons able to walk after a spinal injury. Rehabilitation professionals can use patient education, illustrating relearning to walk with examples of infants' and toddlers' progress, to assist patients in understanding their abilities and limitations. The final decision on ambulation and orthotic prescriptions can be made in stages after a patient adjusts to a wheelchair-independent level. PMID:1866961

Subbarao, J V

1991-05-01

157

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. PMID:25309824

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

2014-01-01

158

Evaluation of artificial sweat in athletes with spinal cord injuries  

Microsoft Academic Search

Athletes with spinal cord injury often experience high heat storage due to reduced sweating capacity below the spinal injury.\\u000a Spray bottle (SB) maybe used to apply mist for evaporative cooling during breaks in competitions. This study examined the\\u000a efficacy of SB during rest breaks. Seven participants, four female and three males, (mean ± SD age 24 ± 4.1 year, weight 56.2 ± 7.0 kg,\\u000a upper-body VO2 peak 2.4 ± 0.6 l\\/min)

R. C. Pritchett; P. A. Bishop; Z. Yang; K. L. Pritchett; J. M. Green; C. P. Katica; A. T. Del Pozzi

2010-01-01

159

Surgical management of multilevel cervical spinal stenosis and spinal cord injury complicated by cervical spine fracture  

PubMed Central

Background There are few reports regarding surgical management of multilevel cervical spinal stenosis with spinal cord injury. Our purpose is to evaluate the safety and feasibility of open-door expansive laminoplasty in combination with transpedicular screw fixation for the treatment of multilevel cervical spinal stenosis and spinal cord injury in the trauma population. Methods This was a retrospective study of 21 patients who had multilevel cervical spinal stenosis and spinal cord injury with unstable fracture. An open-door expansive posterior laminoplasty combined with transpedicular screw fixation was performed under persistent intraoperative skull traction. Outcome measures included postoperative improvement in Japanese Orthopedic Association (JOA) score and incidence of complications. Results The average operation time was 190 min, with an average blood loss of 437 ml. A total of 120 transpedicular screws were implanted into the cervical vertebrae between vertebral C3 and C7, including 20 into C3, 34 into C4, 36 into C5, 20 into C6, and 10 into C7. The mean preoperative JOA score was 3.67?±?0.53. The patients were followed for an average of 17.5 months, and the average JOA score improved to 8.17?±?1.59, significantly higher than the preoperative score (t?=?1.798, P?spinal stenosis and spinal cord injury complicated by unstable fracture. Its advantages include minimum surgical trauma, less intraoperative blood loss, and satisfactory stable supportive effect for reduction of fracture. PMID:25142353

2014-01-01

160

Correlates of life satisfaction among persons with spinal cord injury  

Microsoft Academic Search

Objective: To analyze the correlates of life satisfaction for individuals with spinal cord injury (SCI).Study Design: Survey; follow-up of subjects studied prospectively since onset of injury.Participants: A total of 2,183 persons with SCI, from 1 to 20 years postinjury, self-selected for annual research (and clinical) follow-up by one of 18 model systems of SCI care.Results: Life satisfaction, as measured with

Marcel P. J. M. Dijkers

1999-01-01

161

Bowel dysfunction in spinal-cord-injury patients  

Microsoft Academic Search

SummaryBackground This study aimed to determine the prevalence, nature, and effects-both physical and psychological—of spinal-cord-injury (SCI) on bowel function.Methods 115 consecutive hospital outpatients (89 male, median age 38 years) with chronic SCI (median duration 62 months, range 9-491 months, 48% cervical, 47% thoracic, 5% lumbar) completed a questionnaire about pre and post injury bowel function, the Hospital Anxiety and Depression

S Glickman; M. A Kamm

1996-01-01

162

Sexuality, Identity and Women with Spinal Cord Injury  

Microsoft Academic Search

Sexuality is an integral component of every individual’s identity. The literature offers limited information about the sexuality\\u000a and sexual identity of women with spinal cord injury (SCI), beyond the physiological and neurological aspects. The qualitative\\u000a study described in this paper aimed to explore the experiences and perceptions of a small sample of adult women with SCI regarding\\u000a their sexuality post-injury.

Malorie G. Parker; Matthew K. Yau

163

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

164

Quality of life and traumatic spinal cord injury  

Microsoft Academic Search

Objective: To determine associations between major outcome variables after traumatic spinal cord injury (SCI) and quality of life (QL).Subjects: Of a total population of 353 SCI patients, 320 participated, 261 men and 59 women living in the greater Stockholm area: 124 were tetraplegic, 176 were paraplegic, and 20 had no classified level. Mean age was 42 years (range, 17 to

Ninni Westgren; Richard Levi

1998-01-01

165

Skeletal muscle fibre type transformation following spinal cord injury  

Microsoft Academic Search

Following spinal cord injury (SCI), upper motor neuron paralysed muscles lose the normal type I (slow) and II (fast) fibre mosaic pattern and become predominantly composed of type II (fast glycolytic) fibres. The majority of the research demonstrating this fibre type shift was based on pH sensitive myofibrillar ATPase staining techniques on muscle from longstanding paraplegics and quadriplegics. The purpose

R Burnham; T Martin; R Stein; G Bell; I MacLean; R Steadward

1997-01-01

166

Mortality after spinal cord injury: An 11-year prospective study  

Microsoft Academic Search

Objective: To identify the relative risk of mortality after spinal cord injury (SCI) as a function of level of psychosocial, vocational, and medical adjustment.Design: A prospective design was used: data on life adjustment was obtained at one time (1985), with subsequent survival status ascertained 11 years later (1996). Logistic regression was used to identify the relative risk of mortality given

J. Stuart Krause; Maya Sternberg; Sarah Lottes; Joseph Maides

1997-01-01

167

Premature degenerative shoulder changes in spinal cord injury patients  

Microsoft Academic Search

Shoulder pain and the resultant dysfunction is an expected problem in individuals with spinal cord injury. But there is a remarkable lack of information about the natural history, diagnosis, prevention and long term outcomes. Degenerative changes may develop prematurely in their shoulders, due to overuse and altered mechanical stresses, with or without symptoms was the hypothesis of this prospective study.

Santosh Lal

1998-01-01

168

Adhesion Molecules and Wound Healing in Spinal Cord Injury  

Microsoft Academic Search

The purpose of this study was to design and test a model that could identify and define which cellular adhesion molecules (CAMs) present on peripheral blood leukocytes were depressed in spinal cord injury (SCI) patients. CAMs on peripheral blood cells of SCI patients with pressure ulcers were measured by flow cytometry and compared with those of age-matched healthy controls and

Julius M. Cruse; Robert E. Lewis; Reid Bishop; Jane A. Lampton; Malinda D. Mallory; Lamar Bryant; John C. Keith

1996-01-01

169

Social Support, Stress, and Adjustment to Spinal Cord Injury.  

ERIC Educational Resources Information Center

Social support has been considered an important coping resource moderating the stress associated with physical illness and disability. The role of social support as a buffering agent for stressful life events inherent in physical illness and disability was examined in 78 individuals with spinal cord injury, residing in community settings in…

Rounds, James B; And Others

170

Perceptions of Positive Attitudes toward People with Spinal Cord Injury.  

ERIC Educational Resources Information Center

This New Zealand study examined attitudes toward persons with spinal cord injury (SCI) via a survey of 35 people with SCI, 27 SCI rehabilitation workers, 16 outpatient hospital rehabilitation workers, and 37 people from the general population. Results were analyzed in terms of age, ethnic identity, gender, professional training, and amount of…

Lys, K.; Pernice, R.

1995-01-01

171

Quality of Life in Patients with Spinal Cord Injury  

ERIC Educational Resources Information Center

The primary objective of this study was to assess the quality of life (QoL) in spinal cord injury (SCI) survivors. Secondary objectives were to determine the effects of various sociodemographic and clinical characteristics on QoL. This cross-sectional study included 54 patients with SCI. The Turkish version of the Short-Form-36 Health Survey was…

Gurcay, Eda; Bal, Ajda; Eksioglu, Emel; Cakci, Aytul

2010-01-01

172

Vocational Interests of Persons with Spinal Cord Injury.  

ERIC Educational Resources Information Center

Studied vocational interests of persons with spinal cord injury. Using the Strong Campbell Interest Inventory, participants' scores were compared to norms for men and women in general on the inventory. Showed their interests were often incongruent with their physical limitations and suggested that counselors must assist in identifying vocational…

Rohe, Daniel E.; Athelstan, Gary T.

1982-01-01

173

Drinking Patterns, Drinking Expectancies, and Coping after Spinal Cord Injury.  

ERIC Educational Resources Information Center

Drinking patterns, alcohol expectancies, and coping strategies were assessed for 121 persons with recent spinal cord injuries during hospitalization, 3 months after surgery, and 12 months after surgery. Although the rate of heavy drinking decreased, preinjury problem drinkers still had the lowest rate of positive reappraisal, problem solving, and…

Heinemann, Allen W.; And Others

1994-01-01

174

Necrostatin-1 mitigates mitochondrial dysfunction post-spinal cord injury.  

PubMed

Necrostatin-1 (Nec-1) is an inhibitor of necroptosis, playing an important role in inhibition of pathological death in the central nervous system (CNS). Our earlier study suggests that Nec-1 protects the injured spinal cord. In this study, we found that Nec-1 reduces the elevated Ca(2+) concentration in mitochondria post-injury and preserves the remarkably decreased mitochondrial membrane potential (MMP) level post-spinal cord injury (SCI). It also increases the generation of adenosine triphosphate (ATP) by promoting the activity of mitochondrial respiratory chain complex I instead of other complexes, which are significantly decreased due to the injury. Nec-1 also inhibits the release of cytochrome c in the mitochondria and protects the spinal cord from mitochondrial swelling post-SCI. Nec-1 promotes mitochondrial biogenesis by up-regulating mitochondrial transcription factor A (Tfam), in accordance with the mtDNA content. It also inhibits the up-regulation of mitochondrial fusion genes Mnf1, Mnf2 within 6h post-injury and adjusts the abnormal expression of mitochondrial fission gene Fis1. All these results indicate the improvement of mitochondrial functions in injured spinal cord after the treatment of Nec-1. This research revealed the mechanisms of functional protection of Nec-1 by mitigating mitochondrial dysfunction post-SCI. PMID:25595990

Wang, Y; Wang, J; Yang, H; Zhou, J; Feng, X; Wang, H; Tao, Y

2015-03-19

175

Employment after Spinal Cord Injury: Transition and Life Adjustment.  

ERIC Educational Resources Information Center

Tested two competing hypotheses regarding employment, adjustment, and spinal cord injury (SCI). Longitudinal data collected on 142 participants with SCI on two occasions separated by an 11-year interval showed a correlation between enhanced adjustment and a positive transition from unemployment to employment. Results support hypothesis that…

Krause, J. Stuart

1996-01-01

176

Male fertility and sexual function after spinal cord injury  

Microsoft Academic Search

Spinal cord injury has an enormous impact upon the sexual relationship of a man and his partner. Erection may be partial or absent, orgasm altered or impossible, and fertility severely impaired. New understanding of the physiology of sexual function and improved treatment can enable most cord-injured men to achieve erections suitable for sexual satisfaction. Modern methods of sperm collection and

D. J. Brown; S. T. Hill; H. W. G. Baker

2006-01-01

177

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

PubMed Central

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

2013-01-01

178

Improving the Quality of Life of Caregivers of Persons With Spinal Cord Injury: A Randomized Controlled Trial  

E-print Network

Improving the Quality of Life of Caregivers of Persons With Spinal Cord Injury: A Randomized interventions for caregivers of older persons with spinal cord injury (SCI). Design: A multisite, three of caregivers. Keywords: caregiving, spinal cord injury, intervention Persons with spinal cord injury (SCI

Sheikh, Yaser Ajmal

179

Endogenous Proliferation after Spinal Cord Injury in Animal Models  

PubMed Central

Spinal cord injury (SCI) results in motor and sensory deficits, the severity of which depends on the level and extent of the injury. Animal models for SCI research include transection, contusion, and compression mouse models. In this paper we will discuss the endogenous stem cell response to SCI in animal models. All SCI animal models experience a similar peak of cell proliferation three days after injury; however, each specific type of injury promotes a specific and distinct stem cell response. For example, the transection model results in a strong and localized initial increase of proliferation, while in contusion and compression models, the initial level of proliferation is lower but encompasses the entire rostrocaudal extent of the spinal cord. All injury types result in an increased ependymal proliferation, but only in contusion and compression models is there a significant level of proliferation in the lateral regions of the spinal cord. Finally, the fate of newly generated cells varies from a mainly oligodendrocyte fate in contusion and compression to a mostly astrocyte fate in the transection model. Here we will discuss the potential of endogenous stem/progenitor cell manipulation as a therapeutic tool to treat SCI. PMID:23316243

McDonough, Ashley; Martínez-Cerdeño, Verónica

2012-01-01

180

Functional electrical stimulation for incomplete spinal cord injury  

PubMed Central

This case report describes the early use of functional electrical stimulation on an individual with an incomplete spinal cord injury to assist with motor recovery and a return to ambulation. A 32-year-old woman sustained a C7 burst fracture after a fall, requiring anterior cervical fixation from C6 to T1 prior to transfer to acute rehabilitation. She presented as a C8 AIS B spinal cord injury, meaning she had some sensory function spared below the level of injury but not motor function. At discharge from acute inpatient rehabilitation, she was able to ambulate household distances with supervision using a rolling walker and required a manual wheelchair for community mobility. Four months after discharge, she was ambulating in the community using a standard cane. PMID:25484510

2014-01-01

181

Nanovector-mediated drug delivery for spinal cord injury treatment.  

PubMed

Spinal cord injury (SCI) is the result of a traumatic primary event followed by a so-called secondary injury, which is characterized by a large spectrum of biochemical cellular pathways able to spread the lesion, worsening neurologic recovery. A growing number of potential therapeutic interventions to counteract different neurodegenerative mechanisms of SCI have been proposed, but they did not show relevant efficacy when translated as clinical treatments. Different reasons could explain these disappointing results: on one side the multifactorial evolution of SCI after the primary injury that limits the beneficial effect of just one targeted treatment and, on the other, the restricted access of pharmacological therapies to the spinal cord. For these reasons, recently, a growing interest has been shown in the development of alternative delivery strategies to administer drugs and/or biological/cellular therapies into the spine (hydrogel and nanoparticles). PMID:24845580

Caron, Ilaria; Papa, Simonetta; Rossi, Filippo; Forloni, Gianluigi; Veglianese, Pietro

2014-01-01

182

Dendritic spine dysgenesis contributes to hyperreflexia after spinal cord injury.  

PubMed

Hyperreflexia and spasticity are chronic complications in spinal cord injury (SCI), with limited options for safe and effective treatment. A central mechanism in spasticity is hyperexcitability of the spinal stretch reflex, which presents symptomatically as a velocity-dependent increase in tonic stretch reflexes and exaggerated tendon jerks. In this study we tested the hypothesis that dendritic spine remodeling within motor reflex pathways in the spinal cord contributes to H-reflex dysfunction indicative of spasticity after contusion SCI. Six weeks after SCI in adult Sprague-Dawley rats, we observed changes in dendritic spine morphology on ?-motor neurons below the level of injury, including increased density, altered spine shape, and redistribution along dendritic branches. These abnormal spine morphologies accompanied the loss of H-reflex rate-dependent depression (RDD) and increased ratio of H-reflex to M-wave responses (H/M ratio). Above the level of injury, spine density decreased compared with below-injury spine profiles and spine distributions were similar to those for uninjured controls. As expected, there was no H-reflex hyperexcitability above the level of injury in forelimb H-reflex testing. Treatment with NSC23766, a Rac1-specific inhibitor, decreased the presence of abnormal dendritic spine profiles below the level of injury, restored RDD of the H-reflex, and decreased H/M ratios in SCI animals. These findings provide evidence for a novel mechanistic relationship between abnormal dendritic spine remodeling in the spinal cord motor system and reflex dysfunction in SCI. PMID:25505110

Bandaru, Samira P; Liu, Shujun; Waxman, Stephen G; Tan, Andrew M

2015-03-01

183

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

184

Recent trends in mortality and causes of death among persons with spinal cord injury  

Microsoft Academic Search

Objective: To identify and quantify trends in mortality and causes of death among persons with spinal cord injury.Design: Cohort study.Setting: Model spinal cord injury care systems and Shriner's Hospitals spinal cord injury units throughout the United States.Patients: A total of 28,239 consecutive persons admitted to the model system or to a Shriner's Hospital within 1 year of injury.Main Outcome Measure:

Michael J. De Vivo; J. Stuart Krause; Daniel P. Lammertse

1999-01-01

185

Intrathecal Morphine Attenuates Recovery of Function after a Spinal Cord Injury  

E-print Network

Intrathecal Morphine Attenuates Recovery of Function after a Spinal Cord Injury Michelle A. Hook consequences of spinal cord injury (SCI) (Anderson, 2004). Chronic pain affects approximately two, subsequently, pro-inflammatory cytokine concentrations in the contused spinal cord. Key words: contusion

Grau, James

186

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

E-print Network

W. M. Keck Center for Collaborative Neuroscience THE SPINAL CORD INJURY PROJECT THE MASCIS IMPACTOR Overview The MASCIS Impactor is a device designed to deliver graded reproducible spinal cord contusions in rats. Developed over ten years ago, the Impactor is part of a well-defined rodent spinal cord injury

Chen, Kuang-Yu

187

Windup of Flexion Reflexes in Chronic Human Spinal Cord Injury: A Marker for Neuronal Plateau Potentials?  

E-print Network

Windup of Flexion Reflexes in Chronic Human Spinal Cord Injury: A Marker for Neuronal Plateau., W. Z. Rymer, E. N. Benz, and B. D. Schmit. Windup of flexion reflexes in chronic human spinal cord.2001. The physiological basis of flexion spasms in individuals after spinal cord injury (SCI) may involve alterations

188

Since ancient times it has been recognized that injury to the spinal cord can result in  

E-print Network

Since ancient times it has been recognized that injury to the spinal cord can result in dramatic to the spinal cord, whether caused by injury or disease, cannot currently be repaired by any therapy. Yet, as far as is known, they are not replaced (although the adult spinal cord does contain stem cells

Cai, Long

189

CASE TEACHING NOTES for “A Case of Spinal Cord Injury” by  

E-print Network

The spinal cord carries messages between the brain and the rest of the body. Traumatic injury to the spinal cord can result in a condition called acute spinal cord injury (sci), resulting in motor, sensory, or autonomic dysfunction which may be temporary or permanent. sci is a common cause of permanent disability and death in both children and adults.

190

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

191

Spasticity in rats with sacral spinal cord injury.  

PubMed

We have investigated sacral spinal cord lesions in rats with the goal of developing a rat model of muscular spasticity that is minimally disruptive, not interfering with bladder, bowel, or hindlimb locomotor function. Spinal transections were made at the S2 sacral level and, thus, only affected the tail musculature. After spinal transection, the muscles of the tail were inactive for 2 weeks. Following this initial period, hypertonia, hyperreflexia, and clonus developed in the tail, and grew more pronounced with time. These changes were assessed in the awake rat, since the tail is readily accessible and easy to manipulate. Muscle stretch or cutaneous stimulation of the tail produced muscle spasms and marked increases in muscle tone, as measured with force and electromyographic recordings. When the tail was unconstrained, spontaneous or reflex induced flexor and extensor spasms coiled the tail. Movement during the spasms often triggered clonus in the end of the tail. The tail hair and skin were extremely hyperreflexive to light touch, withdrawing quickly at contact, and at times clonus could be entrained by repeated contact of the tail on a surface. Segmental tail muscle reflexes, e.g., Hoffman reflexes (H-reflexes), were measured before and after spinalization, and increased significantly 2 weeks after transection. These results suggest that sacral spinal rats develop symptoms of spasticity in tail muscles with similar characteristics to those seen in limb muscles of humans with spinal cord injury, and thus provide a convenient preparation for studying this condition. PMID:9989467

Bennett, D J; Gorassini, M; Fouad, K; Sanelli, L; Han, Y; Cheng, J

1999-01-01

192

Segmental organization of spinal reflexes mediating autonomic dysreflexia after spinal cord injury.  

PubMed

Spinal cord injuries above mid-thoracic levels can lead to a potentially life-threatening hypertensive condition termed autonomic dysreflexia that is often triggered by distension of pelvic viscera (bladder or bowel). This syndrome is characterized by episodic hypertension due to sudden, massive discharge of sympathetic preganglionic neurons in the thoracolumbar spinal cord. This hypertension is usually accompanied by bradycardia, particularly if the injury is caudal to the 2nd to 4th thoracic spinal segments. The development of autonomic dysreflexia is correlated with aberrant sprouting of peptidergic afferent fibers into the spinal cord below the injury. In particular, sprouting of nerve growth factor-responsive afferent fibers has been shown to have a major influence on dysreflexia, perhaps by amplifying the activation of disinhibited sympathetic neurons. Using a model of noxious bowel distension after complete thoracic spinal transection at the 4th thoracic segment in rats, we selectively altered C-fiber sprouting, at specified spinal levels caudal to the injury, with microinjections of adenovirus encoding the growth-promoting nerve growth factor or the growth-inhibitory semaphorin 3A. This was followed by assessment of physiological responses to colorectal distension and subsequent histology. Additionally, anterograde tract tracers were injected into the lumbosacral region to compare the extent of labeled propriospinal rostral projections in uninjured cords to those in cords after complete 4th thoracic transection. In summary, overexpression of chemorepulsive semaphorin 3A impeded C-fiber sprouting in lumbosacral segments and mitigated hypertensive autonomic dysreflexia, whereas the opposite results were obtained with nerve growth factor overexpression. Furthermore, compared to naïve rats, there were significantly more labeled lumbosacral propriospinal projections rostrally after thoracic injury. Collectively, our findings suggest that distension of pelvic viscera increases the excitation of expanded afferent terminals in the disinhibited lumbosacral spinal cord. This, in turn, triggers excitation and sprouting of local propriospinal neurons to relay visceral sensory stimuli and amplify the activation of sympathetic preganglionic neurons in the thoracolumbar cord, to enhance transmission in the spinal viscero-sympathetic reflex pathway. These responses are manifested as autonomic dysreflexia. PMID:16198706

Rabchevsky, Alexander G

2006-01-01

193

Spinal Cord Injury: Hope through Research  

MedlinePLUS

... and below the original injury. Changes in blood flow cause ongoing damage. The major reduction in blood ... person’s intent and transfer that to the display screen. How can I help with research? Clinical trials ...

194

Subcutaneous Tri-Block Copolymer Produces Recovery From Spinal Cord Injury  

E-print Network

Subcutaneous Tri-Block Copolymer Produces Recovery From Spinal Cord Injury Richard B. Borgens,1 compression of the adult guinea pig spinal cord is able to: (1) preserve the anatomic integrity of the cord a behavioral recov- ery of a spinal cord dependent long tract spinal cord reflex. These observations stood out

Duerstock, Bradley

195

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

196

Vertebral Artery Anomaly and Injury in Spinal Surgery  

PubMed Central

Study Design?Systematic review. Study Rationale?The purpose of this review is to further define the published literature with respect to vertebral artery (VA) anomaly and injury in patients with degenerative cervical spinal conditions. Objectives?In adult patients with cervical spine or degenerative cervical spine disorders receiving cervical spine surgery, what is the incidence of VA injury, and among resulting VA injuries, which treatments result in a successful outcome and what percent are successfully repaired? Materials and Methods?A systematic review of pertinent articles published up to April 2013. Studies involving traumatic onset, fracture, infection, deformity or congenital abnormality, instability, inflammatory spinal diseases, or neoplasms were excluded. Two independent reviewers assessed the level of evidence quality using the Grades of Recommendation Assessment, Development and Evaluation criteria; disagreements were resolved by consensus. Results?From a total of 72 possible citations, the following met our inclusion criteria and formed the basis for this report. Incidence of VA injuries ranged from 0.20 to 1.96%. None of the studies reported using preoperative imaging to identify anomalous or tortuous VA. Primary repair and ligation were the most effective in treating VA injuries. Conclusion?The incidence of VA injuries in degenerative cervical spinal surgery might be as high as 1.96% and is likely underreported. Direct surgical repair is the most effective treatment option. The most important preventative technique for VA injuries is preoperative magnetic resonance imaging or computed tomography angiographic imaging to detect VA anomalies. The overall strength of evidence for the conclusions is low. PMID:24715869

Molinari, Robert; Bessette, Matthew; Raich, Annie L.; Dettori, Joseph R.; Molinari, Christine

2014-01-01

197

Plasticity for recovery after partial spinal cord injury – hierarchical organization.  

PubMed

To cure the impaired physiological functions after the spinal cord injury, not only development of molecular therapies for axonal regeneration, but also that of therapeutic strategies to induce appropriate rewiring of neural circuits should be necessary. For this purpose, understanding the plastic changes in the central nervous system during spontaneous recovery following the injury would be helpful. In this article, a series of studies conducted in the authors’ laboratory on the reorganization of neural networks in the partial spinal cord injury model using macaque monkeys are reviewed. In this model, after selective lesion of the lateral corticospinal tract at the fifth cervical segment, dexterous digit movements are once impaired, but recover through rehabilitative training in a few weeks to a few months. During the recovery, synaptic transmission and organization of the neural circuits exhibit drastic changes depending on the time after the injury, not only in the spinal cord, but also in hierarchically higher order structures such as motor-related cortical areas and even in limbic structures. It is suggested that on top of the molecular therapies, neurorehabilitative and neuromodulatory therapies targeting such higher order structures should be helpful in inducing appropriate rewiring of the neural circuits. PMID:24512702

Isa, Tadashi; Nishimura, Yukio

2014-01-01

198

Male fertility and sexual function after spinal cord injury.  

PubMed

Spinal cord injury has an enormous impact upon the sexual relationship of a man and his partner. Erection may be partial or absent, orgasm altered or impossible, and fertility severely impaired. New understanding of the physiology of sexual function and improved treatment can enable most cord-injured men to achieve erections suitable for sexual satisfaction. Modern methods of sperm collection and fertility treatment mean that many can also be fathers. The best results are obtained by a team approach involving rehabilitation and reproductive medicine clinicians, nurses, spinal cord injury specialists and counselors with the cord-injured man and his partner. Erections can be achieved by drugs, such as sildenafil, that block phosphodiesterase 5, prolonging the action of nitric oxide with resultant smooth muscle relaxation. Intracavernosal prostaglandin E1 and mechanical systems, such as vacuum pumps and constriction rings, are also effective. Sexual gratification can be promoted in the context of an understanding relationship in which the cord-injured person can gain pleasure from pleasing his partner and also from his partner's exploration of erotogenic areas not affected by the spinal cord injury. An emphasis on the broader view of sexuality in relationships allows for a continuance and strengthening of bonds between the couple. Vibration ejaculation or electroejaculation can be used to collect semen. For a limited period in the acute phase, usually for about 6-12 days after injury, normal semen can be obtained by electroejaculation from some cord-injured men. With chronic spinal cord injury the semen is of variable quality. Some patients have necrospermia, which may be improved by regular ejaculation. Others have poor quality semen or spermatogenic disorders and, in this situation, in vitro fertilization techniques must be used to achieve parenthood. Trials of assisted ejaculation help individualize cost-effective management of the infertility. PMID:16198718

Brown, D J; Hill, S T; Baker, H W G

2006-01-01

199

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

200

Robot-Assisted Locomotion Training after Spinal Cord Injury: Comparison of Rodent Stepping in Virtual and Physical Treadmill Environments  

E-print Network

Robot-Assisted Locomotion Training after Spinal Cord Injury: Comparison of Rodent Stepping to Robotica #12;1 Abstract We are developing robotic devices for locomotion training after spinal cord injury,000 people experience a traumatic spinal cord injury each year, and over 200,000 people with spinal cord

Reinkensmeyer, David J.

201

Soft Exo-Skeletal Arm for C4-C5 Trauma Induced Spinal cord Injuries M. Brauckmann1  

E-print Network

Soft Exo-Skeletal Arm for C4-C5 Trauma Induced Spinal cord Injuries M. Brauckmann1 , E. Calamari1 Introduction: In the United States there are between 236,000 and 327,000 people with spinal cord injuries the elbow of a person with traumatic spinal cord injuries to the C4-C5 vertebra. Users with spinal cord

Camesano, Terri

202

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

203

Leisure participation for individuals living with acquired spinal cord injury.  

PubMed

Traditionally, rehabilitation professionals have viewed and studied leisure participation in terms of quantifiable activities. Advances in leisure studies have, however, led to recognition of the need for and value of examining leisure as a subjective experience too. Accordingly, this study used a qualitative approach to explore postinjury leisure participation for individuals living with acquired spinal cord injury. A secondary analysis was performed for data from a primary study that examined social adaptation needs related to community living after rehabilitation. Participants who had completed their initial rehabilitation at least 3 years earlier took part in in-depth, personal interviews. The analysis identified specific leisure activities participants had done and/or are doing after spinal cord injury. It also provided insight into how and why these activities are being done and/or not being done. Major findings are illustrated by participants' personal verbatim quotes. Implications and recommendations for further research and professional practice in rehabilitation are outlined. PMID:18708845

O'Brien, Aron; Renwick, Rebecca; Yoshida, Karen

2008-09-01

204

Current status of clinical trials for acute spinal cord injury.  

PubMed

Acute spinal cord injury (ASCI) occurs as a result of physical disruption of spinal cord axons through the epicenter of injury leading to deficits in motor, sensory, and autonomic function. This is a debilitating neurological disorder common in young adults that often requires life-long therapy and rehabilitative care, placing a significant burden on our healthcare system. While no cure exists, research has identified various pharmacological compounds that specifically antagonize primary and secondary mechanisms contributing to the etiology of ASCI. Several compounds including methylprednisolone (MPSS), GM-1 ganglio-side, thyrotropin releasing hormone (TRH), nimodipine, and gacyclidine have been tested in prospective randomized clinical trials of ASCI. MPSS and GM-1 ganglioside have shown evidence of modest benefits. Clearly trials of improved neuroprotective agents are required. Promising potential therapies for ASCI include riluzole, minocycline, erythropoietin, and the fusogen polyethylene glycol, as well as mild hypothermia. PMID:15993112

Fehlings, Michael G; Baptiste, Darryl C

2005-07-01

205

Evaluation and treatment of spinal injuries in the obese patient.  

PubMed

Given the increasing incidence and severity of obesity in the adult population, orthopaedic surgeons are evaluating and treating more acutely injured obese patients. Management of obese patients is complicated given their body habitus and associated medical comorbidities. Although evaluation and treatment are almost the same as for nonobese patients, some special considerations are necessary to prevent errors in diagnosis and treatment of obese trauma patients. This article focuses on spine injuries in obese patients. Predisposition to spinal injury, effective evaluation and early management, principles of treatment planning, operative technical pearls, and postoperative management are discussed. PMID:21095437

Greenleaf, Robert M; Altman, Daniel T

2011-01-01

206

Activation of the caspase-3 apoptotic cascade in traumatic spinal cord injury  

Microsoft Academic Search

Traumatic spinal cord injury often results in complete loss of voluntary motor and sensory function below the site of injury. The long-term neurological deficits after spinal cord trauma may be due in part to widespread apoptosis of neurons and oligodendroglia in regions distant from and relatively unaffected by the initial injury. The caspase family of cysteine proteases regulates the execution

Robert D. Azbill; Pamela E. Knapp; Joe E. Springer

1999-01-01

207

Sexual Function Among Patients with Spinal Cord Injury  

Microsoft Academic Search

Summary Hundred and fifty spinal cord injury patients were interviewed concerning erections, coitus, ejaculation and orgasm. 123 (82%) were able to attain erections. 115 patients had upper motor neuron lesions (reflex activity present in the sacral segments). Seventy-five of the 115 patients had complete lesions; 9% had psychic erections, 95% had spontaneous erections, 92% had erections from penile stimulation. 44%

A. E. Comarr

1970-01-01

208

Urinary tract infection in persons with spinal cord injury  

Microsoft Academic Search

Persons with spinal cord injury (SCI) have an increased risk of developing urinary tract infections. Certain structural and physiological factors, such as bladder over-distention, vesicoureteral reflux, high-pressure voiding, large post-void residuals, stones in the urinary tract, and outlet obstruction increase the risk of infection. The method of bladder drainage also influences the risk of urinary tract infection, and most persons

Diana D. Cardenas; Thomas M. Hooton

1995-01-01

209

The gastrointestinal system and bowel management following spinal cord injury.  

PubMed

Gastrointestinal system changes following spinal cord injury (SCI) are generally less obvious than other body system changes. These alterations in function and the response to management, however, may have profound implications on the social, emotional, and physical well-being of the individual with SCI. This article reviews changes in gastrointestinal function following SCI and discusses current issues related to the management of the neurogenic bowel. PMID:10680157

Chen, D; Nussbaum, S B

2000-02-01

210

Understanding Decisions About Work After Spinal Cord Injury  

Microsoft Academic Search

Introduction Research has consistently shown that many people with spinal cord injury (SCI) do not return to work (RTW), despite evidence\\u000a that being employed is associated with better quality of life, participation and physical and psychological well-being. While\\u000a some factors associated with RTW outcome have been identified, very little is known about what influences people’s own decisions\\u000a about their employment

Joanna K. Fadyl; Kathryn M. McPherson

2010-01-01

211

Psychological factors affecting alcohol use after spinal cord injury  

Microsoft Academic Search

Study design:Cross-sectional.Objective:The purpose of this study is to assess risk factors, including personality and socioeconomic indicators, with alcohol use among persons with spinal cord injury (SCI).Setting:A large rehabilitation hospital in the Southeastern United States.Methods:A total of 1549 participants responded to a survey on outcomes after SCI. We used polychotomous logistic regression to assess the relationships of personality and socioeconomic factors

L L Saunders; J S Krause

2011-01-01

212

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

213

Amitriptyline pharmacokinetics in experimental spinal cord injury in the rabbit.  

PubMed

Previous studies have demonstrated that pharmacokinetic behavior of several drugs such as paracetamol, theophylline, and aminoglycosides are significantly altered in spinal cord injured patients. No pharmacokinetic study of amitriptyline has been performed in patients and experimental models of spinal cord injury. Pharmacokinetic parameters of amitriptyline in orally treated rabbits subjected to laminectomy and spinal cord injury compared with those underwent laminectomy alone. Among twenty four male rabbits were included in this study, nine of them subjected to spinal cord injury at the 8(th) thoracic level by knife severance method and six rabbits underwent laminectomy alone (sham group) and nine rabbits treated as control. All received a single oral dose of amitriptyline (20 mg/kg) 24 h after injury. Blood sampling were done at predetermined times to 36 h after drug administration. Amitriptyline concentration in serum samples was determined by high-performance liquid chromatography. Pharmacokinetic parameters including maximum concentration (C(max)), time to reach maximum concentration (T(max)), half life, and the area under the curve to last detectable concentration time point (AUC(0-t)) were directly determined from the concentration-time curve. Maximum concentration was observed at 6.5 h after administration in sham group with a concentration of 439.6 ng/ml, whereas in SCI group T(max) was at 2.7 h with a concentration of 2763.9 ng/ml. In control group it was 3.3 h and 396 ng/ml, respectively. In SCI group, AUC was 9465.6 ng.h/ml and half life was 6 h and for control group it was 2817.4 ng.h/ml and 6.4 h, respectively. Statistical analysis of data showed that SCI didn't induce significant changes in amitriptyline pharmacokinetic parameters. PMID:21369441

Reihanikermani, H; Ansari, M; Soltani, A; Meymandi, M S

2008-11-01

214

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

215

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

216

Expression of CAPON after Spinal Cord Injury in Rats  

Microsoft Academic Search

The adaptor protein, carboxy-terminal PDZ ligand of nNOS (CAPON), regulates the distribution of neuronal nitric oxide synthase\\u000a (nNOS) that increased after spinal cord injury (SCI) and produces the key signaling molecule nitric oxide (NO). But little\\u000a is known about the role of CAPON in the pathological process of SCI. The main objective of the present study was to investigate\\u000a expression

Chun Cheng; Xin Li; Shangfeng Gao; Shuqiong Niu; Mengling Chen; Jing Qin; Zhiqin Guo; Jian Zhao; Aiguo Shen

2008-01-01

217

Diagnostic coding accuracy for traumatic spinal cord injuries  

Microsoft Academic Search

Study design:Retrospective register study enhanced and verified by medical records.Objectives:To study whether electronic searches of discharge diagnosis are valid for epidemiological research of traumatic spinal cord injury (SCI), using the International Classification of Diseases (ICD).Settings:Haukeland University Hospital, Bergen, NorwayMethods:We identified all hospital admissions with discharge codes suggesting a traumatic SCI from ICD-8 to ICD-10 in the electronic database at Haukeland

E M Hagen; T Rekand; N E Gilhus; M Gronning; EM Hagen

2009-01-01

218

Serotonergic pharmacotherapy promotes cortical reorganization after spinal cord injury.  

PubMed

Cortical reorganization plays a significant role in recovery of function after injury of the central nervous system. The neural mechanisms that underlie this reorganization may be the same as those normally responsible for skilled behaviors that accompany extended sensory experience and, if better understood, could provide a basis for further promoting recovery of function after injury. The work presented here extends studies of spontaneous cortical reorganization after spinal cord injury to the role of rehabilitative strategies on cortical reorganization. We use a complete spinal transection model to focus on cortical reorganization in response to serotonergic (5-HT) pharmacotherapy without any confounding effects from spared fibers left after partial lesions. 5-HT pharmacotherapy has previously been shown to improve behavioral outcome after SCI but the effect on cortical organization is unknown. After a complete spinal transection in the adult rat, 5-HT pharmacotherapy produced more reorganization in the sensorimotor cortex than would be expected by transection alone. This reorganization was dose dependent, extended into intact (forelimb) motor cortex, and, at least in the hindlimb sensorimotor cortex, followed a somatotopic arrangement. Animals with the greatest behavioral outcome showed the greatest extent of cortical reorganization suggesting that the reorganization is likely to be in response to both direct effects of 5-HT on cortical circuits and indirect effects in response to the behavioral improvement below the level of the lesion. PMID:23262119

Ganzer, Patrick D; Moxon, Karen A; Knudsen, Eric B; Shumsky, Jed S

2013-03-01

219

An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury  

PubMed Central

Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Although isolated injuries of both nerves following a whiplash injury have been reported, combined injury of the two nerves following a whiplash injury is very uncommon and is being reported for the first time. PMID:17587067

Omar, N.; Srinivasan, M. S.

2007-01-01

220

Neuroprotective Effects of Perflurocarbon (Oxycyte) after Contusive Spinal Cord Injury  

PubMed Central

Abstract Spinal cord injury (SCI) often results in irreversible and permanent neurological deficits and long-term disability. Vasospasm, hemorrhage, and loss of microvessels create an ischemic environment at the site of contusive or compressive SCI and initiate the secondary injury cascades leading to progressive tissue damage and severely decreased functional outcome. Although the initial mechanical destructive events cannot be reversed, secondary injury damage occurs over several hours to weeks, a time frame during which therapeutic intervention could be achieved. One essential component of secondary injury cascade is the reduction in spinal cord blood flow with resultant decrease in oxygen delivery. Our group has recently shown that administration of fluorocarbon (Oxycyte) significantly increased parenchymal tissue oxygen levels during the usual postinjury hypoxic phase, and fluorocarbon has been shown to be effective in stroke and head injury. In the current study, we assessed the beneficial effects of Oxycyte after a moderate-to-severe contusion SCI was simulated in adult Long-Evans hooded rats. Histopathology and immunohistochemical analysis showed that the administration of 5?mL/kg of Oxycyte perfluorocarbon (60% emulsion) after SCI dramatically reduced destruction of spinal cord anatomy and resulted in a marked decrease of lesion area, less cell death, and greater white matter sparing at 7 and 42 days postinjury. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining showed a significant reduced number of apoptotic cells in Oxycyte-treated animals, compared to the saline group. Collectively, these results demonstrate the potential neuroprotective effect of Oxycyte treatment after SCI, and its beneficial effects may be, in part, a result of reducing apoptotic cell death and tissue sparing. Further studies to determine the most efficacious Oxycyte dose and its mechanisms of protection are warranted. PMID:24025081

Yacoub, Adly; Hajec, Marygrace C.; Stanger, Richard; Wan, Wen; Young, Harold

2014-01-01

221

A proposed algorithm for the management of pain following spinal cord injury  

Microsoft Academic Search

Study design:Review.Objectives:To review published articles on the assessment, diagnosis and treatment of pain following spinal cord injury (SCI) and to synthesise evidence from these materials to formulate and propose a systematic approach to management.Methods:Relevant articles regarding the treatment of pain were identified from electronic databases using the search terms ((‘spinal cord injury’ or ‘spinal cord injuries’) and ‘pain’) and both

P J Siddall; J W Middleton

2006-01-01

222

NG2 expression in rats with acute T10 spinal cord injury?  

PubMed Central

Rat models of T10 spinal cord injury were established with a clamp method. NG2 expression was detected with immunohistochemical staining and western blot. Ten days after spinal cord injury, the number of NG2-positive cells in the damaged areas and NG2 absorbance were both significantly increased. The findings indicate that acute T10 spinal cord injury in rats can lead to upregulation of NG2 protein expression in damaged areas.

Lv, Haoran; Yang, Jinshun; Liao, Zhuangwen; Zhao, Yu; Huang, Yan

2012-01-01

223

Exercise modulates chloride homeostasis after spinal cord injury.  

PubMed

Activity-based therapies are routinely integrated in spinal cord injury (SCI) rehabilitation programs because they result in a reduction of hyperreflexia and spasticity. However, the mechanisms by which exercise regulates activity in spinal pathways to reduce spasticity and improve functional recovery are poorly understood. Persisting alterations in the action of GABA on postsynaptic targets is a signature of CNS injuries, including SCI. The action of GABA depends on the intracellular chloride concentration, which is determined largely by the expression of two cation-chloride cotransporters (CCCs), KCC2 and NKCC1, which serve as chloride exporters and importers, respectively. We hypothesized that the reduction in hyperreflexia with exercise after SCI relies on a return to chloride homeostasis. Sprague Dawley rats received a spinal cord transection at T12 and were assigned to SCI-7d, SCI-14d, SCI-14d+exercise, SCI-28d, SCI-28d+exercise, or SCI-56d groups. During a terminal experiment, H-reflexes were recorded from interosseus muscles after stimulation of the tibial nerve and the low-frequency-dependent depression (FDD) was assessed. We provide evidence that exercise returns spinal excitability and levels of KCC2 and NKCC1 toward normal levels in the lumbar spinal cord. Acutely altering chloride extrusion using the KCC2 blocker DIOA masked the effect of exercise on FDD, whereas blocking NKCC1 with bumetanide returned FDD toward intact levels after SCI. Our results indicate that exercise contributes to reflex recovery and restoration of endogenous inhibition through a return to chloride homeostasis after SCI. This lends support for CCCs as part of a pathway that could be manipulated to improve functional recovery when combined with rehabilitation programs. PMID:24990918

Côté, Marie-Pascale; Gandhi, Sapan; Zambrotta, Marina; Houlé, John D

2014-07-01

224

An exploration of cognitive appraisals following spinal cord injury.  

PubMed

This study explored the cognitive appraisals that people make following spinal cord injury (SCI) about their situation and their ability to cope with it. Appraisals are thought to be important in determining individual responses to different events and have been shown to predict psychological well-being following injury. A cross-sectional interview study was used. Ten individuals who had recently started rehabilitation at the National Spinal Injuries Centre following an SCI were interviewed. Eight men and two women with a variety of injury level and completeness participated. Interviews were semi-structured and aimed to elicit participants' appraisals of their experiences and their ability to cope. Interviews were analysed qualitatively using interpretative phenomenological analysis. Four super-ordinate themes emerged from the interviews. These were making sense of a traumatic experience, impact of the SCI, coping and altered view of self and life. The interviews revealed that appraisals following SCI are complex and relate not only to the individual but also to their context, life stage, roles and relationships. The study adds to the theoretical understanding of the appraisal process following SCI. Ideas for further research are generated and clinical implications for improving patient experiences and developing appraisal-focused interventions are considered. PMID:21678200

Kaiser, Sally; Kennedy, Paul

2011-12-01

225

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

226

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.

David F. Dean

2005-01-01

227

Autologous mesenchymal stem cells in chronic spinal cord injury.  

PubMed

Spinal cord injury (SCI) occurs in the most productive part of life. Treatment options for treatment of chronic SCI are few and have limited impact on clinical outcome. Central nervous system (CNS) has limited intrinsic regeneration capability. The study included patients with chronic complete SCI. Previously harvested autologous mesenchymal stem cells were administered at the site of injury after a laminectomy. Follow-up was done by a neutral examiner not involved in the surgery every 3 months. One patient had improvement in motor power. Two patients had a patchy improvement in pin prick sensation below the level of injury. Three different, progressively increasing doses did not result in improvement in the clinical outcome. Though the administration of allogenic human mesenchymal stem cells is safe in patients with SCI, it may not be efficacious; especially in patients with chronic SCI. PMID:21749185

Bhanot, Yanish; Rao, Sujay; Ghosh, Debapriya; Balaraju, Sudheer; Radhika, C R; Satish Kumar, K V

2011-08-01

228

Role of Melatonin in Traumatic Brain Injury and Spinal Cord Injury  

PubMed Central

Brain and spinal cord are implicated in incidences of two of the most severe injuries of central nervous system (CNS). Traumatic brain injury (TBI) is a devastating neurological deficit involving primary and secondary injury cascades. The primary and secondary mechanisms include complex consequences of activation of proinflammatory cytokines, cerebral edema, upregulation of NF-??, disruption of blood-brain barrier (BBB), and oxidative stress. Spinal cord injury (SCI) includes primary and secondary injury cascades. Primary injury leads to secondary injury in which generation of free radicals and oxidative or nitrative damage play an important pathophysiological role. The indoleamine melatonin is a hormone secreted or synthesized by pineal gland in the brain which helps to regulate sleep and wake cycle. Melatonin has been shown to be a versatile hormone having antioxidative, antiapoptotic, neuroprotective, and anti-inflammatory properties. It has a special characteristic of crossing BBB. Melatonin has neuroprotective role in the injured part of the CNS after TBI and SCI. A number of studies have successfully shown its therapeutic value as a neuroprotective agent in the treatment of neurodegenerative diseases. Here in this review we have compiled the literature supporting consequences of CNS injuries, TBI and SCI, and the protective role of melatonin in it. PMID:25587567

Naseem, Mehar; Parvez, Suhel

2014-01-01

229

Adaptations of peripheral vasoconstrictor pathways after spinal cord injury.  

PubMed

The consequences of spinal cord injury on the function of sympathetic pathways in the periphery have generally been ignored. We discuss two types of plasticity that follow disruption of sympathetic pathways in rats . The first relates to the partial denervation of sympathetic ganglia that would follow the loss of some preganglionic neurones. Sprouting of residual connections rapidly reinnervates many postganglionic neurones, restoring functional transmission within a few weeks, but other neurones may be permanently decentralized. Some of the new functional connections may generate inappropriate pathways leading to abnormal reflexes . The second type of plasticity concerns the markedly enhanced and prolonged contractile responses to nerve activity in arterial vessels to which ongoing sympathetic activity has been reduced or silenced following spinal cord transection or ganglion decentralization. In a cutaneous artery (the rat tail artery), the mechanisms underlying this arterial hyperreactivity differ from those in the splanchnic arteries (the rat mesenteric artery). In the former, hyperreactivity is mainly postjunctional but independent of changes in alpha1-adrenoceptor sensitivity, whereas the increased responsiveness in the latter vessels can be attributed to a greater responsiveness to alpha1-adrenoceptor activation. There are enough data from humans to suggest that both of these novel findings in experimental animals are likely to apply after spinal cord injury and contribute to autonomic dysreflexia . PMID:16198708

McLachlan, Elspeth M; Brock, James A

2006-01-01

230

Modulating inflammatory cell responses to spinal cord injury: all in good time.  

PubMed

Spinal cord injury can have a range of debilitating effects, permanently impacting a patient's quality of life. Initially thought to be an immune privileged site, the spinal cord is able to mount a timely and well organized inflammatory response to injury. Intricate immune cell interactions are triggered, typically consisting of a staggered multiphasic immune cell response, which can become deregulated if left unchecked. Although several immunomodulatory compounds have yielded success in experimental rodent spinal cord injury models, their translation to human clinical studies needs further consideration. Because temporal differences between rodent and human inflammatory responses to spinal cord injury do exist, drug delivery timing will be a crucial component in recovery from spinal cord injury. Given too early, immunomodulatory therapies may impede beneficial inflammatory reactions to the injured spinal cord or even miss the opportunity to dampen delayed harmful autoimmune processes. Therefore, this review aims to summarize the temporal inflammatory response to spinal cord injury, as well as detailing specific immune cell functions. By clearly defining the chronological order of inflammatory events after trauma, immunomodulatory drug delivery timing can be better optimized. Further, we compare spinal cord injury-induced inflammatory responses in rodent and human studies, enabling clinicians to consider these differences when initiating clinical trials. Improved understanding of the cellular immune response after spinal cord injury would enhance the efficacy of immunomodulatory agents, enabling combined therapies to be considered. PMID:24934600

Bowes, Amy L; Yip, Ping K

2014-11-01

231

Post-traumatic growth following spinal cord injury  

PubMed Central

Context/objective Examine the relationship of post-traumatic psychological growth (PTG), depression, and personal and injury characteristics in persons with spinal cord injury (SCI). Design Cross-sectional survey. Setting Community. Participants Eight hundred and twenty-four adults with SCI. Interventions None. Outcome measures Five items from the Post-traumatic Growth Inventory, reflecting positive change after injury in life priorities, closeness to others, new opportunities being available, stronger faith, and personal strength. Results Initial structural equation model testing of a conceptual model of personal and injury characteristics, violent etiology, depression, and PTG resulted in a poor fit. Model modifications resulted in an improved fit, but explained only 5% of the variance in PTG. Being female, younger, having less formal education, and less time since injury had significant relationships with PTG, whereas depression, violent etiology, and injury level/severity did not. In each PTG domain, between 54 and 79% of the sample reported at least some positive change after injury. Conclusions The results of this study, while promising, explained only a small portion of the variance in PTG. A majority of the sample experienced some positive change after injury, with the greatest change in discovering that they were stronger than they thought they were. Comparing means previously reported in a non-SCI sample of those who experienced trauma, positive change after injury was comparable for each PTG item except for new opportunities being available, which was significantly lower for those with SCI. Future directions of research include the development of theoretical models of PTG after SCI. PMID:24559420

Kalpakjian, Claire Z.; McCullumsmith, Cheryl B.; Fann, Jesse R.; Richards, John S.; Stoelb, Brenda L.; Heinemann, Allen W.; Bombardier, Charles H.

2014-01-01

232

The relationships among the severity of spinal cord injury, residual neurological function, axon counts, and counts of retrogradely labeled neurons after experimental spinal cord injury  

Microsoft Academic Search

Substantial residual neurological function may persist after spinal cord injury (SCI) with survival of as few as 5–10% of the original number of axons. A detailed understanding of the relationships among the severity of injury, the number and origin of surviving axons at the injury site, and the extent of neurological recovery after SCI is of importance in understanding the

Michael G. Fehlings; Charles H. Tator

1995-01-01

233

Intranasal nerve growth factor bypasses the blood-brain barrier and affects spinal cord neurons in spinal cord injury  

PubMed Central

The purpose of this work was to investigate whether, by intranasal administration, the nerve growth factor bypasses the blood-brain barrier and turns over the spinal cord neurons and if such therapeutic approach could be of value in the treatment of spinal cord injury. Adult Sprague-Dawley rats with intact and injured spinal cord received daily intranasal nerve growth factor administration in both nostrils for 1 day or for 3 consecutive weeks. We found an increased content of nerve growth factor and enhanced expression of nerve growth factor receptor in the spinal cord 24 hours after a single intranasal administration of nerve growth factor in healthy rats, while daily treatment for 3 weeks in a model of spinal cord injury improved the deficits in locomotor behaviour and increased spinal content of both nerve growth factor and nerve growth factor receptors. These outcomes suggest that the intranasal nerve growth factor bypasses blood-brain barrier and affects spinal cord neurons in spinal cord injury. They also suggest exploiting the possible therapeutic role of intranasally delivered nerve growth factor for the neuroprotection of damaged spinal nerve cells. PMID:25206755

Aloe, Luigi; Bianchi, Patrizia; De Bellis, Alberto; Soligo, Marzia; Rocco, Maria Luisa

2014-01-01

234

Neurophysiological Characterization of Motor Recovery in Acute Spinal Cord Injury  

PubMed Central

Study Design Prospective cohort study Objective This study was designed to neurophysiologically characterize motor control recovery after spinal cord injury (SCI). Setting University of Louisville, Louisville, Kentucky, USA. Material Eleven acute SCI admissions and five non-injured subjects were recruited for this study. Methods The American Spinal Injury Association Impairment Scale (AIS) was used to categorize injury level and severity at onset. Multi-muscle surface EMG (sEMG) recording protocol of reflex and volitional motor tasks was initially performed between the day of injury and 11 days post onset (6.4 ± 3.6, mean ± SD days). Follow-up recordings were performed for up to 17 months after injury. Initial AIS distribution was: 4 AIS-A; 2 AIS-C; 5 AIS-D. Multi-muscle activation patterns were quantified from the sEMG amplitudes of selected muscles using a vector-based calculation that produces values for Magnitude and Similarity of SCI test-subject patterns to those produced by non-injured subjects. Results In SCI subjects, overall sEMG amplitudes were lower after SCI. Prime mover muscle voluntary recruitment was slower and multi-muscle patterns were disrupted by SCI. Recovery occurred in 9 of the 11 showing an increase in sEMG amplitudes, more rapid prime mover muscle recruitment rates and the progressive normalization of the multi-muscle activation patterns. The rate of increase was highly individualized, differing over time by limb and proximal or distal joint within each subject and across the SCI group. Conclusions Recovery of voluntary motor function can be quantitatively tracked using neurophysiological methods in the domains of time and multi-muscle motor unit activation. Sponsorship NIH NINDS funded project #NS049954-01 PMID:21079622

McKay, WB; Ovechkin, AV; Vitaz, TW; de Paleville, DGL Terson; Harkema, SJ

2012-01-01

235

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

E-print Network

The eventual outcome of spinal cord injury is largely influenced by damage that occurs after the injury. Damaged connections between spinal cord cells and the brain allow a positive feedback mechanism to go unchecked when activated by ascending pain...

Petrich, Christine

2006-08-16

236

Following spinal cord injury (SCI) significant reorganization of the sensorimotor pathways occurs  

E-print Network

Following spinal cord injury (SCI) significant reorganization of the sensorimotor pathways occurs, on the lesioned and non-lesioned side of the lumbosacral spinal cord following a low-thoracic hemisection Retraining the injured spinal cord V. Reggie Edgerton*, Ray D. de Leon*, Susan J. Harkema*§, John A. Hodgson

Reinkensmeyer, David J.

237

Advances in three-dimensional reconstruction of the experimental spinal cord injury  

E-print Network

Advances in three-dimensional reconstruction of the experimental spinal cord injury B.S. Duerstocka) computer reconstruction is an ideal tool for evaluating the centralized pathology of mammalian spinal cord. Finally, we demonstrate dynamic navigation into a 3D spinal cord reconstruction. 2000 Elsevier Science Ltd

Texas at Austin, University of

238

Combinatory Electrical and Pharmacological Neuroprosthetic Interfaces to Regain Motor Function After Spinal Cord Injury  

Microsoft Academic Search

Severe lesions of the rodent or human spinal cord lead to permanent paralysis of the legs. Here, we review novel evidences suggesting that interventions combining pharmacological and electrical stimulations of the spinal cord have a high potential to promote the recovery of locomotion following severe spinal cord injuries in humans. These strategies are based on the existence of webs of

Pavel Musienko; Rubia van den Brand; Olivia Maerzendorfer; Alexandre Larmagnac

2009-01-01

239

Quality Assessment of Spinal Cord Injury Patient Education Resources.  

PubMed

Study Design. Analysis of spinal cord injury patient education resources.Objective. To assess the quality of online patient education materials written about spinal cord injury.Summary of Background Data. The use of online materials by healthcare consumers to access medical information presents unique challenges. Most Americans have access to the Internet and frequently turn to it as a first-line resource.Methods. The quality of online patient education materials was evaluated via a readability analysis. Materials provided by the National Institute of Neurological Disorders and Stroke (NINDS); Centers for Disease Control (CDC); American Association of Neurological Surgeons (AANS); National Spinal Cord Injury Association (NSCIA); Mayo Clinic (Mayo); Department of Veterans Affairs (VA); Kessler Institute for Rehabilitation (Kessler); American Academy of Neurology (AAN); Paralyzed Veterans of America (PVA); and the Shepherd Center (SC) were assessed using the Flesch Reading Ease and Flesch-Kincaid Grade Level evaluations with Microsoft Office Word software. Unnecessary formatting was removed and the readability was evaluated with the Spelling and Grammar function.Results. A total of 104 sections from 10 different websites were analyzed. Overall, the average values of the Flesch-Kincaid Grade Level (11.9) and Flesch Reading Ease (40.2) indicated that most Americans would not be able to fully comprehend this material.Conclusion. Results indicate that the language used on materials provided by the aforementioned sites is perhaps too advanced for the average American to fully comprehend. The quality of these education resources may be improved via website revisions, which might be beneficial for improved patient utilization. PMID:24718059

Agarwal, Nitin; Hansberry, David R; Singh, Priyanka L; Heary, Robert F; Goldstein, Ira M

2014-04-01

240

Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury.  

PubMed

Neuromodulation of spinal sensorimotor circuits improves motor control in animal models and humans with spinal cord injury. With common neuromodulation devices, electrical stimulation parameters are tuned manually and remain constant during movement. We developed a mechanistic framework to optimize neuromodulation in real time to achieve high-fidelity control of leg kinematics during locomotion in rats. We first uncovered relationships between neuromodulation parameters and recruitment of distinct sensorimotor circuits, resulting in predictive adjustments of leg kinematics. Second, we established a technological platform with embedded control policies that integrated robust movement feedback and feed-forward control loops in real time. These developments allowed us to conceive a neuroprosthetic system that controlled a broad range of foot trajectories during continuous locomotion in paralyzed rats. Animals with complete spinal cord injury performed more than 1000 successive steps without failure, and were able to climb staircases of various heights and lengths with precision and fluidity. Beyond therapeutic potential, these findings provide a conceptual and technical framework to personalize neuromodulation treatments for other neurological disorders. PMID:25253676

Wenger, Nikolaus; Moraud, Eduardo Martin; Raspopovic, Stanisa; Bonizzato, Marco; DiGiovanna, Jack; Musienko, Pavel; Morari, Manfred; Micera, Silvestro; Courtine, Grégoire

2014-09-24

241

Patient dignity in persons with spinal cord injury.  

PubMed

Technology is changing the way nurses provide patient care in spinal cord injury. A key nursing concern is the impact of technology-assisted caregiving tasks (TACT) on the patients' sense of dignity. Despite frequent use of the term dignity in discussing treatment of persons with disabilities, there is a dearth of empirical research related to this topic. In particular, there have been few attempts to define the construct for the purposes of valid measurement. The purpose of this article is, therefore, to critically review the relevant literature on patient dignity with an aim toward eventual development and validation of a Dignity Assessment Tool. PMID:14626015

Belanger, Heather G; Nelson, Audrey L; McMillan, Susan; Gavin-Dreschnack, Deborah; Holley, Sandra; Rosenberg, Deborah

2003-01-01

242

Advances in stem cell therapy for spinal cord injury  

PubMed Central

Spinal cord injury (SCI) is a devastating condition producing great personal and societal costs and for which there is no effective treatment. Stem cell transplantation is a promising therapeutic strategy, though much preclinical and clinical research work remains. Here, we briefly describe SCI epidemiology, pathophysiology, and experimental and clinical stem cell strategies. Research in stem cell biology and cell reprogramming is rapidly advancing, with the hope of moving stem cell therapy closer to helping people with SCI. We examine issues important for clinical translation and provide a commentary on recent developments, including termination of the first human embryonic stem cell transplantation trial in human SCI. PMID:23114605

Mothe, Andrea J.; Tator, Charles H.

2012-01-01

243

Spinal Cord Injury-Induced Osteoporosis: Pathogenesis and Emerging Therapies  

PubMed Central

Spinal cord injury causes rapid, severe osteoporosis with increased fracture risk. Mechanical unloading after paralysis results in increased osteocyte expression of sclerostin, suppressed bone formation, and indirect stimulation of bone resorption. At this time there are no clinical guidelines to prevent bone loss after SCI and fractures are common. More research is required to define the pathophysiology and epidemiology of SCI-induced osteoporosis. This review summarizes emerging therapeutics including anti-sclerostin antibodies, mechanical loading of the lower extremity with electrical stimulation, and mechanical stimulation via vibration therapy. PMID:22983921

Battaglino, Ricardo A.; Lazzari, Antonio A.; Garshick, Eric; Morse, Leslie R.

2012-01-01

244

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

245

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

246

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

247

Towards a method to study neurorobotic control in a rat model of spinal cord injury  

Microsoft Academic Search

Neurorobotic control of prosthetic devices may be a viable therapeutic intervention that provides spinal cord injury patients with the ability to use the neuronal activity of populations of single neurons to control an external device (i.e. cursor on a computer screen or robotic arm). However, we are limited by our understanding of how spinal cord injury alters the ability of

Robert D. Flint; Karen A. Moxon

2006-01-01

248

Cervical transforaminal injection of corticosteroids into a radicular artery: a possible mechanism for spinal cord injury  

Microsoft Academic Search

Spinal cord injury has been recognized as a complication of cervical transforaminal injections, but the mechanism of injury is uncertain. In the course of a transforaminal injection, an observation was made after the initial injection of contrast medium. The contrast medium filled a radicular artery that passed to the spinal cord. The procedure was summarily abandoned, and the patient suffered

Ray Baker; Paul Dreyfuss; Susan Mercer; Nikolai Bogduk

2003-01-01

249

Secondary conditions following spinal cord injury in a population-based sample  

Microsoft Academic Search

This prospective study investigates the frequency of both medical and non-medical complications reported by the population based cohort of SCI survivors reported to the Colorado Spinal Cord Injury Early Notification System (ENS). Persons reported to the ENS between January 1 1986 and December 31 1993, representing the broad spectrum of all severities of spinal cord injury and potential complications, were

Renee L Johnson; Kenneth A Gerhart; Jeannie McCray; Jean C Menconi; Gale G Whiteneck

1998-01-01

250

Pain following spinal cord injury: the clinical problem and experimental studies  

Microsoft Academic Search

The problem of pain following spinal cord injury challenges the health care community to develop new treatment strategies for patients requiring pain management. A number of pain syndromes are associated with spinal injury based on the nature of the lesion, neurological structures damaged, and secondary pathophysiological changes. Efforts to identify specific characteristics of each syndrome are an important beginning to

Robert P. Yezierski

1996-01-01

251

Depletion of Hematogenous Macrophages Promotes Partial Hindlimb Recovery and Neuroanatomical Repair after Experimental Spinal Cord Injury  

Microsoft Academic Search

Traumatic injury to the spinal cord initiates a series of destructive cellular processes which accentuate tissue damage at and beyond the original site of trauma. The cellular inflammatory response has been implicated as one mechanism of secondary degeneration. Of the various leukocytes present in the spinal cord after injury, macrophages predominate. Through the release of chemicals and enzymes involved in

Phillip G. Popovich; Zhen Guan; Ping Wei; Inge Huitinga; Nico van Rooijen; Bradford T. Stokes

1999-01-01

252

Post pressure response of skin blood flowmotions in anesthetized rats with spinal cord injury  

Microsoft Academic Search

Pressure ulcer is a common complication developed in persons with spinal cord injury (SCI) when prolonged unrelieved pressure was applied to the body\\/skin and underlying tissues. The objective of this study is to assess the hyperemic response of the skin blood flowmotions in anesthetized rats with spinal cord injury subjected to prolonged pressure using spectral analysis based on wavelets transform

Zengyong Li; Eric W. C. Tam; Roy Y. C. Lau; Kwok-Fai So; Wutian Wu; Arthur F. T. Mak

2009-01-01

253

Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system after spinal cord injury  

Microsoft Academic Search

Teasell RW, Arnold JMO, Krassioukov A, Delaney GA. Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system after spinal cord injury. Arch Phys Med Rehabil 2000;81:506-16. Spinal cord injury (SCI) with resultant quadriplegia or high paraplegia is associated with significant dysfunction of the sympathetic nervous system. This alteration of sympathetic nervous system activity occurs as a consequence

Robert W. Teasell; J. Malcolm O. Arnold; Andrei Krassioukov; Gail A. Delaney

2000-01-01

254

Body composition of active persons with spinal cord injury and with poliomyelitis  

Technology Transfer Automated Retrieval System (TEKTRAN)

This study sought to evaluate the body composition of subjects with active spinal cord injuries and polio. Two groups of males and females, active, free-living, of similar ages and body mass index (BMI), were distributed according to the source of deficiency: SCI – low spinal cord injury (T5-T12) an...

255

A 20-year Longitudinal Perspective on the Vocational Experiences of Persons with Spinal Cord Injury.  

ERIC Educational Resources Information Center

Uses interviews conducted in 1974 and 1994 to investigate the vocational experiences of individuals with spinal cord injuries. Participants had received a spinal cord injury 22-45 years previously. Results revealed that all but seven of the participants had been in remunerative employment. Work experiences, comprehensive rehabilitation service,…

Crewe, Nancy M.

2000-01-01

256

Religiosity and Spirituality among Persons with Spinal Cord Injury: Attitudes, Beliefs, and Practices  

ERIC Educational Resources Information Center

A total of 157 persons with spinal cord injury completed the "Spirituality and Spinal Cord Injury Survey" in relation to their spiritual and/or religious attitudes, beliefs, and practices in terms of adapting to their disability. Factor analysis accounting for 69% of the variance revealed four factors related to Spiritual Help and Improvement…

Marini, Irmo; Glover-Graf, Noreen M.

2011-01-01

257

Influence of Alcohol Intake on the Course and Consequences of Spinal Cord Injury.  

ERIC Educational Resources Information Center

This study compared the neurological state and results of treatment for patients with traumatic spinal cord injury who were intoxicated (n=424) or sober (n=769) on admission to a Warsaw (Poland) hospital. In the intoxicated group, the number of patients with symptoms of complete spinal cord injury was much greater than that of the sober group. (DB)

Kiwerski, J. E.; Krasuski, M.

1992-01-01

258

Semen retrieval by penile vibratory stimulation in men with spinal cord injury  

Microsoft Academic Search

Traumatic spinal cord injury resulting from car accidents, falls, violence or sport-related activities is a common occurrence throughout the world. Spinal cord injuries occur most often to young men in their parenting years. Among the medical challenges facing many of these men is the inability to ejaculate via sexual intercourse. To achieve biological fatherhood, their semen may be retrieved by

Nancy L. Brackett

259

Clean intermittent catheterization and prevention of renal disease in spinal cord injury patients  

Microsoft Academic Search

Upper urinary tract complications have been reported in about 20 – 30% of spinal cord injury patients. Their pathogenesis is linked to the presence of high-pressure uninhibited detrusor contractions, high leak point pressure and low bladder compliance. The aim of this study was to evaluate the incidence of upper urinary tract complications in two homogeneous groups of spinal cord injury

A Giannantoni; G Scivoletto; SM Di Stasi; A Silecchia; E Finazzi-Agrò; I Micali; V Castellano

1998-01-01

260

Does Spinal Cord Injury Affect Personality? A Study of Monozygotic Twins  

Microsoft Academic Search

ABSTRACT. Objective: To assess whether spinal cord injury (SCI) is associated with personality change. Study Design: NEO Personality Inventory—Revised results of identical twins, one of whom had a spinal cord injury, were compared. Setting: Veterans Affairs Medical Center, Bronx, New York. Participants: Eleven sets of twins recruited through a nationwide search involving advertisements in periodicals and referrals from other professionals.

Christine Hollick; Cynthia L. Radnitz; Jeremy Silverman; Dennis Tirch; Sandra Birstein; William A. Bauman

2001-01-01

261

Age-related changes in the spinal cord microglial and astrocytic response profile to nerve injury  

Microsoft Academic Search

Neuropathic pain, arising from nerve injury or secondary to other diseases, occurs in young children as well as adults but little is known about its postnatal development. Neonatal rat pups do not display mechanical allodynia following nerve injury and young rats recover faster from spinal nerve damage. Since both spinal microglia and astrocytes are strongly implicated in the maintenance of

David Vega-Avelaira; Andrew Moss; Maria Fitzgerald

2007-01-01

262

Protective Factors and Posttraumatic Stress Disorder in Veterans With Spinal Cord Injury  

Microsoft Academic Search

This study examined the effects of putative protective factors, including current family structure (marital status and children), level of education, and perceived social support, upon posttraumatic stress disorder (PTSD) symptomatology in veterans with spinal cord injury (SCI). Participants were 124 veterans with traumatic spinal cord injuries, recruited from SCI services at Veterans Affairs Medical Centers in the Bronx, NY, Castle

Gina Danner; Cynthia L. Radnitz

2000-01-01

263

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

264

The Spinal Cord Injury- Functional Index: Item Banks to Measure Physical Functioning of Individuals with Spinal Cord Injury  

PubMed Central

Objective To develop a comprehensive set of patient reported items to assess multiple aspects of physical functioning relevant to the lives of people with spinal cord injury (SCI) and to evaluate the underlying structure of physical functioning. Design Cross-sectional Setting Inpatient and community Participants Item pools of physical functioning were developed, refined and field tested in a large sample of 855 individuals with traumatic spinal cord injury stratified by diagnosis, severity, and time since injury Interventions None Main Outcome Measure SCI-FI measurement system Results Confirmatory factor analysis (CFA) indicated that a 5-factor model, including basic mobility, ambulation, wheelchair mobility, self care, and fine motor, had the best model fit and was most closely aligned conceptually with feedback received from individuals with SCI and SCI clinicians. When just the items making up basic mobility were tested in CFA, the fit statistics indicate strong support for a unidimensional model. Similar results were demonstrated for each of the other four factors indicating unidimensional models. Conclusions Though unidimensional or 2-factor (mobility and upper extremity) models of physical functioning make up outcomes measures in the general population, the underlying structure of physical function in SCI is more complex. A 5-factor solution allows for comprehensive assessment of key domain areas of physical functioning. These results informed the structure and development of the SCI-FI measurement system of physical functioning. PMID:22609299

Tulsky, David S.; Jette, Alan; Kisala, Pamela A.; Kalpakjian, Claire; Dijkers, Marcel P.; Whiteneck, Gale; Ni, Pengsheng; Kirshblum, Steven; Charlifue, Susan; Heinemann, Allen W.; Forchheimer, Martin; Slavin, Mary; Houlihan, Bethlyn; Tate, Denise; Dyson-Hudson, Trevor; Fyffe, Denise; Williams, Steve; Zanca, Jeanne

2012-01-01

265

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 Vázquez, Rita; Rascado Sedes, Pedro; Montoto Marqués, Antonio; Ferreiro Velasco, M. Elena

2013-01-01

266

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

267

CD47 knockout mice exhibit improved recovery from spinal cord injury Scott A. Myers a,b  

E-print Network

CD47 knockout mice exhibit improved recovery from spinal cord injury Scott A. Myers a,b , William H. Hoying e , Theo Hagg a,b,d , Scott R. Whittemore a,b,c, a Kentucky Spinal Cord Injury Research Center Accepted 10 December 2010 Available online xxxx Keywords: CD47 Thrombospondin-1 Spinal cord injury

Harkema, Susan

268

Brain-Derived Neurotrophic Factor Stimulates Hindlimb Stepping and Sprouting of Cholinergic Fibers after Spinal Cord Injury  

Microsoft Academic Search

Neurotrophic factors have been proposed as a therapeutic treatment for traumatic brain and spinal cord injury. The present study determined whether exogenous administration of one such factor, brain-derived neurotrophic factor (BDNF), could effect behavioral recovery and\\/or histopathological changes after spinal cord injury. Adult rats received a mild or moderate contusion injury or complete transection of the midthoracic spinal cord. Immediately

Lyn B. Jakeman; Ping Wei; Zhen Guan; Bradford T. Stokes

1998-01-01

269

Risk for Subsequent Injuries After Spinal Cord Injury: A 10-Year Longitudinal Analysis  

PubMed Central

Objectives To identify: (a) the annual incidence of subsequent injury and injury related hospitalizations among individuals with pre-existing spinal cord injury (SCI) and (b) risk and protective behaviors associated with differential risk of injury. Design Longitudinal, mailed survey. Participants were enrolled in 1997-1998, with a follow-up conducted 10 years later. Setting Data were collected from participants identified from a specialty hospital and analyzed at a medical university in the Southeastern United States. Participants There were 1386 participants during the baseline enrollment, 821 of whom also participated in the 10-year follow-up. Inclusion criteria were: (1) traumatic SCI with residual impairment A-D, (2) non-surgical onset, (3) age 18 years or older, and (4) a minimum of 12 months post-SCI. Interventions Main Outcome Measures Number of injuries severe enough to require treatment in a clinic, emergency department, or hospital in the 12 months prior to the survey, and number of injury related hospitalizations. Predictor variables included selected items from the Behavioral Risk Factor Surveillance System, the Zuckerman-Kuhlman Personality Questionnaire, and prescription medication usage. Results Over 23% of participants reported at least 1 injury within the past year, an increase from that reported 10 years earlier by the same participants (19%), and 7% reported at least 1 injury related hospitalization. Those who reported a subsequent injury during the preliminary baseline data collection were about twice as likely to report at least 1 injury 10 years later. Binge drinking, psychotropic prescription medication use, and several personality characteristics were also related to injuries and/or injury hospitalization. Conclusions Risk of injury continues to be a significant concern in the years and decades after SCI onset. Behavioral and personality factors hold the key to prevention. PMID:21044720

Krause, James S.

2011-01-01

270

Current research outcomes from the spinal cord injury model systems.  

PubMed

This article serves as an introduction to this issue of the Archives of Physical Medicine and Rehabilitation that is devoted to current research findings of the Spinal Cord Injury Model Systems (SCIMS) program. The SCIMS program began in 1970, with funding from the National Institute on Disability and Rehabilitation Research in the U.S. Department of Education, to demonstrate a comprehensive care system for spinal cord injury (SCI) and also to conduct research to improve the health and quality of life of persons with SCI. Over the last 20 years, similar collaborative efforts for the dissemination of SCIMS research outcomes have produced conference proceedings in 1990, a book in 1995, and dedicated journal issues in 1999 and 2004. The collection of 24 articles in this issue shows the depth and breadth of work being carried out by the SCIMS investigators, from descriptive epidemiology to a randomized controlled trial, from neurologic recovery to community reintegration, and from health services utilization to assistive technology for mobility. Herein, we provide a brief overview of the SCIMS program, highlight the research initiatives currently underway, and describe the important findings of the original research articles contained in this issue. PMID:21353816

Chen, Yuying; Deutsch, Anne; DeVivo, Michael J; Johnson, Kurt; Kalpakjian, Claire Z; Nemunaitis, Gregory; Tulsky, David

2011-03-01

271

Clinical assessment of spasticity in individuals with spinal cord injury  

PubMed Central

Objective To evaluate the effect of neuromuscular electrical stimulation on spasticity in patients with spinal cord injury. Methods The study included eleven subjects with spinal cord injuries (C4 to T5). The modified Ashworth scale and pendulum test, which is accomplished through the Pendular Test Device - PTD (equipment which has a quartz crystal transducer accelerometer and optic fiber flexible electrogoniometer measuring the tensions and angular displacements). Patients underwent neuromuscular electrical stimulation (NMES) to the quadriceps muscle from fibular nerve, and the tests were administered before and after therapy. Results The data show a decrease in spasticity after NMES, with features such as increased variation between maximum and minimum peaks, i.e. increased amplitude of the curves. Furthermore, data from the subjective scale, and modified Ashworth scale after neuromuscular electrical stimulation also showed a reduction in the values of spasticity. Conclusion The data suggest that NMES is effective in reducing spasticity immediately after completion. Level of Evidence II, Therapeutic Studies-Investigating the Results of Treatment. PMID:24453687

Tancredo, Janaina Roland; Maria, Renata Manzano; de Azevedo, Eliza Regina Ferreira Braga Machado; Alonso, Karina Cristina; Varoto, Renato; Cliquet, Alberto

2013-01-01

272

Spinal cord injury impacts B cell production, homeostasis, and activation.  

PubMed

Complex interactions govern the interplay of central nervous and immune systems, including the generation, homeostatic maintenance, and activation of B cells. Accordingly, spinal cord injury will likely impact all of these processes. Several laboratories have recently explored this possibility, and their observations in aggregate reveal both acute and chronic consequences that can vary based on the injury location. Acute effects include a transient cessation of bone marrow B lymphopoiesis, with a corresponding drop in the peripheral follicular and transitional B cell subsets, whereas the marginal zone subset is preserved. Despite recovery of B lymphopoiesis by 28 days post injury, follicular B cell numbers remain depressed; this may reflect reduced levels of the homeostatic cytokine BLyS. In general, the ability to mount T dependent antibody responses after injury are intact, as are pre-existing memory B cell pools and antibody levels. In contrast, T-independent responses are chronically compromised. Both glucocorticoid-dependent and -independent processes mediate these effects, but a detailed understanding of the mechanisms involved awaits further study. Nonetheless, these observations in toto strengthen the growing appreciation for bidirectional interactions between the CNS and immune system, highlighting the need for further basic and translational efforts. PMID:25443579

Oropallo, Michael A; Goenka, Radhika; Cancro, Michael P

2014-10-01

273

New surgical approach for late complications from spinal cord injury  

PubMed Central

Background The most frequent late complications in spinal cord injury result from arachnoiditis and consequent alterations in dynamics of cerebrospinal fluid flow. A surgical procedure carried out on patients with these alterations, resolved the various pathologies more efficiently in all cases. Methods From October 2000 to March 2006, 23 patients were selected for surgery: three showed signs of syringomyelia, three presented with microcystic lesions, three presented with arachnoid cysts in different locations but always confluent to the scar area, and 14 showed evidence of tethered cords. The surgery consisted of laminectomy at four levels, followed by dural opening in order to remove all the arachnoiditis at the level of the scar and to remove the altered arachnoid and its cysts, at least at two levels above and below the lesion. The dentate ligaments were cut at all exposed levels. Results The patients had no postoperative problems and not only retained all neurological functions but also showed neurological recovery. According to the motor and sensory scale of the American Spinal Injury Association, the recoveries were motor 20.6% (P < 0.001), touch 15.6% ((P < 0.001) and pinprick 14.4% (P < 0.001). These patients showed no signs of relapse at 4–66 month follow-up. Conclusion This alternative surgery resolved the pathologies provoking neurological deterioration by releasing the complete spinal cord at the level of the scar and the levels above and below it. It thus avoids myelotomies and the use of shunts and stents, which have a high long-term failure rate and consequent relapses. Nevertheless, this surgical procedure allows patients the chance to opt for any further treatment that may evolve in the future. PMID:17059598

Reis, Antonio J

2006-01-01

274

Effect of Regular Exercise on Cardiopulmonary Fitness in Males With Spinal Cord Injury  

PubMed Central

Objective To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. Methods We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to the exercise protocol and was stopped when the subject was exhausted or when VO2 reached an equilibriu Results Among the 40 subjects, there were 10 subjects with cervical cord injury, 27 with thoracic cord injury, and 3 with lumbar cord injury. Twenty-five subjects who were exercised regularly showed statistically higher results of VO2max than those who did not exercise regularly. Subjects with cervical injury showed statistically lower VO2max than the subjects with thoracic or lumbar injury out of the 40 subjects with neurologic injury. In addition, higher age showed a statistically lower VO2max. Lastly, the regularly exercising paraplegic group showed higher VO2max than the non-exercising paraplegic group. Conclusion There are differences in VO2max of subjects with spinal cord injury according to the degree of neurologic injury, age, and whether the subject participates in regular exercise. We found that regular exercise increased the VO2max in individuals with spinal cord injury.

Lee, Young Hee; Kong, In Deok; Kim, Sung Hoon; Shinn, Jong Mock; Kim, Jong Heon; Yi, Dongsoo; Lee, Jin Hyeong; Chang, Jae Seung; Kim, Tae-ho; Kim, Eun Ju

2015-01-01

275

Subcortical Control of Precision Grip after Human Spinal Cord Injury  

PubMed Central

The motor cortex and the corticospinal system contribute to the control of a precision grip between the thumb and index finger. The involvement of subcortical pathways during human precision grip remains unclear. Using noninvasive cortical and cervicomedullary stimulation, we examined motor evoked potentials (MEPs) and the activity in intracortical and subcortical pathways targeting an intrinsic hand muscle when grasping a small (6 mm) cylinder between the thumb and index finger and during index finger abduction in uninjured humans and in patients with subcortical damage due to incomplete cervical spinal cord injury (SCI). We demonstrate that cortical and cervicomedullary MEP size was reduced during precision grip compared with index finger abduction in uninjured humans, but was unchanged in SCI patients. Regardless of whether cortical and cervicomedullary stimulation was used, suppression of the MEP was only evident 1–3 ms after its onset. Long-term (?5 years) use of the GABAb receptor agonist baclofen by SCI patients reduced MEP size during precision grip to similar levels as uninjured humans. Index finger sensory function correlated with MEP size during precision grip in SCI patients. Intracortical inhibition decreased during precision grip and spinal motoneuron excitability remained unchanged in all groups. Our results demonstrate that the control of precision grip in humans involves premotoneuronal subcortical mechanisms, likely disynaptic or polysynaptic spinal pathways that are lacking after SCI and restored by long-term use of baclofen. We propose that spinal GABAb-ergic interneuronal circuits, which are sensitive to baclofen, are part of the subcortical premotoneuronal network shaping corticospinal output during human precision grip. PMID:24849366

Bunday, Karen L.; Tazoe, Toshiki; Rothwell, John C.

2014-01-01

276

Risk of hospitalizations after spinal cord injury: relationship with biographical, injury, educational, and behavioral factors  

Microsoft Academic Search

Study design:Cross-sectional survey.Objectives:To assess the risk factors associated with hospitalization and the relationship of individual health behaviors with hospitalizations after spinal cord injury (SCI).Setting:A large specialty hospital in the southeastern USA.Methods:Persons with SCI responded (n=1386) to a mail survey assessing various aspects of their health, including health behaviors and number of hospitalizations in the past year. Logistic regression was used

J S Krause; L L Saunders

2009-01-01

277

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

278

Changes in pubococcygeus muscle tension in the pelvic floor of rats after spinal cord injury  

Microsoft Academic Search

Study design:The purpose of this study was to explore the changes in pelvic floor muscle tension at different times after suprasacral spinal cord injury (SS) and sacral cord injury (SC), and learn more about pelvic floor dysfunction (PFD) after spinal cord injury (SCI).Method:A total of 70 healthy female Sprague–Dawley (SD) rats, weighing between 250 and 280 g, were randomly divided

Z Lu; J J Li; L M Liao; Y Hong; JJ Li

2010-01-01

279

Interleukin-33 treatment reduces secondary injury and improves functional recovery after contusion spinal cord injury.  

PubMed

Interleukin-33 (IL-33) is a member of the interleukin-1 cytokine family and highly expressed in the naïve mouse brain and spinal cord. Despite the fact that IL-33 is known to be inducible by various inflammatory stimuli, its cellular localization in the central nervous system and role in pathological conditions is controversial. Administration of recombinant IL-33 has been shown to attenuate experimental autoimmune encephalomyelitis progression in one study, yet contradictory reports also exist. Here we investigated for the first time the pattern of IL-33 expression in the contused mouse spinal cord and demonstrated that after spinal cord injury (SCI) IL-33 was up-regulated and exhibited a nuclear localization predominantly in astrocytes. Importantly, we found that treatment with recombinant IL-33 alleviated secondary damage by significantly decreasing tissue loss, demyelination and astrogliosis in the contused mouse spinal cord, resulting in dramatically improved functional recovery. We identified both central and peripheral mechanisms of IL-33 action. In spinal cord, IL-33 treatment reduced the expression of pro-inflammatory tumor necrosis factor-alpha and promoted the activation of anti-inflammatory arginase-1 positive M2 microglia/macrophages, which chronically persisted in the injured spinal cord for up to at least 42 days after the treatment. In addition, IL-33 treatment showed a tendency towards reduced T-cell infiltration into the spinal cord. In the periphery, IL-33 treatment induced a shift towards the Th2 type cytokine profile and reduced the percentage and absolute number of cytotoxic, tumor necrosis factor-alpha expressing CD4+ cells in the spleen. Additionally, IL-33 treatment increased expression of T-regulatory cell marker FoxP3 and reduced expression of M1 marker iNOS in the spleen. Taken together, these results provide the first evidence that IL-33 administration is beneficial after CNS trauma. Treatment with IL33 may offer a novel therapeutic strategy for patients with acute contusion SCI. PMID:25153903

Pomeshchik, Yuriy; Kidin, Iurii; Korhonen, Paula; Savchenko, Ekaterina; Jaronen, Merja; Lehtonen, Sarka; Wojciechowski, Sara; Kanninen, Katja; Koistinaho, Jari; Malm, Tarja

2015-02-01

280

Thrombospondin-4 and excitatory synaptogenesis promote spinal sensitization after painful mechanical joint injury.  

PubMed

Facet joint injury induces persistent pain that may be maintained by structural plasticity in the spinal cord. Astrocyte-derived thrombospondins, especially thrombospondin-4 (TSP4), have been implicated in synaptogenesis and spinal sensitization in neuropathic pain, but the TSP4 response and its relationship to synaptic changes in the spinal cord have not been investigated for painful joint injury. This study investigates the role of TSP4 in the development and maintenance of persistent pain following injurious facet joint distraction in rats and tests the hypothesis that excitatory synaptogenesis contributes to such pain. Painful facet joint loading induces dorsal horn excitatory synaptogenesis along with decreased TSP4 in the DRG and increased astrocytic release of TSP4 in the spinal cord, all of which parallel the time course of sustained tactile allodynia. Blocking injury-induced spinal TSP4 expression with antisense oligonucleotides or reducing TSP4 activity at its neuronal receptor in the spinal cord with gabapentin treatment both attenuate the allodynia and dorsal horn synaptogenesis that develop after painful facet joint loading. Increased spinal TSP4 also facilitates the development of allodynia and spinal hyperexcitability, even after non-painful physiological loading of the facet joint. These results suggest that spinal TSP4 plays an important role in the development and maintenance of persistent joint-mediated pain by inducing excitatory synaptogenesis and facilitating the transduction of mechanical loading of the facet joint that leads to spinal hyperexcitability. PMID:25483397

Crosby, Nathan D; Zaucke, Frank; Kras, Jeffrey V; Dong, Ling; Luo, Z David; Winkelstein, Beth A

2015-02-01

281

Olfactory ensheathing cell transplantation improves sympathetic skin responses in chronic spinal cord injury.  

PubMed

Forty-three patients with chronic spinal cord injury for over 6 months were transplanted with bryonic olfactory ensheathing cells, 2-4 × 10(6), into multiple sites in the injured area under the surgical microscope. The sympathetic skin response in patients was measured with an electromyography/evoked potential instrument 1 day before transplantation and 3-8 weeks after transtion. Spinal nerve function of patients was assessed using the American Spinal Injury Association impairment scale. The sympathetic skin response was elicited in 32 cases before olfactory ensheathing cell transplantation, while it was observed in 34 cases after transplantation. tantly, sympathetic skin response latency decreased significantly and amplitude increased cantly after transplantation. Transplantation of olfactory ensheathing cells also improved American Spinal Injury Association scores for movement, pain and light touch. Our findings indicate that factory ensheathing cell transplantation improves motor, sensory and autonomic nerve functions in patients with chronic spinal cord injury. PMID:25206606

Zheng, Zuncheng; Liu, Guifeng; Chen, Yuexia; Wei, Shugang

2013-10-25

282

Olfactory ensheathing cell transplantation improves sympathetic skin responses in chronic spinal cord injury  

PubMed Central

Forty-three patients with chronic spinal cord injury for over 6 months were transplanted with bryonic olfactory ensheathing cells, 2–4 × 106, into multiple sites in the injured area under the surgical microscope. The sympathetic skin response in patients was measured with an electromyography/evoked potential instrument 1 day before transplantation and 3–8 weeks after transtion. Spinal nerve function of patients was assessed using the American Spinal Injury Association impairment scale. The sympathetic skin response was elicited in 32 cases before olfactory ensheathing cell transplantation, while it was observed in 34 cases after transplantation. tantly, sympathetic skin response latency decreased significantly and amplitude increased cantly after transplantation. Transplantation of olfactory ensheathing cells also improved American Spinal Injury Association scores for movement, pain and light touch. Our findings indicate that factory ensheathing cell transplantation improves motor, sensory and autonomic nerve functions in patients with chronic spinal cord injury. PMID:25206606

Zheng, Zuncheng; Liu, Guifeng; Chen, Yuexia; Wei, Shugang

2013-01-01

283

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

284

Spinal cord trauma  

MedlinePLUS

Spinal cord injury; Compression of spinal cord; SCI; Cord compression ... them more likely to fall may also have spinal cord injury. ... vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and ...

285

Serum Lipid Profile in Subjects with Traumatic Spinal Cord Injury  

PubMed Central

Background and Aims Few large studies have examined the relationship between spinal cord injury (SCI) and lipid profile. We studied serum lipid concentrations in subjects with traumatic SCI in relation to the degree of neurological involvement and time since injury, and compared them with values from a reference sample for the Spanish population (DRECE study). Materials and Methods A retrospective cohort was built from 177 consecutive cases with traumatic SCI admitted to the SCI unit of the Miguel Servet Hospital in Aragon (Spain). Outcome measures (cholesterol, triglycerides, HDL-c and LDL-c levels) were analyzed according to the ASIA Impairment Scale (AIS), neurological level of injury (involvement of all limbs vs. only lower limbs), and time since injury. All analyses were adjusted for age and sex. Results Cases without preserved motor function (AIS A or B) had lower total and HDL cholesterol than the others (-11.4 [-21.5, -1.4] mg/dL total cholesterol and -5.1 [-8.8, -1.4] mg/dL HDL-c), and cases with all-limb involvement had lower total, HDL, and LDL cholesterol than those with only lower-limb involvement (-14.0 [-24.6, -3.4] mg/dL total cholesterol, -4.1 [-8.0, -0.2] mg/dL HDL-c, and -10.0 [-19.7, -0.3] mg/dL LDL-c) (all p<0.05). No association was found between lipid concentrations and time since injury. Concentrations of lipid subfractions and triglycerides in SCI subjects were lower than in sex- and age-stratified values from the reference sample. Conclusion A high degree of neurological involvement in SCI (anatomically higher lesions and AIS A or B) is associated with lower total cholesterol and HDL-c. PMID:25706982

Laclaustra, Martin; Van Den Berg, Elizabeth Louise Maayken; Hurtado-Roca, Yamilée; Castellote, Juan Manuel

2015-01-01

286

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

287

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

288

Occupational therapy treatment time during inpatient spinal cord injury rehabilitation  

PubMed Central

Background Occupational therapy (OT) is a critical component of the rehabilitation process after spinal cord injury (SCI), the constitution of which has not been studied or documented in full detail previously. Objective To describe the type and distribution of SCI rehabilitation OT activities, including the amount of time spent on evaluation and treatment, and to discuss predictors (patient and injury characteristics) of the amount of time dedicated to OT treatment activities. Methods Six inpatient rehabilitation centers enrolled 600 patients with traumatic SCI in the first year of the SCIRehab. Occupational therapists documented 32 512 therapy sessions including time spent and specifics of each therapeutic activity. Analysis of variance and contingency tables/chi-square tests were used to test differences across neurologic injury groups for continuous and categorical variables. Results SCIRehab patients received a mean total of 52 hours of OT over the course of their rehabilitation stay. Statistically significant differences among four neurologic injury groups were seen in time spent on each OT activity. The activities that consumed the most OT time (individual and group sessions combined) were strengthening/endurance exercises, activities of daily living (ADLs), range of motion (ROM)/stretching, education, and a grouping of ‘therapeutic activities’ that included tenodesis training, fine motor activities, manual therapy, vestibular training, edema management, breathing exercise, cognitive retraining, visual/perceptual training desensitization, and don/doff adaptive equipment. Seventy-seven percent of OT work occurred in individual treatment sessions, with the most frequent OT activity involving ADLs. The variation in time (mean minutes per week) spent on OT ROM/stretching, ADLs, transfer training, assessment, and therapeutic activities can be explained in part by patient and injury characteristics, such as admission Functional Independence Measure (FIM) score, neurologic injury group, and the medical severity of illness score. Conclusion OT treatment patterns for patients with traumatic SCI show much variation in activity selection and time spent on activities, within and among neurologic level of injury groups. Some of the variation can be explained by patient and injury characteristics. Almost all patients with SCI participated in strengthening/endurance and ROM/stretching exercises during OT treatment and these two activities are where the most time was spent when therapy provided in individual and group settings was combined. ADL work consumed the most time in individual therapy sessions. PMID:21675355

Foy, Teresa; Perritt, Ginger; Thimmaiah, Deepa; Heisler, Lauren; Offutt, Jennifer Lookingbill; Cantoni, Kara; Hseih, Ching-Hui; Gassaway, Julie; Ozelie, Rebecca; Backus, Deborah

2011-01-01

289

Nanocarrier-mediated inhibition of macrophage migration inhibitory factor attenuates secondary injury after spinal cord injury.  

PubMed

Spinal cord injury (SCI) can lead to permanent motor and sensory deficits. Following the initial traumatic insult, secondary injury mechanisms characterized by persistent heightened inflammation are initiated and lead to continued and pervasive cell death and tissue damage. Anti-inflammatory drugs such as methylprednisolone (MP) used clinically have ambiguous benefits with debilitating side effects. Typically, these drugs are administered systemically at high doses, resulting in toxicity and paradoxically increased inflammation. Furthermore, these drugs have a small time window postinjury (few hours) during which they need to be infused to be effective. As an alternative to MP, we investigated the effect of a small molecule inhibitor (Chicago sky blue, CSB) of macrophage migration inhibitory factor (MIF) for treating SCI. The pleiotropic cytokine MIF is known to contribute to upregulation of several pro-inflammatory cytokines in various disease and injury states. In vitro, CSB administration alleviated endotoxin-mediated inflammation in primary microglia and macrophages. Nanocarriers such as liposomes can potentially alleviate systemic side effects of high-dose therapy by enabling site-specific drug delivery to the spinal cord. However, the therapeutic window of 100 nm scale nanoparticle localization to the spinal cord after contusion injury is not fully known. Thus, we first investigated the ability of nanocarriers of different sizes to localize to the injured spinal cord up to 2 weeks postinjury. Results from the study showed that nanocarriers as large as 200 nm in diameter could extravasate into the injured spinal cord up to 96 h postinjury. We then formulated nanocarriers (liposomes) encapsulating CSB and administered them intravenously 48 h postinjury, within the previously determined 96 h therapeutic window. In vivo, in this clinically relevant contusion injury model in rats, CSB administration led to preservation of vascular and white matter integrity, improved wound healing, and an increase in levels of arginase and other transcripts indicative of a resolution phase of wound healing. This study demonstrates the potential of MIF inhibition in SCI and the utility of nanocarrier-mediated drug delivery selectively to the injured cord. PMID:25587936

Saxena, Tarun; Loomis, Kristin H; Pai, S Balakrishna; Karumbaiah, Lohitash; Gaupp, Eric; Patil, Ketki; Patkar, Radhika; Bellamkonda, Ravi V

2015-02-24

290

Assessment and Evaluation of Primary Prevention in Spinal Cord Injury  

PubMed Central

Although the incidence of spinal cord injury (SCI) is low, the consequences of this disabling condition are extremely significant for the individual, family, and the community. Sequelae occur in the physical, psychosocial, sexual, and financial arenas, making global prevention of SCI crucial. Understanding how to assess and evaluate primary prevention programs is an important competency for SCI professionals. Assessing a program’s success requires measuring processes, outcomes, and impact. Effective evaluation can lead future efforts for program design while ensuring accountability for the program itself. The intended impact of primary prevention programs for SCI is to decrease the number of individuals who sustain traumatic injury; many programs have process and outcome goals as well. An understanding of the basic types of evaluation, evaluation design, and the overall process of program evaluation is essential for ensuring that these programs are efficacious. All health care professionals have the opportunity to put prevention at the forefront of their practice. With the current paucity of available data, it is important that clinicians share their program design, their successes, and their failures so that all can benefit and future injury can be prevented. PMID:23678281

2013-01-01

291

Muscle spindle feedback directs locomotor recovery and circuit reorganization after spinal cord injury.  

PubMed

Spinal cord injuries alter motor function by disconnecting neural circuits above and below the lesion, rendering sensory inputs a primary source of direct external drive to neuronal networks caudal to the injury. Here, we studied mice lacking functional muscle spindle feedback to determine the role of this sensory channel in gait control and locomotor recovery after spinal cord injury. High-resolution kinematic analysis of intact mutant mice revealed proficient execution in basic locomotor tasks but poor performance in a precision task. After injury, wild-type mice spontaneously recovered basic locomotor function, whereas mice with deficient muscle spindle feedback failed to regain control over the hindlimb on the lesioned side. Virus-mediated tracing demonstrated that mutant mice exhibit defective rearrangements of descending circuits projecting to deprived spinal segments during recovery. Our findings reveal an essential role for muscle spindle feedback in directing basic locomotor recovery and facilitating circuit reorganization after spinal cord injury. PMID:25525880

Takeoka, Aya; Vollenweider, Isabel; Courtine, Grégoire; Arber, Silvia

2014-12-18

292

Clinical Outcomes of Surgical Treatments for Traumatic Spinal Injuries due to Snowboarding  

PubMed Central

Study Design Retrospective study. Purpose To assess treatment outcomes of snowboarding-related spinal and spinal cord injuries. Overview of Literature Snowboarding-related spinal or spinal cord injury have a great impact on social and sporting activities. Methods A retrospective review of 19 cases of surgically treated snowboard-related injury was done. Analyzed parameters included site of injury, type of fracture, peri- and postoperative complications, pre- and postoperative neurological status, activities of daily living, and participation in sports activities at the final follow-up. Results The major site of injury was the thoracolumbar junction caused by fracture-dislocation (13/19 cases). The remaining 6 cases had cervical spine injuries. Over 60% of the patients had Frankel A and B paralysis. All patients were surgically treated by posterior fusion with instrumentation. Five underwent additional anterior fusion. Surgical outcome was restoration of ambulatory capacity in 12 patients (63.2%). Ultimately, 15 patients (78.9%) could return to work. Patients with complete paralysis upon admission showed reduced ambulatory capacity compared to those with incomplete paralysis. None of the patients again participated in any sports activities, including snowboarding. Conclusions Snowboarding-related spinal or spinal cord injury has a great impact on social as well as sports activities. It is necessary to enhance promotion of injury prevention emphasizing the snowboarders' responsibility code. PMID:25705340

Masuda, Takahiro; Wakahara, Kazuhiko; Matsumoto, Kazu; Hioki, Akira; Shimokawa, Tetsuya; Shimizu, Katsuji; Ogura, Shinji; Akiyama, Haruhiko

2015-01-01

293

Psychological Adjustment to Spinal Cord Injury as Related to Manner of Onset of Disability.  

ERIC Educational Resources Information Center

People with spinal cord injury have behavioral tendencies that place them at-risk of such injuries. This study investigated the relationship between personality characteristics as suggested by manner of onset of injury and long-term medical, vocational, and psychological adjustment. Imprudent subjects tended to be better adjusted at follow-up than…

Athelstan, Gary T.; Crewe, Nancy M.

1979-01-01

294

Survey of spinal cord injury-induced neurogenic bladder studies using the Web of Science  

PubMed Central

OBJECTIVE: To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL: We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science. Data retrieval was performed using key words “spinal cord injury”, “spinal injury”, “neurogenic bladder”, “neuropathic bladder”, “neurogenic lower urinary tract dysfunction”, “neurogenic voiding dysfunction”, “neurogenic urination disorder” and “neurogenic vesicourethral dysfunction”. SELECTION CRITERIA: Inclusion criteria: (a) published peer-reviewed articles on spinal cord injury-induced neurogenic bladder indexed in the Web of Science; (b) type of articles: original research articles and reviews; (c) year of publication: no limitation. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) Corrected papers and book chapters. MAIN OUTCOME MEASURES: (1) Annual publication output; (2) distribution according to journals; (3) distribution according to subject areas; (4) distribution according to country; (5) distribution according to institution; and (6) top cited publications. RESULTS: There were 646 research articles addressing spinal cord injury-induced neurogenic bladder in the Web of Science. Research on spinal cord injury-induced neurogenic bladder was found in the Science Citation Index-Expanded as of 1946. The United States, Ireland and Switzerland were the three major countries contributing to studies in spinal cord injury-induced neurogenic bladder in the 1970s. However, in the 1990s, the United States, the United Kingdom, the Netherlands, Germany and Japan published more papers on spinal cord injury-induced neurogenic bladder than Switzerland, and Ireland fell off the top ten countries list. In this century, the United States ranks first in spinal cord injury-induced neurogenic bladder studies, followed by France, the United Kingdom, Germany, Switzerland and Japan. Subject categories including urology, nephrology and clinical neurology, as well as rehabilitation, are represented in spinal cord injury-induced neurogenic bladder studies. CONCLUSION: From our analysis of the literature and research trends, we conclude that spinal cord injury-induced neurogenic bladder is a hot topic that will continue to generate considerable research interest in the future. PMID:25624808

Zou, Benjing; Zhang, Yongli; Li, Yucheng; Wang, Zantao; Zhang, Ping; Zhang, Xiyin; Wang, Bingdong; Long, Zhixin; Wang, Feng; Song, Guo; Wang, Yan

2012-01-01

295

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

296

Neuroprosthetic technology for individuals with spinal cord injury  

PubMed Central

Context Spinal cord injury (SCI) results in a loss of function and sensation below the level of the lesion. Neuroprosthetic technology has been developed to help restore motor and autonomic functions as well as to provide sensory feedback. Findings This paper provides an overview of neuroprosthetic technology that aims to address the priorities for functional restoration as defined by individuals with SCI. We describe neuroprostheses that are in various stages of preclinical development, clinical testing, and commercialization including functional electrical stimulators, epidural and intraspinal microstimulation, bladder neuroprosthesis, and cortical stimulation for restoring sensation. We also discuss neural recording technologies that may provide command or feedback signals for neuroprosthetic devices. Conclusion/clinical relevance Neuroprostheses have begun to address the priorities of individuals with SCI, although there remains room for improvement. In addition to continued technological improvements, closing the loop between the technology and the user may help provide intuitive device control with high levels of performance. PMID:23820142

Collinger, Jennifer L.; Foldes, Stephen; Bruns, Tim M.; Wodlinger, Brian; Gaunt, Robert; Weber, Douglas J.

2013-01-01

297

Surgical management of urolithiasis in spinal cord injury patients.  

PubMed

Urolithiasis is a common condition in patients with spinal cord injury (SCI). Surgical management of stones in this population is more challenging and associated with lower clearance rates than the general population. The rate of complications - specifically infectious complications - is also high due to the chronic bacterial colonization. Shock wave lithotripsy (SWL) has a low clearance rate of 44-73 %. Percutaneous nephrolithotripsy is indicated for larger nephrolithiasis, but multiple procedures may be required to clear the stones. Ureteroscopy has been associated with low success rates because of difficulty in obtaining ureteral access. Historically, bladder stones were managed with open surgery or SWL. Recently, good results have been reported with the combination of endoscopic and laparoscopic techniques. Surgical management of urolithiasis in patients with SCI should be performed in high-volume centers in light of the technical challenges and higher rate of perioperative complications. PMID:24740271

Nabbout, Philippe; Slobodov, Gennady; Culkin, Daniel J

2014-06-01

298

Recommendations for Mobility in Children with Spinal Cord Injury  

PubMed Central

Background: Mobility is an important aspect of the rehabilitation of children with spinal cord injury (SCI), is a necessary component of life, and is critical in a child’s development. Depending upon the individual’s age and degree of neurological impairment, the nature of mobility may vary. Objectives: The objective of this article is to establish recommendations surrounding the selection of mobility for children with SCI. Methods: Extensive literature review and multidisciplinary peer review. Results: Types of mobility including power, manual, upright, and community are discussed, and recommendations are made based on medical necessity, neurological level, ASIA Impairment Scale score, and developmental considerations and challenges. Conclusion: Mobility is critical for proper development to occur in the pediatric population, and it may be challenging to make recommendations for mobility in children with SCI. It is essential for clinicians providing care to children with SCI to address mobility in a comprehensive and longitudinal manner across the children’s environments. PMID:23671384

2013-01-01

299

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

300

Exercise awareness and barriers after spinal cord injury  

PubMed Central

Exercise is an essential element in managing several of the non-communicable diseases after spinal cord injury (SCI). Awareness of the importance of prescribing a customized exercise program that meets the goals of persons with SCI should be highly considered in the rehabilitation community. The barriers of implementing specific exercise program as well as the factors that may mask the outcomes of regular exercise regimen need to be continuously addressed as a part of patients’ rehabilitation care. The focus of this editorial is to encourage the medical community to consider routine physical activity as one of the necessary vital signs that needs to be routinely checked in patients with SCI. Providing education tips, nutritional counseling and engaging in recreational programs may provide motivational route to the community of SCI. This may result in reinforcing active lifestyle in survivors with SCI as well as to reduce the impact of chronic life threatening medical disorders. PMID:25035817

Gorgey, Ashraf S

2014-01-01

301

Gap junction proteins and their role in spinal cord injury  

PubMed Central

Gap junctions are specialized intercellular communication channels that are formed by two hexameric connexin hemichannels, one provided by each of the two adjacent cells. Gap junctions and hemichannels play an important role in regulating cellular metabolism, signaling, and functions in both normal and pathological conditions. Following spinal cord injury (SCI), there is damage and disturbance to the neuronal elements of the spinal cord including severing of axon tracts and rapid cell death. The initial mechanical disruption is followed by multiple secondary cascades that cause further tissue loss and dysfunction. Recent studies have implicated connexin proteins as playing a critical role in the secondary phase of SCI by propagating death signals through extensive glial networks. In this review, we bring together past and current studies to outline the distribution, changes and roles of various connexins found in neurons and glial cells, before and in response to SCI. We discuss the contribution of pathologically activated connexin proteins, in particular connexin 43, to functional recovery and neuropathic pain, as well as providing an update on potential connexin specific pharmacological agents to treat SCI. PMID:25610368

Tonkin, Ryan S.; Mao, Yilin; O’Carroll, Simon J.; Nicholson, Louise F. B.; Green, Colin R.; Gorrie, Catherine A.; Moalem-Taylor, Gila

2015-01-01

302

Spinal cord injury: From inflammation to glial scar  

PubMed Central

Background: Glial scar (GS) is the most important inhibitor factor to neuroregeneration after spinal cord injury (SCI) and behaves as a tertiary lesion. The present review of the literature searched for representative studies concerning GS and therapeutic strategies to neuroregeneration. Methods: The author used the PubMed database and Google scholar to search articles published in the last 20 years. Key words used were SCI, spinal cord (SC) inflammation, GS, and SCI treatment. Results: Both inflammation and GS are considered important events after SCI. Despite the fact that firstly they seem to cause benefit, in the end they cause more harm than good to neuroregeneration. Each stage has its own aspects under the influence of the immune system causing inflammation, from the primary to secondary lesion and from those to GS (tertiary lesion). Conclusion: Future studies should stress the key points where and when GS presents itself as an inhibitory factor to neuroregeneration. Considering GS as an important event after SCI, the author defends GS as being a tertiary lesion. Current strategies are presented with emphasis on stem cells and drug therapy. A better understanding will permit the development of a therapeutic basis in the treatment of the SCI patients considering each stage of the lesion, with emphasis on GS and neuroregeneration. PMID:21886885

Leal-Filho, Manoel Baldoino

2011-01-01

303

Evaluation of artificial sweat in athletes with spinal cord injuries.  

PubMed

Athletes with spinal cord injury often experience high heat storage due to reduced sweating capacity below the spinal injury. Spray bottle (SB) may be used to apply mist for evaporative cooling during breaks in competitions. This study examined the efficacy of SB during rest breaks. Seven participants, four female and three males, (mean +/- SD age 24 +/- 4.1 year, weight 56.2 +/- 7.0 kg, upper-body VO(2) peak 2.4 +/- 0.6 l/min) volunteered for the study. Participants were paraplegic athletes (T3-T12/L1) with both complete and incomplete lesions. Participants arm-cranked using a ramp protocol in an environment of 21 +/- 1.5 degrees C and 55 +/- 3% rh once using a SB during 1-min rest between 7-min stages of increasing intensity and once without the SB (CON). Mean total work was similar (p = 0.86) for the SB and CON (2495.7 +/- 914.6 vs. 2407.1 +/- 982.3 kJ, respectively). Likewise, the mean work times were similar between trials (27 +/- 6 and 26 +/- 7 min for SB and CON, respectively). Furthermore, there were no significant differences detected between trials for skin temperature, rectal temperature, esophageal temperature (p > 0.05). There were no statistically significant differences detected between trials for RPE (p > 0.05). In conclusion, the application of artificial sweat via SB was ineffective in attenuating the onset of uncompensable heat strain during high-intensity arm exercise in a comfortable environment. PMID:20135144

Pritchett, R C; Bishop, P A; Yang, Z; Pritchett, K L; Green, J M; Katica, C P; Del Pozzi, A T

2010-05-01

304

Preliminary study of a genetically engineered spinal cord implant on urinary bladder after experimental spinal cord injury in rats.  

PubMed

The objective of this study was to determine the effect of neurotrophin-secreting Schwann cell implants on the urinary bladder after spinal cord contusion. One hour after severe spinal cord contusion at the T8 to T11 level, carbon filaments containing nonsecreting Schwann cells, brain-derived neurotrophic factor (BDNF)-secreting Schwann cells, neurotrophin-3 (NT-3)-secreting Schwann cells, or Schwann cells secreting both BDNF and NT-3 were implanted into the spinal cord. Untreated spinal cord injured (SCI) rats and noncontused rats (C) were also studied. Two months after spinal cord injury, cystometry was performed and the bladders were studied using light microscopy. SCI rats had significantly increased bladder mass, thickness, and smooth muscle mass compared to C rats. Bladder capacity of SCI rats and rats with spinal cord implants were both significantly greater than that of C rats. This preliminary study suggests that neurotrophin-secreting Schwann cell implants may lead to improved bladder structure after spinal cord injury. PMID:12173755

Sakamoto, Kyoko; Uvelius, Bengt; Khan, Talat; Damaser, Margot S

2002-01-01

305

Pain behaviors after spinal cord contusion injury in two commonly used mouse strains.  

PubMed

We have characterized spontaneous and evoked pain behaviors that develop in a model of severe spinal contusion injury using two commonly used strains of mice. Using the Infinite Horizon Tissue Impactor to produce these contusion injuries, we were able to set strict limits on the injury parameters (i.e., force of impact and tissue displacement). This helps to generate a uniform population of spinal cord injury severity and allows for meaningful comparisons to be made across the two strains of mice. After contusion injury, strain differences were apparent in several injury-evoked behaviors such as hindlimb spasticity, spontaneous caudally directed nociceptive behaviors and over-grooming. Similar to the anatomical rearrangements observed in the rat after spinal cord injury, we observed significant changes in sensory innervation of the dorsal horn in both strains. In addition, there was increased expression of protein kinase C gamma (PKCgamma) in cells outside of the inner region of lamina II (IIi) in both strains after spinal contusion injury. However, the magnitude and intensity of this increase was more pronounced in BALB/c mice. PKCgamma is an important mediator of persistent pain behaviors after peripheral nerve injury and inflammation. Our results suggest that PKCgamma may also contribute to neuropathic pain behaviors after direct lesion to the spinal cord. PMID:17586495

Kerr, Bradley J; David, Samuel

2007-08-01

306

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

307

Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects  

PubMed Central

Summary The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved. PMID:25505497

Szwedowski, Dawid; Walecki, Jerzy

2014-01-01

308

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

309

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

310

Arrested development of the dorsal column following neonatal spinal cord injury in the opossum, Monodelphis domestica.  

PubMed

Developmental studies of spinal cord injury in which regrowth of axons occurs across the site of transection rarely distinguish between the recovery of motor-controlling pathways and that of ascending axons carrying sensory information. We describe the morphological changes that occur in the dorsal column (DC) of the grey short-tailed opossum, Monodelphis domestica, following spinal cord injury at two early developmental ages. The spinal cords of opossums that had had their mid-thoracic spinal cords completely transected at postnatal day 7 (P7) or P28 were analysed. Profiles of neurofilament immunoreactivity in transected cords showing DC development were differentially affected by the injury compared with the rest of the cord and cytoarchitecture was modified in an age- and site-dependent manner. The ability of DC neurites to grow across the site of transection was confirmed by injection of fluorescent tracer below the injury. P7 transected cords showed labelling in the DC above the site of original transection indicating that neurites of this sensory tract were able to span the injury. No growth of any neuronal processes was seen after P28 transection. Thus, DC is affected by spinal injury in a differential manner depending on the age at which the transection occurs. This age-differential response, together with other facets of remodelling that occur after neonatal spinal injury, might explain the locomotor adaptations and recovery observed in these animals. PMID:25487408

Wheaton, Benjamin J; Noor, Natassya M; Dziegielewska, Katarzyna M; Whish, Sophie; Saunders, Norman R

2015-03-01

311

Specialized Respiratory Management for Acute Cervical Spinal Cord Injury:  

PubMed Central

Background: In individuals with cervical spinal cord injury (SCI), respiratory complications arise within hours to days of injury. Paralysis of the respiratory muscles predisposes the patient toward respiratory failure. Respiratory complications after cervical SCI include hypoventilation, hypercapnea, reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Ultimately, the patient must use increased work to breathe, which results in respiratory fatigue and may eventually require intubation for mechanical ventilation. Without specialized respiratory management for individuals with tetraplegia, recurrent pneumonias, bronchoscopies, and difficulty in maintaining a stable respiratory status will persist. Objective: This retrospective analysis examined the effectiveness of specialized respiratory management utilized in a regional SCI center. Methods: Individuals with C1-C4 SCI (N = 24) were the focus of this study as these neurological levels present with the most complicated respiratory status. Results: All of the study patients’ respiratory status improved with the specialized respiratory management administered in the SCI specialty unit. For a majority of these patients, respiratory improvements were noted within 1 week of admission to our SCI unit. Conclusion: Utilization of high tidal volume ventilation, high frequency percussive ventilation, and mechanical insufflation– exsufflation have demonstrated efficacy in stabilizing the respiratory status of these individuals. Optimizing respiratory status enables the patients to participate in rehabilitation therapies, allows for the opportunity to vocalize, and results in fewer days on mechanical ventilation for patients who are weanable. PMID:23459555

Wong, Sandra Lynn; Shem, Kazuko; Crew, James

2012-01-01

312

AN ANALYSIS OF 653 TRIALS OF PENILE VIBRATORY STIMULATION IN MEN WITH SPINAL CORD INJURY  

Microsoft Academic Search

PurposeWe evaluated ejaculatory response and semen quality in 653 trials of penile vibratory stimulation in 211 men with spinal cord injury, and compared results with low versus high amplitude vibratory stimulation.

NANCY L. BRACKETT; SEAN M. FERRELL; TEODORO C. ABALLA; MARIA J. AMADOR; OSVALDO F. PADRON; JENS SONKSEN; CHARLES M. LYNNE

1998-01-01

313

Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: A multicenter trial  

Microsoft Academic Search

Wirz M, Zemon DH, Rupp R, Scheel A, Colombo G, Dietz V, Hornby TG. Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. Arch Phys Med Rehabil 2005; 86:672–80.

Markus Wirz; David H. Zemon; Ruediger Rupp; Anke Scheel; Gery Colombo; Volker Dietz; T. George Hornby

2005-01-01

314

Spinal injury in a U.S. Army light observation helicopter.  

PubMed

All accident reports involving U.S. Army OH-58 series helicopters were analyzed to determine vertical and horizontal velocity change at impact and the relationship of this kinematic data to the production of spinal injury. This analysis determined that spinal injury is related primarily to vertical velocity change at impact and is relatively independent of horizontal velocity change. The dramatic increase in the rate of spinal injury occurring just above the design sink speed of the aircraft landing gear (3.7 m/s) suggests that the fuselage and seat provide little additional impact attenuation capability above that of the gear alone. It is concluded that if this aircraft were modified to provide protection to the occupants for impacts up to 9.1 m/s (30 ft/s), approximately 80% of all spinal injury incurred in survivable accidents could be substantially mitigated. The incorporation of energy absorbing seats is recommended. PMID:6696693

Shanahan, D F; Mastroianni, G R

1984-01-01

315

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

316

Charcot Arthropathy of the Lumbosacral Spine Mimicking a Vertebral Tumor after Spinal Cord Injury  

PubMed Central

Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury. PMID:24527202

Son, Soo-Bum; Kim, Eun-Sang; Eoh, Whan

2013-01-01

317

Locomotor Training After Human Spinal Cord Injury: A Series of Case Studies  

Microsoft Academic Search

Many individuals with spinal cord injury (SCI) do not regain their ability to walk, even though it is a primary goal of rehabilitation. Mammals with thoracic spinal cord transection can relearn to step with their hind limbs on a treadmill when trained with sensory input associated with stepping. If humans have similar neural mechanisms for locomotion, then providing comparable training

Andrea L Behrman; Susan J Harkema

2000-01-01

318

Bladder afferent pathway and spinal cord injury: possible mechanisms inducing hyperreflexia of the urinary bladder  

Microsoft Academic Search

Lower urinary tract dysfunction is a common problem in patients with spinal cord injury (SCI). Since the coordination of the urinary bladder and urethra is controlled by the complex mechanisms in spinal and supraspinal neural pathways, SCI rostral to the lumbosacral level disrupts voluntary and supraspinal control of voiding and induces a considerable reorganization of the micturition reflex pathway.Following SCI,

Naoki Yoshimura

1999-01-01

319

Clinical observations in vibratory stimulation of the penis of men with spinal cord injury  

Microsoft Academic Search

Less than 10% of men with complete spinal cord injury experience ejaculation in intercourse. Vibratory stimulation of the penis triggers a predictable series of body reactions in most men with lessions above the thoracic 11th spinal cord level. These reactions are very similar to the physical manifestations of the sexual response in men with intact nervous systems. Between half and

George Szasz; Chris Carpenter

1989-01-01

320

Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions  

Microsoft Academic Search

Repair of the injured spinal cord by regeneration therapy remains an elusive goal. In contrast, progress in medical care and rehabilitation has resulted in improved health and function of persons with spinal cord injury (SCI). In the absence of a cure, raising the level of achievable function in mobility and self-care will first and foremost depend on creative use of

K T Ragnarsson

2008-01-01

321

Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and in fibromyalgia  

Microsoft Academic Search

Patients with chronic pain after whiplash injury and fibromyalgia patients display exaggerated pain after sensory stimulation. Because evident tissue damage is usually lacking, this exaggerated pain perception could be explained by hyperexcitability of the central nervous system. The nociceptive withdrawal reflex (a spinal reflex) may be used to study the excitability state of spinal cord neurons. We tested the hypothesis

Borut Banic; Steen Petersen-Felix; Ole K. Andersen; Bogdan P. Radanov; P. M. Villiger; Lars Arendt-Nielsen; Michele Curatolo

2004-01-01

322

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

323

Bone Marrow Stem Cells and Polymer Hydrogels—Two Strategies for Spinal Cord Injury Repair  

Microsoft Academic Search

Summary  1. Emerging clinical studies of treating brain and spinal cord injury (SCI) led us to examine the effect of autologous adult stem cell transplantation as well as the use of polymer scaffolds in spinal cord regeneration. We compared an intravenous injection of mesenchymal stem cells (MSCs) or the injection of a freshly prepared mononuclear fraction of bone marrow cells (BMCs)

Eva Syková; Pavla Jendelová; Lucia Urdzíková; Petr Lesný; Aleš Hej?l

2006-01-01

324

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

325

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

326

Age at spinal cord injury determines muscle strength  

PubMed Central

As individuals with spinal cord injury (SCI) age they report noticeable deficits in muscle strength, endurance and functional capacity when performing everyday tasks. These changes begin at ~45 years. Here we present a cross-sectional analysis of paralyzed thenar muscle and motor unit contractile properties in two datasets obtained from different subjects who sustained a cervical SCI at different ages (?46 years) in relation to data from uninjured age-matched individuals. First, completely paralyzed thenar muscles were weaker when C6 SCI occurred at an older age. Muscles were also significantly weaker if the injury was closer to the thenar motor pools (C6 vs. C4). More muscles were strong (>50% uninjured) in those injured at a younger (?25 years) vs. young age (>25 years), irrespective of SCI level. There was a reduction in motor unit numbers in all muscles tested. In each C6 SCI, only ~30 units survived vs. 144 units in uninjured subjects. Since intact axons only sprout 4–6 fold, the limits for muscle reinnervation have largely been met in these young individuals. Thus, any further reduction in motor unit numbers with time after these injuries will likely result in chronic denervation, and may explain the late-onset muscle weakness routinely described by people with SCI. In a second dataset, paralyzed thenar motor units were more fatigable than uninjured units. This gap widened with age and will reduce functional reserve. Force declines were not due to electromyographic decrements in either group so the site of failure was beyond excitation of the muscle membrane. Together, these results suggest that age at SCI is an important determinant of long-term muscle strength, and fatigability, both of which influence functional capacity. PMID:24478643

Thomas, Christine K.; Grumbles, Robert M.

2014-01-01

327

Bone loss following spinal cord injury in a rat model.  

PubMed

The current study was undertaken to follow the time course of bone loss in the proximal tibia of rats over several weeks following thoracic contusion spinal cord injury (SCI) of varying severity. It was hypothesized that bone loss would be more pronounced in the more severely injured animals, and that hindlimb weight bearing would help prevent bone loss. Twenty-six female Sprague-Dawley rats (200-225 g, 6-7 weeks old) received standard thoracic (T9) injuries at energies of 6.25, 12.5, 25, or 50 g-cm. The rats were scored weekly for hindlimb function during locomotion. At 0, 2 or 3, and 8 weeks, high-resolution micro-CT images of each right tibia were obtained. Mechanical indentation testing was done to measure the compressive strength of the cancellous bone structure. The 6.25 g-cm group showed near normal locomotion, the 12.5 and 25 g-cm groups showed the ability to frequently or occasionally generate weight-supported plantar steps, respectively, and the 50 g-cm group showed only movement without weight-supported plantar stepping. The 6.25, 12.5 and 25 g-cm groups remained at the same level of bone volume fraction (cancBV/TV=0.24±0.07), while the 50 g-cm group experienced severe bone loss (67%), resulting in significantly lower (p<0.05) bone volume fraction (cancBV/TV=0.11±0.05) at 8 weeks. Proximal tibia cancellous bone strength was reduced by approximately 50% in these severely injured rats. Instead of a linear proportionality between injury severity and bone loss, there appears to be a distinct functional threshold, marked by occasional weight-supported stepping, above which bone loss does not occur. PMID:22181016

Voor, Michael J; Brown, Edward H; Xu, Qian; Waddell, Seid W; Burden, Robert L; Burke, Darlene A; Magnuson, David S K

2012-05-20

328

Longitudinal study of body composition in spinal cord injury patients  

PubMed Central

Background: Bone mass loss and muscle atrophy are the frequent complications occurring after spinal cord injury (SCI). The potential risks involved with these changes in the body composition have implications for the health of the SCI individual. Thus, there is a need to quantitate and monitor body composition changes accurately in an individual with SCI. Very few longitudinal studies have been reported in the literature to assess body composition and most include relatively small number of patients. The present prospective study aimed to evaluate the body composition changes longitudinally by DEXA in patients with acute SCI. Materials and Methods: Ninety five patients with acute SCI with neurological deficits were evaluated for bone mineral content (BMC), body composition [lean body mass (LBM) and fat mass] by dual-energy X-ray absorptiometry during the first year of SCI. Results: There was a significant decrease in BMC (P < 0.05) and LBM (P < 0.05) and increase in total body fat mass (TBFM) and percentage fat at infra-lesional sites. The average decrease was 14.5% in BMC in lower extremities, 20.5% loss of LBM in legs and 15.1% loss of LBM in trunk, and increase of 0.2% in fat mass in legs and 17.3% increased fat in the lower limbs at 1 year. The tetraplegic patients had significant decrease in arm BMC (P < 0.001), arm LBM (P < 0.01) and fat percentage (P < 0.01) compared to paraplegics. Patients with complete motor injury had higher values of TBFM and fat percentage, but comparable values of BMC and LBM to patients with incomplete motor injury. Conclusions: Our findings suggest that there is a marked decrease in BMC and LBM with increase in adiposity during the first year of SCI. Although these changes depend on the level and initial severity of lesions, they are also influenced by the neurological recovery after SCI. PMID:24741139

Singh, Roop; Rohilla, Rajesh K; Saini, Gaurav; Kaur, Kiranpreet

2014-01-01

329

Functional magnetic stimulation of the colon in persons with spinal cord injury  

Microsoft Academic Search

Lin VW, Nino-Murcia M, Frost F, Wolfe V, Perkash I. Functional magnetic stimulation of the colon in persons with spinal cord injury. Arch Phys Med Rehabil 2001;82:167-73. Objective: To evaluate the usefulness of functional magnetic stimulation (FMS) as a noninvasive method to stimulate the colon in individuals with spinal cord injury (SCI). Design: A prospective before-after trial consisting of 2

Vernon W. Lin; Matilda Nino-Murcia; Frederick Frost; Vickie Wolfe; Ian Hsiao; Inder Perkash

2001-01-01

330

The acute effects of continuous and conditional neuromodulation on the bladder in spinal cord injury  

Microsoft Academic Search

Study design: Laboratory investigation using serial slow-fill cystometrograms.Objectives: To examine the acute effects of different modes of dorsal penile nerve stimulation on detrusor hyperreflexia, bladder capacity and bladder compliance in spinal cord injury (SCI).Setting: Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.Methods: Fourteen SCI patients were examined. Microtip transducer catheters enabled continuous measurement of anal sphincter, urethral sphincter

APS Kirkham; NC Shah; SL Knight; PJR Shah

2001-01-01

331

Consumer preference in ranking walking function utilizing the walking index for spinal cord injury II  

Microsoft Academic Search

Study design:Blinded rank ordering.Objective:To determine consumer preference in walking function utilizing the walkingIndex for spinal cord injury II (WISCI II) in individuals with spinal cord injury (SCI)from the Canada, the Italy and the United States of America.Method:In all, 42 consumers with incomplete SCI (25 cervical, 12 thoracic, 5 lumbar) from Canada (12\\/42), Italy (14\\/42) and the United States of America

M Patrick; P Ditunno; J F Ditunno; R J Marino; G Scivoletto; T Lam; J Loffree; F Tamburella; B Leiby

2011-01-01

332

A correction procedure for the minnesota Multiphasic Personality Inventory—2 for persons with spinal cord injury  

Microsoft Academic Search

Barncord SB, Wanlass RL. A correction procedure for the Minnesota Multiphasic Personality Inventory—2 for persons with spinal cord injury. Arch Phys Med Rehabil 2000;81:1185-90. Objective: To develop a procedure that adjusts scoring of the Minnesota Multiphasic Personality Inventory—2 (MMPI-2) for the items related to spinal cord injury (SCI) that skew interpretations with this population, and to assess the accuracy of

Steven W. Barncord; Richard L. Wanlass

2000-01-01

333

Inhibition of Cysteine Proteases in Acute and Chronic Spinal Cord Injury  

Microsoft Academic Search

Summary  Spinal cord injury (SCI) is a serious neurological disorder that debilitates mostly young people. Unfortunately, we still\\u000a do not have suitable therapeutic agents for treatment of SCI and prevention of its devastating consequences. However, we have\\u000a gained a good understanding of pathological mechanisms that cause neurodegeneration leading to paralysis or even death following\\u000a SCI. Primary injury to the spinal cord

Swapan K. Ray; Supriti Samantaray; Joshua A. Smith; Denise D. Matzelle; Arabinda Das; Naren L. Banik

2011-01-01

334

Chronic pain after spinal injury: Interference with sleep and daily activities  

Microsoft Academic Search

Widerstr[ouml ]m-Noga EG, Felipe-Cuervo E, Yezierski RP. Chronic pain after spinal injury: interference with sleep and daily activities. Arch Phys Med Rehabil 2001;82:1571-7. Objectives: To determine how chronic pain after spinal cord injury (SCI) interfered with sleep, exercise, work, household chores, and other daily activities and to define which clinical aspects of pain and psychosocial factors best predicted the extent

Ernesto Felipe-Cuervo; Robert P. Yezierski

2001-01-01

335

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

336

Beneficial effects of secretory leukocyte protease inhibitor after spinal cord injury  

PubMed Central

Secretory leukocyte protease inhibitor is a serine protease inhibitor produced by various cell types, including neutrophils and activated macrophages, and has anti-inflammatory properties. It has been shown to promote wound healing in the skin and other non-neural tissues, however, its role in central nervous system injury was not known. We now report a beneficial role for secretory leukocyte protease inhibitor after spinal cord injury. After spinal cord contusion injury in mice, secretory leukocyte protease inhibitor is expressed primarily by astrocytes and neutrophils but not macrophages. We show, using transgenic mice over-expressing secretory leukocyte protease inhibitor, that this molecule has an early protective effect after spinal cord contusion injury. Furthermore, wild-type mice treated for the first week after spinal cord contusion injury with recombinant secretory leukocyte protease inhibitor exhibit sustained improvement in locomotor control and reduced secondary tissue damage. Recombinant secretory leukocyte protease inhibitor injected intraperitoneally localizes to the nucleus of circulating leukocytes, is detected in the injured spinal cord, reduces activation of nuclear factor-?B and expression of tumour necrosis factor-?. Administration of recombinant secretory leukocyte protease inhibitor might therefore be useful for the treatment of acute spinal cord injury. PMID:20047904

Ghasemlou, Nader; Bouhy, Delphine; Yang, Jingxuan; López-Vales, Rubèn; Haber, Michael; Thuraisingam, Thusanth; He, Guoan; Radzioch, Danuta; Ding, Aihao

2010-01-01

337

Partial Peripheral Nerve Injury Promotes a Selective Loss of GABAergic Inhibition in the Superficial Dorsal Horn of the Spinal Cord  

Microsoft Academic Search

To clarify whether inhibitory transmission in the superficial dor- sal horn of the spinal cord is reduced after peripheral nerve injury, we have studied synaptic transmission in lamina II neu- rons of an isolated adult rat spinal cord slice preparation after complete sciatic nerve transection (SNT), chronic constriction injury (CCI), or spared nerve injury (SNI). Fast excitatory trans- mission remains

Kimberly A. Moore; Tatsuro Kohno; Laurie A. Karchewski; Joachim Scholz; Hiroshi Baba; Clifford J. Woolf

2002-01-01

338

Effects of Rolipram on Adult Rat Oligodendrocytes and Functional Recovery after Contusive Cervical Spinal Cord Injury  

PubMed Central

Traumatic human spinal cord injury 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 SCI are being investigated. We previously demonstrated that oligodendrocytes in the adult rat epicenter ventrolateral funiculus express 3?-5?-cyclic adenosine monophosphate-dependent phosphodiesterase 4 subtypes and that their death was attenuated up to 3 days after contusive cervical spinal cord injury when rolipram, a specific inhibitor of phosphodiesterase 4, was administered. Here, we report that 1) there are more oligodendrocyte somata in the adult rat epicenter ventrolateral funiculus, 2) descending and ascending axonal conductivity in the ventrolateral funiculus improves, and that 3) there are fewer hindlimb footfall errors during grid-walking at 5 weeks after contusive cervical spinal cord injury when rolipram is delivered for 2 weeks. This is the first demonstration of improved descending and ascending long-tract axonal conductivity across a spinal cord injury 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 spinal cord injury. PMID:19635528

Beaumont, Eric; Whitaker, Christopher M.; Burke, Darlene A.; Hetman, Michal; Onifer, Stephen M.

2009-01-01

339

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

340

Theoretical aspects of sensory substitution and of neurotransmission-related reorganization in spinal cord injury.  

PubMed

Spinal cord rehabilitation has progressed enormously since World War II, and persons with spinal cord injuries now have long life expectancies. Research has recently concentrated on improvement of the quality of life, and on neural mechanisms of recovery. This article will explore some aspects of both of these areas. In the first section, the potential applications of sensory substitution systems for such functions as sex sensation and sensation from feet and from robotic hands will be examined. In the second section, the potential role of nonsynaptic diffusion neurotransmission (NDN) in neural reorganization after spinal cord injury will be considered. This article includes portions of previous publications and reports. PMID:10438112

Bach-y-Rita, P

1999-07-01

341

Quantitative sensory tests (perceptual thresholds) in patients with spinal cord injury.  

PubMed

This article was presented at the Premeeting Workshop on Outcome Measures at the American Spinal Injury Association (ASIA) Annual Scientific Meeting in Dallas, Texas, in May 2005. The article summarizes preliminary findings of three quantitative sensory tests that were evaluated as part of the International Spinal Research Trust Clinical Initiative study: perceptual thresholds to electrical, vibration, and thermal stimulation. The results gathered so far suggest that the three tests are simple, reproducible, and applicable in a clinical setting. The tests seem to add resolution and sensitivity to the standard clinical testing and could be useful adjuncts in longitudinal monitoring of spinal cord injury for research purposes. PMID:17551861

Savic, Gordana; Bergström, Ebba M K; Davey, Nick J; Ellaway, Peter H; Frankel, Hans L; Jamous, Ali; Nicotra, Alessia

2007-01-01

342

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

343

Vocational Rehabilitation of Persons with Spinal Cord Injuries  

ERIC Educational Resources Information Center

Reviews historical development of organized vocational rehabilitation programming for the spinal cord injured in the United States. Significant factors that affect vocational rehabilitation outcomes with spinal cord injured persons are listed and discussed. (Author)

Poor, Charles R.

1975-01-01

344

Full Anatomical Recovery of the Dopaminergic System after a Complete Spinal Cord Injury in Lampreys  

PubMed Central

Following a spinal injury, lampreys at first are paralyzed below the level of transection. However, they recover locomotion after several weeks, and this is accompanied by the regeneration of descending axons from the brain and the production of new neurons in the spinal cord. Here, we aimed to analyse the changes in the dopaminergic system of the sea lamprey after a complete spinal transection by studying the changes in dopaminergic cell numbers and dopaminergic innervation in the spinal cord. Changes in the expression of the D2 receptor were also studied. We report the full anatomical regeneration of the dopaminergic system after an initial decrease in the number of dopaminergic cells and fibres. Numbers of dopaminergic cells were recovered rostrally and caudally to the site of injury. Quantification of dopaminergic profiles revealed the full recovery of the dopaminergic innervation of the spinal cord rostral and caudal to the site of injury. Interestingly, no changes in the expression of the D2 receptor were observed at time points in which a reduced dopaminergic innervation of the spinal cord was observed. Our observations reveal that in lampreys a spinal cord injury is followed by the full anatomical recovery of the dopaminergic system.

Fernández-López, Blanca; Romaus-Sanjurjo, Daniel; Cornide-Petronio, María Eugenia; Gómez-Fernández, Sonia; Barreiro-Iglesias, Antón; Rodicio, María Celina

2015-01-01

345

Sponge-mediated lentivirus delivery to acute and chronic spinal cord injuries.  

PubMed

The environment within the spinal cord after injury, which changes in the progression from the acute to chronic stages, limits the extent of regeneration. The delivery of inductive factors to promote regeneration following spinal cord injury has been promising, yet, few strategies are versatile to allow delivery during acute or chronic injury that would facilitate screening of candidate therapies. This report investigates the intrathecal delivery of lentiviruses for long-term expression of regenerative factors. Lentivirus-filled sponges were inserted into the intrathecal space surrounding the spinal cord, with transgene expression observed within multiple cell types that persists for 12weeks for both intact and injured spinal cord, without any apparent damage to the spinal cord tissue. Sponges loaded with lentivirus encoding for Sonic hedgehog (Shh) were investigated for acute (delivered at 0weeks) and chronic (at 4weeks) injuries, and for multiple locations relative to the injury. In an acute model, sponges placed directly above the injury increased oligodendrocyte and decreased astrocyte presence. Sponges placed caudal to the injury had reduced impact on oligodendrocytes and astrocytes in the injury. In a chronic model, sponges increased oligodendrocyte and decreased astrocyte presence. Furthermore, the effect of Shh was shown to be mediated in part by reduction of Bmp signaling, monitored with an Msx2-sensitive reporter vector. The implantation of lentivirus-loaded biomaterials intrathecally provides the opportunity to induce the expression of a factor at a specified time without entering the spinal cord, and has the potential to promote gene delivery within the spinal cord, which can influence the extent of regeneration. PMID:25724274

Thomas, Aline M; Palma, Jaime L; Shea, Lonnie D

2015-04-28

346

Risk of hospitalizations after spinal cord injury: Relationship with biographic, injury, educational, and behavioral factors  

PubMed Central

Objectives To assess the risk factors associated with hospitalization and the relationship of individual health behaviors with hospitalizations following spinal cord injury (SCI). Study Design Cross-sectional survey. Setting A large specialty hospital in the Southeastern USA. Methods Persons with SCI responded (n=1386) to a mail survey assessing various aspects of their health including health behaviors and number of hospitalizations in the past year. Logistic regression was used to assess the relationships between biographic, injury, educational, and health behavior factors with hospitalization in the past year. Results Overall, 36.6% of participants were hospitalized on at least one occasion during the previous year. Two biographic and injury characteristics were associated with hospitalization: race and SCI severity. Specifically, minorities and persons with non-motor functional high cervical or non-cervical SCI (ASIA grades A–C) were more likely to be hospitalized. Three behavioral factors were significantly associated with hospitalization after controlling for biographic and injury characteristics. Persons who used prescription medications, those who engaged more in smoking behaviors, and persons who reported more SCI specific health behaviors were more likely to be hospitalized. Conclusion Specific health behaviors are associated with increased hospitalization among persons with SCI. Future research is needed to assessing the time-sequence of these relationships. PMID:19255585

Krause, James S.; Saunders, Lee L.

2008-01-01

347

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

348

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

349

Edaravone combined with Schwann cell transplantation may repair spinal cord injury in rats  

PubMed Central

Edaravone has been shown to delay neuronal apoptosis, thereby improving nerve function and the microenvironment after spinal cord injury. Edaravone can provide a favorable environment for the treatment of spinal cord injury using Schwann cell transplantation. This study used rat models of complete spinal cord transection at T9. Six hours later, Schwann cells were transplanted in the head and tail ends of the injury site. Simultaneously, edaravone was injected through the caudal vein. Eight weeks later, the PKH-26-labeled Schwann cells had survived and migrated to the center of the spinal cord injury region in rats after combined treatment with edaravone and Schwann cells. Moreover, the number of PKH-26-labeled Schwann cells in the rat spinal cord was more than that in rats undergoing Schwann cell transplantation alone or rats without any treatment. Horseradish peroxidase retrograde tracing revealed that the number of horseradish peroxidase-positive nerve fibers was greater in rats treated with edaravone combined withSchwann cells than in rats with Schwann cell transplantation alone. The results demonstrated that lower extremity motor function and neurophysiological function were better in rats treated with edaravone and Schwann cells than in rats with Schwann cell transplantation only. These data confirmed that Schwann cell transplantation combined with edaravone injection promoted the regeneration of nerve fibers of rats with spinal cord injury and improved neurological function.

Zhang, Shu-quan; Wu, Min-fei; Piao, Zhe; Yao, Jin; Li, Ji-hai; Wang, Xin-gang; Liu, Jun

2015-01-01

350

Spinal injury hospitalizations among u.s. Army soldiers deployed to iraq and afghanistan.  

PubMed

This retrospective study examined spinal-related hospitalizations of U.S. Army soldiers deployed to Afghanistan and Iraq. Spinal cord injuries (SCI) and vertebral column injuries (VCI) were identified using International Classification of Disease, 9th Revision, Clinical Modification diagnosis codes. In our study, spinal hospitalizations represented 8.2% of total injury admissions. Risk factors for SCI and VCI incidences were determined using Poisson regression. Lack of previous deployment experience increased risk of having SCI by 33% and VCI by 24% in Iraq (similar increases, but not statistically significant in Afghanistan). Male soldiers had 4.85 times higher risk for SCI in Iraq and 69% higher risk in Afghanistan than female soldiers. In Afghanistan, almost 60% of spinal episodes included traumatic brain injury (TBI), compared to about 40% in Iraq. In both theaters, mild TBI accounted for more than 50% of all TBI-spinal episodes. Sixteen percent of SCI inpatient episodes in Afghanistan and 13% in Iraq were associated with paralysis, with median bed days of 46 and 33 days compared to a median of 6 days in both theaters for nonparalysis spinal injuries. The mortality rate was 2.5 times lower in Afghanistan than in Iraq. PMID:25643390

Wojcik, Barbara E; Curley, Kenneth C; Szeszel-Fedorowicz, Wioletta; Stein, Catherine R; Humphrey, Rebecca J

2015-02-01

351

Oudega M: Degenerative and spontaneous regenerative processes after spinal cord injury  

E-print Network

Spinal cord injury results in acute as well as progressive secondary destruction of local and distant nervous tissue through a number of degenerative mechanisms. Spinal cord injury also initiates a number of endogenous neuroprotective and regenerative responses. Understanding of these mechanisms might identify potential targets for treatments after spinal cord injury in humans. Here, we first discuss recent developments in our understanding of the immediate traumatic and subsequent secondary degeneration of local tissue and long projecting pathways in animal models. These include the inflammatory and vascular responses during the acute phase, as well as cell death, demyelination and scar formation in the subacute and chronic phases. Secondly, we discuss the spontaneous axonal regeneration of injured and plasticity of uninjured systems, and other repair-related responses in animals, including the upregulation of regeneration-associated genes in some neurons, increases in neurotrophic factors in the spinal cord and remyelination by oligodendrocyte precursors and invading Schwann cells. Lastly, we comment on the still limited understanding of the neuropathology in humans, which is largely similar to that in rodents. However, there also are potentially important differences, including the reduced glial scarring, inflammation and demyelination, the increased Schwannosis and the protracted Wallerian degeneration in humans. The validity of current rodent models for human spinal cord injury is also discussed. The emphasis of this review is on the literature from 2002 to early 2005. Key words: acute degeneration; axonal dieback; regeneration; scar formation; spinal cord injury

352

Monitoring somatosensory evoked potentials in spinal cord ischemia-reperfusion injury  

PubMed Central

It remains unclear whether spinal cord ischemia-reperfusion injury caused by ischemia and other non-mechanical factors can be monitored by somatosensory evoked potentials. Therefore, we monitored spinal cord ischemia-reperfusion injury in rabbits using somatosensory evoked potential detection technology. The results showed that the somatosensory evoked potential latency was significantly prolonged and the amplitude significantly reduced until it disappeared during the period of spinal cord ischemia. After reperfusion for 30–180 minutes, the amplitude and latency began to gradually recover; at 360 minutes of reperfusion, the latency showed no significant difference compared with the pre-ischemic value, while the somatosensory evoked potential amplitude in-creased, and severe hindlimb motor dysfunctions were detected. Experimental findings suggest that changes in somatosensory evoked potential latency can reflect the degree of spinal cord ischemic injury, while the amplitude variations are indicators of the late spinal cord reperfusion injury, which provide evidence for the assessment of limb motor function and avoid iatrogenic spinal cord injury. PMID:25206629

Ji, Yiming; Meng, Bin; Yuan, Chenxi; Yang, Huilin; Zou, Jun

2013-01-01

353

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

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

Dvorak, Marcel F; 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, Jérôme; Parent, Stefan; Townson, Andrea; Ho, Chester; Craven, B C; Gagnon, Dany; Tsui, Deborah; Fox, Richard; Mac-Thiong, Jean-Marc; Kwon, Brian K

2014-09-15

354

Worldwide, an estimated 2.5 million people live with spinal cord injury (SCI), with more than 130,000 new  

E-print Network

Worldwide, an estimated 2.5 million people live with spinal cord injury (SCI), with more than 130,000 new injuries reported each year (see International Campaign for Cures of Spinal Cord Injury Paralysis for Spinal Cord Injury Prevention, Care and Cure in Online links box). SCI has a significant impact

Cai, Long

355

Spinal neuronal plasticity is evident within 1 day after a painful cervical facet joint injury  

PubMed Central

Excessive stretch of the cervical facet capsular ligament induces persistent pain and spinal plasticity at later time points. Yet, it is not known when such spinal modifications are initiated following this painful injury. This study investigates the development of hyperalgesia and neuronal hyperexcitability in the spinal cord after a facet joint injury. Behavioral sensitivity was measured in a model of painful C6/C7 facet joint injury in the rat, and neuronal hyperexcitability in the spinal cord was evaluated at 6 hours and 1 day after injury or a sham procedure, in separate groups. Extracellular recordings of C6/C7 dorsal horn neuronal activity (229 neurons) were used to quantify spontaneous and evoked firing. Rats exhibited no change in sensitivity to mechanical stimulation of the forepaw at 6 hours, but did exhibit increased sensitivity at 1 day after injury (p=0.012). At 6 hours, both spontaneous neuronal activity and firing evoked by light brushing, pinch, and von Frey filaments (1.4–26g) applied at the forepaw were not different between sham and injury. At 1 day, spontaneous firing was noted in a greater number of neurons after injury than sham (p<0.04). Evoked firing was also increased 1 day after injury compared to normal and sham (p<0.03). Dorsal horn hyperexcitability and increased spontaneous firing developed between 6 and 24 hours after painful facet injury, suggesting that the development of hyperalgesia parallels dorsal horn hyperexcitability following mechanical facet joint injury, and these spinal mechanisms are initiated as early as 1 day after injury. PMID:23523644

Crosby, Nathan D.; Weisshaar, Christine L.; Winkelstein, Beth A.

2013-01-01

356

Modification of spasticity by transcutaneous spinal cord stimulation in individuals with incomplete spinal cord injury  

PubMed Central

Context/objective To examine the effects of transcutaneous spinal cord stimulation (tSCS) on lower-limb spasticity. Design Interventional pilot study to produce preliminary data. Setting Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria. Participants Three subjects with chronic motor-incomplete spinal cord injury (SCI) who could walk ?10 m. Interventions Two interconnected stimulating skin electrodes (Ø 5 cm) were placed paraspinally at the T11/T12 vertebral levels, and two rectangular electrodes (8 × 13 cm) on the abdomen for the reference. Biphasic 2 ms-width pulses were delivered at 50 Hz for 30 minutes at intensities producing paraesthesias but no motor responses in the lower limbs. Outcome measures The Wartenberg pendulum test and neurological recordings of surface-electromyography (EMG) were used to assess effects on exaggerated reflex excitability. Non-functional co-activation during volitional movement was evaluated. The timed 10-m walk test provided measures of clinical function. Results The index of spasticity derived from the pendulum test changed from 0.8 ± 0.4 pre- to 0.9 ± 0.3 post-stimulation, with an improvement in the subject with the lowest pre-stimulation index. Exaggerated reflex responsiveness was decreased after tSCS across all subjects, with the most profound effect on passive lower-limb movement (pre- to post-tSCS EMG ratio: 0.2 ± 0.1), as was non-functional co-activation during voluntary movement. Gait speed values increased in two subjects by 39%. Conclusion These preliminary results suggest that tSCS, similar to epidurally delivered stimulation, may be used for spasticity control, without negatively impacting residual motor control in incomplete SCI. Further study in a larger population is warranted. PMID:24090290

Hofstoetter, Ursula S.; McKay, William B.; Tansey, Keith E.; Mayr, Winfried; Kern, Helmut; Minassian, Karen

2014-01-01

357

Causes and costs of spinal cord injury in the United States  

Microsoft Academic Search

A cross-sectional multicenter study was conducted to estimate the direct costs for each cause of spinal cord injury in the United States. Random samples of 227 new injuries and 508 persons 2 – 16 years postinjury were selected. Prospective data were collected during one year on all charges for emergency medical services, hospitalizations, attendant care, equipment, supplies, medications, environmental modifications,

Michael J DeVivo

1997-01-01

358

Characteristics of the functional independence measure in traumatic spinal cord injury  

Microsoft Academic Search

Objectives: The characteristics of the Functional Independence Measure (FIM)™ were examined for spinal cord injury (SCI) in regard to norms over time by level and completeness of injury, differential benefit of motor and cognition subscales, and “ceiling effect” after rehabilitation discharge.Design: Descriptive study of raw FIM data collected prospectively at admission and discharge from acute inpatient rehabilitation, and at 1,

Karyl M. Hall; Michelle E. Cohen; Jerry Wright; Mary Call; Peter Werner

1999-01-01

359

Effects of palmitoylethanolamide on release of mast cell peptidases and neurotrophic factors after spinal cord injury  

Microsoft Academic Search

Spinal cord injury (SCI) has a significant impact on quality of life, expectancy, and economic burden, with considerable costs associated with primary care and loss of income. The complex pathophysiology of SCI may explain the difficulty in finding a suitable therapy for limiting neuronal injury and promoting regeneration. Although innovative medical care, advances in pharmacotherapy have been limited. The aim

Emanuela Esposito; Irene Paterniti; Emanuela Mazzon; Tiziana Genovese; Rosanna Di Paola; Maria Galuppo; Salvatore Cuzzocrea

2011-01-01

360

DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES  

Microsoft Academic Search

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 examine whether death denial and death awareness

ERIN MARTZ

2004-01-01

361

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

362

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

363

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

364

Vocationally Orientated Rehabilitation Service Requests: The Case of Employed Persons Experiencing a Spinal Cord Injury.  

ERIC Educational Resources Information Center

A survey of 168 employed people who suffered spinal cord injuries found that 50% were employed after injury; 61% thought they could have benefitted from additional services such as discussion of options and follow-up on vocational issues. Dissatisfaction with employment status was related to perceived need for more services. (Contains 20…

Young, Amanda E.; Murphy, Gregory C.

2003-01-01

365

Regional cortical and trabecular bone loss after spinal cord injury  

PubMed Central

Spinal cord injury (SCI) triggers rapid loss of trabecular bone mineral density (BMD) in bone epiphyses and a loss of cortical cross-sectional area (CSA) in bone diaphyses, increasing fracture risk for people with SCI. The purpose of this study was to measure trabecular BMD and cortical CSA loss at several previously unexamined lower-limb sites (4% fibula, 12% femur, 86% tibia, cortical) in individuals with SCI. Using peripheral quantitative computed tomography, we scanned 13 participants with SCI longitudinally and 16 on one occasion; 21 participants without SCI served as controls. In the first year post-SCI, 15% to 35% of BMD was lost at the distal femur, proximal tibia, and distal fibula. Bone loss at the distal fibula accelerated between 1 and 2 years post-SCI. BMD at these sites reached a steady state value of ~50% of the non-SCI value 4 years post-SCI. At the tibia diaphysis, cortical CSA decline was slower, eventually reaching 65% of the non-SCI value. Because of the extensive loss of bone observed at these sites, careful consideration needs to be given to the dose of musculoskeletal stress delivered during rehabilitation interventions like standing, muscle electrical stimulation, and aggressive stretching of spastic muscles. PMID:23408218

Dudley-Javoroski, Shauna; Shields, Richard K.

2013-01-01

366

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

367

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

368

Combination Drug Therapy for Pain following Chronic Spinal Cord Injury  

PubMed Central

A number of mechanisms have been elucidated that maintain neuropathic pain due to spinal cord injury (SCI). While target-based therapeutics are being developed based on elucidation of these mechanisms, treatment for neuropathic SCI pain has not been entirely satisfactory due in part to the significant convergence of neurological and inflammatory processes that maintain the neuropathic pain state. Thus, a combination drug treatment strategy, wherein several pain-related mechanism are simultaneously engaged, could be more efficacious than treatment against individual mechanisms alone. Also, by engaging several targets at once, it may be possible to reduce the doses of the individual drugs, thereby minimizing the potential for adverse side effects. Positive preclinical and clinical studies have demonstrated improved efficacy of combination drug treatment over single drug treatment in neuropathic pain of peripheral origin, and perhaps such combinations could be utilized for neuropathic SCI pain. At the same time, there are mechanisms that distinguish SCI from peripheral neuropathic pain, so novel combination therapies will be needed. PMID:22550581

Hama, Aldric; Sagen, Jacqueline

2012-01-01

369

Epigenetic Regulation of Sensory Axon Regeneration after Spinal Cord Injury  

PubMed Central

Axon regeneration is hindered by a decline of intrinsic axon growth capability in mature neurons. Reversing this decline is associated with the induction of a large repertoire of regeneration-associated genes (RAGs), but the underlying regulatory mechanisms of the transcriptional changes are largely unknown. Here, we establish a correlation between diminished axon growth potential and histone 4 (H4) hypoacetylation. When neurons are triggered into a growth state, as in the conditioning lesion paradigm, H4 acetylation is restored, and RAG transcription is initiated. We have identified a set of target genes of Smad1, a proregenerative transcription factor, in conditioned DRG neurons. We also show that, during the epigenetic reprogramming process, histone-modifying enzymes work together with Smad1 to facilitate transcriptional regulation of RAGs. Importantly, targeted pharmacological modulation of the activity of histone-modifying enzymes, such as histone deacetylases, leads to induction of multiple RAGs and promotion of sensory axon regeneration in a mouse model of spinal cord injury. Our findings suggest epigenetic modulation as a potential therapeutic strategy to enhance axon regeneration. PMID:24336730

Finelli, Mattéa J.; Wong, Jamie K.

2013-01-01

370

Recent advances in the pharmacologic treatment of spinal cord injury.  

PubMed

A need exists for the effective treatment of individuals suffering from spinal cord injury (SCI). Recent advances in the understanding of the pathophysiological mechanisms occurring in SCI have resulted in an expansion of new therapeutic targets. This review summarizes both preclinical and clinical findings investigating the mechanisms and cognate pharmacologic therapeutics targeted to modulate hypoxia, ischemia, excitotoxicity, inflammation, apoptosis, epigenetic alterations, myelin regeneration and scar remodeling. Successful modulation of these targets has been demonstrated in both preclinical and clinical studies with agents such as Oxycyte, Minocycline, Riluzole, Premarin, Cethrin, and ATI-355. The translation of these agents into clinical studies highlights the progress the field has made in the past decade. SCI proves to be a complex condition; the numerous pathophysiological mechanisms occurring at varying time points suggests that a single agent approach to the treatment of SCI may not be optimal. As the field continues to mature, the hope is that the knowledge gained from these studies will be applied to the development of an effective multi-pronged treatment strategy for SCI. PMID:24833553

Cox, April; Varma, Abhay; Banik, Naren

2015-04-01

371

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

372

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

373

Treatment of infertility in men with spinal cord injury.  

PubMed

Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses, and vacuum constriction devices. In anejaculatory patients who wish to father children, semen retrieval is necessary. Penile vibratory stimulation is recommended as the first line of treatment. Patients who fail penile vibratory stimulation can be referred for electroejaculation. If this approach is not possible, prostate massage is an alternative. Surgical sperm retrieval should be considered as a last resort when other methods fail. Most men with SCI have a unique semen profile characterized by normal sperm count but abnormally low sperm motility. Scientific investigations indicate that accessory gland dysfunction and abnormal semen constituents contribute to the problem. Despite abnormalities, sperm from men with SCI can successfully induce pregnancy. In selected couples, the simple method of intravaginal insemination is a viable option. Another option is intrauterine insemination. The efficacy of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male factor infertility. PMID:20157304

Brackett, Nancy L; Lynne, Charles M; Ibrahim, Emad; Ohl, Dana A; Sønksen, Jens

2010-03-01

374

Incontinence-associated dermatitis in patients with spinal cord injury.  

PubMed

Evidence-based patient care for those with urinary and faecal incontinence involves routine tasks that are integral to essential patient care. However, over the past few decades, researchers have demonstrated how ritualistic practice in this area has become. There is also a growing range of skin care products that can be used to prevent incontinence-associated dermatitis and for nurses, deciding which ones to use can be problematic Incontinent patients have a 22% higher risk of developing pressure ulcers - when immobile this risk increases to 30% - and the often indiscriminate use of various lotions, without a significant evidence base, is a growing cause of concern. Maintaining healthy skin for those patients who have a spinal cord injury and also experience urinary and faecal incontinence is a challenge faced by nurses in primary and secondary care. Research undertaken in secondary care demonstrates that standardization to an evidence-based skin care regime, to be used after incontinent episodes, improves patient care in this specialist area. PMID:19543157

Foxley, Susan; Baadjies, Ruth

375

Suppression of spinal connexin 43 expression attenuates mechanical hypersensitivity in rats after an L5 spinal nerve injury.  

PubMed

Activation of spinal astrocytes may contribute to neuropathic pain. Adjacent astrocytes can make direct communication through gap junctions formed by connexin 43 (Cx43) in the central nervous system. Yet, the role of spinal astroglial gap junctions in neuropathic pain is not fully understood. Since Cx43 is the connexin isoform expressed preferentially in astrocytes in the spinal cord, we used a small interfering RNA (siRNA) approach to examine whether suppression of spinal Cx43 expression inhibits mechanical hypersensitivity in rats after an L5 spinal nerve ligation (SNL). SNL rats were administered intrathecal Cx43 siRNA (3?g/15?l, twice/day) or an equal amount of mismatch siRNA (control) on days 14-17 post-SNL. Cx43 siRNA, but not mismatch siRNA, alleviated mechanical hypersensitivity in SNL rats. Furthermore, Western blot analysis showed that the pain inhibition induced by Cx43 siRNA correlated with downregulation of Cx43 expression, but not that of Cx36 (the neuronal gap junction protein) or glial fibrillary acidic protein (GFAP, a marker for reactive astrocytes) in the spinal cord of SNL rats. Western blot analysis and immunohistochemistry also showed that SNL increased GFAP expression, but decreased Cx43 expression, in spinal cord. Our results provide direct evidence that selective suppression of spinal Cx43 after nerve injury alleviates neuropathic mechanical hypersensitivity. These findings suggest that in the spinal cord, the enhanced function of astroglial gap junctions, especially those formed by Cx43, may be important to neuropathic pain in SNL rats. PMID:24631560

Xu, Qian; Cheong, Yong-Kwan; He, Shao-Qiu; Tiwari, Vinod; Liu, Jian; Wang, Yun; Raja, Srinivasa N; Li, Jinheng; Guan, Yun; Li, Weiyan

2014-04-30

376

The neonatal injury-induced spinal learning deficit in adult rats: central mechanisms.  

PubMed

Previous research has shown that small injuries early in development can alter adult pain reactivity and processing of stimuli presented to the side of injury. However, the mechanisms involved and extent of altered adult spinal function following neonatal injury remain unclear. The present experiments were designed to 1) determine whether the effects of neonatal injury affect processing contralateral to the injury and 2) evaluate the role of cells expressing the NK1 receptor, shown to be involved in central sensitization in adults, in the negative effects of neonatal injury. The present findings indicate that the effects of neonatal injury are primarily isolated to the injured hind limb and do not result in a bilateral alteration in adult spinal function. In addition, the effects of neonatal injury appear to be partially dependent on cells expressing the NK1 receptor as ablating these cells at the time of injury or in adulthood results in attenuation of the neonatal injury-induced spinal learning deficit. PMID:18513129

Young, Erin E; Baumbauer, Kyle M; Hillyer, Jessica E; Patterson, Ann Marie; Hoy, Kevin C; Mintz, Eric M; Joynes, Robin L

2008-06-01

377

Improved functional recovery with oxandrolone after spinal cord injury in rats.  

PubMed

At present, only the corticosteroid, methylprednisolone, is used for acute spinal cord injury to improve function. However, improvements are modest, and are associated with myopathy and immunosuppression so that alternative treatments are needed. Oxandrolone is an androgenic steroid with potential neuroprotective properties that is used to prevent muscle loss and is not immunosuppressive. Oxandrolone increased locomotor recovery concomitant with reduced loss of cord tissue in a standard weight drop model of spinal cord contusion injury indicating oxandrolone as a possible alternative to methylprednisolone. Oxandrolone also increased axonal sprouting within the ventral horns distal to the injury consistent with formation of relay circuits mediating locomotor recovery. PMID:19424096

Zeman, Richard J; Bauman, William A; Wen, Xialing; Ouyang, Nengtai; Etlinger, Joseph D; Cardozo, Christopher P

2009-06-17

378

The Asparaginyl Endopeptidase Legumain Is Essential for Functional Recovery after Spinal Cord Injury in Adult Zebrafish  

PubMed Central

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

379

Key role for pregnenolone in combination therapy that promotes recovery after spinal cord injury.  

PubMed Central

Controlled compressive injury to rat spinal cord was chosen to test therapies that might attenuate the progression of tissue destruction and locomotor deficits that characteristically occur after spinal injury. A highly significant reduction of damage was achieved by immediate postinjury treatment with a combination of the following: an antiinflammatory substance, indomethacin; a stimulator of cytokine secretion, bacterial lipopolysaccharide; and the parent steroid, from which all other steroids arise, pregnenolone. This treatment reduced histopathological changes, spared tissue from secondary injury, and increased restoration of motor function. Remarkably, 11 of 16 of the animals treated with the above combination were able to stand and walk at 21 days after injury, 4 of them almost normally. The results were far superior to those obtained in controls or in animals to which the substances were given separately or in combination of two. This approach may prove to be applicable to nervous system injury, in general, and to injury in other tissues. Images PMID:7991623

Guth, L; Zhang, Z; Roberts, E

1994-01-01

380

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

Microsoft Academic Search

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

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

2002-01-01

381

Predictors of health status and life satisfaction in spinal cord injury  

Microsoft Academic Search

Objective: To analyze relationships between injury-related variables, demographic variables, functional health status, and life satisfaction of people with spinal cord injury (SCI).Design: Cross-sectional survey.Setting: A community in the Netherlands.Subjects: Three hundred eighteen people with SCI, aged 18 to 65 years. Mean age was 39.4 years and mean time after injury was 3.6 years.Main Outcome Measures: Health status was measured with

Marcel W. M. Post; Luc P. de Witte; Floris W. A. van Asbeck; Alphons J. van Dijk; August J. P. Schrijvers

1998-01-01

382

Minimum information about a spinal cord injury experiment: a proposed reporting standard for spinal cord injury experiments.  

PubMed

The lack of reproducibility in many areas of experimental science has a number of causes, including a lack of transparency and precision in the description of experimental approaches. This has far-reaching consequences, including wasted resources and slowing of progress. Additionally, the large number of laboratories around the world publishing articles on a given topic make it difficult, if not impossible, for individual researchers to read all of the relevant literature. Consequently, centralized databases are needed to facilitate the generation of new hypotheses for testing. One strategy to improve transparency in experimental description, and to allow the development of frameworks for computer-readable knowledge repositories, is the adoption of uniform reporting standards, such as common data elements (data elements used in multiple clinical studies) and minimum information standards. This article describes a minimum information standard for spinal cord injury (SCI) experiments, its major elements, and the approaches used to develop it. Transparent reporting standards for experiments using animal models of human SCI aim to reduce inherent bias and increase experimental value. PMID:24870067

Lemmon, Vance P; Ferguson, Adam R; Popovich, Phillip G; Xu, Xiao-Ming; Snow, Diane M; Igarashi, Michihiro; Beattie, Christine E; Bixby, John L

2014-08-01

383

Minimum Information about a Spinal Cord Injury Experiment: A Proposed Reporting Standard for Spinal Cord Injury Experiments  

PubMed Central

Abstract The lack of reproducibility in many areas of experimental science has a number of causes, including a lack of transparency and precision in the description of experimental approaches. This has far-reaching consequences, including wasted resources and slowing of progress. Additionally, the large number of laboratories around the world publishing articles on a given topic make it difficult, if not impossible, for individual researchers to read all of the relevant literature. Consequently, centralized databases are needed to facilitate the generation of new hypotheses for testing. One strategy to improve transparency in experimental description, and to allow the development of frameworks for computer-readable knowledge repositories, is the adoption of uniform reporting standards, such as common data elements (data elements used in multiple clinical studies) and minimum information standards. This article describes a minimum information standard for spinal cord injury (SCI) experiments, its major elements, and the approaches used to develop it. Transparent reporting standards for experiments using animal models of human SCI aim to reduce inherent bias and increase experimental value. PMID:24870067

Ferguson, Adam R.; Popovich, Phillip G.; Xu, Xiao-Ming; Snow, Diane M.; Igarashi, Michihiro; Beattie, Christine E.; Bixby, John L.

2014-01-01

384

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

385

Expression and activation of Ephexin is altered after spinal cord injury  

PubMed Central

Failure of axon regeneration after traumatic spinal cord injury (SCI) is attributable in part to the presence of inhibitory molecular interactions. Recent evidence demonstrates that activation of Eph signaling pathways leads to modulation of growth cone dynamics and repulsion through the activation of ephexin, a novel guanine nucleotide exchange factor (GEF). However, little is known about the expression and modulation of Eph molecular targets in the injured spinal cord. In this study, we determined the expression profile of ephexin after a moderate spinal cord contusion at thoracic level (T10) in young adult rats. Western Blot studies showed increased protein expression in injured rats at 4, and 7 days post-injury (DPI) when compared to control animals. The protein levels returned to normal at 14 DPI and remained steady until 28 DPI. However, immunoprecipitation studies of the phosphorylated ephexin demonstrated that this protein is activated by day 2 until 14 DPI. Expression of ephexin was noticeable in neurons, axons, microglia/macrophages and reactive astrocytes, and co-localized with EphA3, A4 and A7. These results demonstrate the presence of ephexin in the adult spinal cord, and its activation after SCI. Therefore, we show, for the first time, the spatio-temporal pattern of ephexin expression and activation after contusive spinal cord injury. Collectively, our data supports our previous findings on the putative non-permissive roles of Eph receptors after spinal cord injury, and the possible involvement of ephexin in the intracellular cascade of events. PMID:20949525

Rosas, Odrick R.; Figueroa, Johnny D.; Torrado, Aranza I.; Rivera, Mónica; Santiago, José M.; Konig-Toro, Franchesca; Miranda, Jorge D.

2012-01-01

386

Effects of human OEC-derived cell transplants in rodent spinal cord contusion injury.  

PubMed

Numerous reports indicate that rodent olfactory ensheathing cells (OECs) assist in spinal cord repair and clinical trials have been undertaken using autologous transplantation of human olfactory ensheathing cells (hOECs) as a treatment for spinal cord injury. However, there are few studies investigating the efficacy of hOECs in animal models of spinal cord injury. In this study hOECs were derived from biopsies of human olfactory mucosa, purified by culture in a serum-free medium containing neurotrophin-3, genetically labelled with EGFP, and stored frozen. These hOEC-derived cells were thawed and transplanted into the spinal cord injury site 7 days after a moderate contusion injury of the spinal cord at thoracic level T10 in the athymic rat. Six weeks later the animals receiving the hOEC-derived transplants had greater functional improvement in their hindlimbs than controls, assessed using open field (BBB scale) and horizontal rung walking tests. Histological analysis demonstrated beneficial effects of hOEC-derived cell transplantation: reductions in the volume of the lesion and the cavities within the lesion. The transplanted cells were located at the periphery of the lesion where they integrated with GFAP-positive astrocytes resulting in a significant reduction of GFAP staining intensity adjacent to the lesion. Although their mechanism of action is unclear we conclude that hOEC-derived cell transplants improved functional recovery after transplantation into the contused spinal cord, probably by modulating inflammatory responses and reducing secondary damage to the cord. PMID:20399758

Gorrie, Catherine Anne; Hayward, Ian; Cameron, Nicholas; Kailainathan, Gajan; Nandapalan, Neilan; Sutharsan, Ratneswary; Wang, Jennifer; Mackay-Sim, Alan; Waite, Phil M E

2010-06-14

387

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

388

Tail spasms in rat spinal cord injury: changes in interneuronal connectivity.  

PubMed

Uncontrolled muscle spasms often develop after spinal cord injury. Structural and functional maladaptive changes in spinal neuronal circuits below the lesion site were postulated as an underlying mechanism but remain to be demonstrated in detail. To further explore the background of such secondary phenomena, rats received a complete sacral spinal cord transection at S(2) spinal level. Animals progressively developed signs of tail spasms starting 1 week after injury. Immunohistochemistry was performed on S(3/4) spinal cord sections from intact rats and animals were sacrificed 1, 4 and 12 weeks after injury. We found a progressive decrease of cholinergic input onto motoneuron somata starting 1 week post-lesion succeeded by shrinkage of the cholinergic interneuron cell bodies located around the central canal. The number of inhibitory GABAergic boutons in close contact with Ia afferent fibers was greatly reduced at 1 week after injury, potentially leading to a loss of inhibitory control of the Ia stretch reflex pathways. In addition, a gradual loss and shrinkage of GAD65 positive GABAergic cell bodies was detected in the medial portion of the spinal cord gray matter. These results show that major structural changes occur in the connectivity of the sacral spinal cord interneuronal circuits below the level of transection. They may contribute in an important way to the development of spastic symptoms after spinal cord injury, while reduced cholinergic input on motoneurons is assumed to result in the rapid exhaustion of the central drive required for the performance of locomotor movements in animals and humans. PMID:22569103

Kapitza, Sandra; Zörner, Björn; Weinmann, Oliver; Bolliger, Marc; Filli, Linard; Dietz, Volker; Schwab, Martin E

2012-07-01

389

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

E-print Network

A model was developed to examine the effect of different football helmet designs on energy dissipation and injury mitigation during head-on impacts which approach, but do not exceed, critical cervical spinal cord injury threshold levels. Based upon...

Yung, Adelino

1995-01-01

390

Role of plasminogen activator in spinal cord remodeling after spinal cord injury.  

PubMed

Plasminogen activators play an active role in synaptic plasticity associated with the crossed phrenic phenomenon (CPP) and recovery of respiratory function following spinal cord injury. A genetic approach has been used to identify molecular mechanisms underlying this synaptic plasticity. Knockout mice lacking different genes in the plasminogen activator/plasmin system demonstrate that expression of urokinase plasminogen activator (uPA) is required during the critical 1-2h delay period following C2-hemisection for the acquisition of a good CPP response. uPA knockout mice fail to show the structural remodeling of phrenic motorneuron synapses that underlie the CPP response. Potential mechanisms by which uPA may promote phrenic motorneuron synaptic plasticity have been explored. Expression of uPA receptors, uPAR and LRP-1, are both up-regulated in the ipsilateral phrenic motor nucleus (PMN) following C2-hemisection. A comparison of microarray data and real-time PCR analysis of mRNAs induced in the PMN after hemisection indicate potential cell signaling pathways downstream of uPA's interaction with these cell surface receptors in the PMN. Knowledge of these uPA-mediated signaling pathways may identify potential means for the pharmacological activation of the synaptic plasticity required for recovery of phrenic motorneuron activity. PMID:19651246

Seeds, Nicholas W; Akison, Lisa; Minor, Kenneth

2009-11-30

391

Pathological Changes in the White Matter after Spinal Contusion Injury in the Rat  

PubMed Central

It has been shown previously that after spinal cord injury, the loss of grey matter is relatively faster than loss of white matter suggesting interventions to save white matter tracts offer better therapeutic possibilities. Loss of white matter in and around the injury site is believed to be the main underlying cause for the subsequent loss of neurological functions. In this study we used a series of techniques, including estimations of the number of axons with pathology, immunohistochemistry and mapping of distribution of pathological axons, to better understand the temporal and spatial pathological events in white matter following contusion injury to the rat spinal cord. There was an initial rapid loss of axons with no detectable further loss beyond 1 week after injury. Immunoreactivity for CNPase indicated that changes to oligodendrocytes are rapid, extending to several millimetres away from injury site and preceding much of the axonal loss, giving early prediction of the final volume of white matter that survived. It seems that in juvenile rats the myelination of axons in white matter tracts continues for some time, which has an important bearing on interpretation of our, and previous, studies. The amount of myelin debris and axon pathology progressively decreased with time but could still be observed at 10 weeks after injury, especially at more distant rostral and caudal levels from the injury site. This study provides new methods to assess injuries to spinal cord and indicates that early interventions are needed for the successful sparing of white matter tracts following injury. PMID:22952690

Ek, C. Joakim; Habgood, Mark D.; Dennis, Ross; Dziegielewska, Katarzyna M.; Mallard, Carina; Wheaton, Benjamin; Saunders, Norman R.

2012-01-01

392

Spinal cord injury in the pediatric population: a systematic review of the literature.  

PubMed

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

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

2011-08-01

393

Proprioceptive neuropathy affects normalization of the H-reflex by exercise after spinal cord injury  

PubMed Central

The H-reflex habituates at relatively low frequency (10 Hz) stimulation in the intact spinal cord, but loss of descending inhibition resulting from spinal cord transection reduces this habituation. There is a return towards a normal pattern of low-frequency habituation in the reflex activity with cycling exercise of the affected hind limbs. This implies that repetitive passive stretching of the muscles in spinalized animals and the accompanying stimulation of large (Group I and II) proprioceptive fibers has modulatory effects on spinal cord reflexes after injury. To test this hypothesis, we induced pyridoxine neurotoxicity that preferentially affects large dorsal root ganglia neurons in intact and spinalized rats. Pyridoxine or saline injections were given twice daily (IP) for 6 weeks and half of the spinalized animals were subjected to cycling exercise during that period. After 6 weeks, the tibial nerve was stimulated electrically and recordings of M and H waves were made from interosseous muscles of the hind paw. Results show that pyridoxine treatment completely eliminated the H-reflex in spinal intact animals. In contrast, transection paired with pyridoxine treatment resulted in a reduction of the frequency-dependent habituation of the H-reflex that was not affected by exercise. These results indicate that normal Group I and II afferent input is critical to achieve exercise-based reversal of hyper-reflexia of the H-reflex after spinal cord injury. PMID:19913536

Ollivier-Lanvin, Karen; Keeler, Benjamin E.; Siegfried, Rachel; Houlé, John D.; Lemay, Michel A.

2009-01-01

394

MicroRNA Dysregulation in the Spinal Cord following Traumatic Injury  

PubMed Central

Spinal cord injury (SCI) triggers a multitude of pathophysiological events that are tightly regulated by the expression levels of specific genes. Recent studies suggest that changes in gene expression following neural injury can result from the dysregulation of microRNAs, short non-coding RNA molecules that repress the translation of target mRNA. To understand the mechanisms underlying gene alterations following SCI, we analyzed the microRNA expression patterns at different time points following rat spinal cord injury. The microarray data reveal the induction of a specific microRNA expression pattern following moderate contusive SCI that is characterized by a marked increase in the number of down-regulated microRNAs, especially at 7 days after injury. MicroRNA downregulation is paralleled by mRNA upregulation, strongly suggesting that microRNAs regulate transcriptional changes following injury. Bioinformatic analyses indicate that changes in microRNA expression affect key processes in SCI physiopathology, including inflammation and apoptosis. MicroRNA expression changes appear to be influenced by an invasion of immune cells at the injury area and, more importantly, by changes in microRNA expression specific to spinal cord cells. Comparisons with previous data suggest that although microRNA expression patterns in the spinal cord are broadly similar among vertebrates, the results of studies assessing SCI are much less congruent and may depend on injury severity. The results of the present study demonstrate that moderate spinal cord injury induces an extended microRNA downregulation paralleled by an increase in mRNA expression that affects key processes in the pathophysiology of this injury. PMID:22511948

Yunta, Mónica; Nieto-Díaz, Manuel; Esteban, Francisco J.; Caballero-López, Marcos; Navarro-Ruíz, Rosa; Reigada, David; Pita-Thomas, D. Wolfgang; del Águila, Ángela; Muñoz-Galdeano, Teresa; Maza, Rodrigo M.

2012-01-01

395

INCREASED INTERLEUKIN-1? & PROSTAGLANDIN E2 EXPRESSION IN THE SPINAL CORD AT 1 DAY AFTER PAINFUL FACET JOINT INJURY: EVIDENCE OF EARLY SPINAL INFLAMMATION  

PubMed Central

Study Design This study used immunohistochemistry and an enzyme immunoassay to quantify interleukin-1? (IL-1?) and prostaglanding E2 (PGE2) levels in the spinal cord of rats at one day after painful cervical facet joint injury. Objective The objective of this study was to determine to what extent spinal inflammation is initiated early after a painful loading-induced injury of the C6/C7 facet joint in a rat model. Summary of Background Data A common source of neck pain, the cervical facet joint is susceptible to loading-induced injury, which can lead to persistent pain. IL-1? and PGE2 are associated with joint inflammation and pain, both locally in the joint and centrally in the spinal cord. Joint inflammation has been shown to contribute to pain after facet joint injury. Although spinal neuronal hyperactivity is evident within one day of painful facet injury, it is unknown if inflammatory mediators, such as IL-1? and PGE2, are also induced early after painful injury. Methods Rats underwent either a painful C6/C7 facet joint distraction or sham procedure. Mechanical sensitivity was assessed, and immunohistochemical and enzyme immunoassay techniques were utilized to quantify IL-1? and PGE2 expression in the spinal cord at day 1. Results Both IL-1? and PGE2 were significantly elevated (p?0.04) at day 1 after painful injury. Moreover, although both spinal IL-1? and PGE2 levels were correlated with the withdrawal threshold in response to mechanical stimulation of the forepaw, this correlation was only significant (p=0.01) for PGE2. Conclusions The increased expression of two inflammatory markers in the spinal cord at one day after painful joint injury suggest that spinal inflammation may contribute to the initiation of pain after cervical facet joint injury. Further studies will help identify functional roles of both spinal IL-1? and PGE2 in loading-induced joint pain. PMID:24253784

Kras, Jeffrey V.; Dong, Ling; Winkelstein, Beth A.

2014-01-01

396

Spinal cord injury in the emergency context: review of program outcomes of a spinal cord injury rehabilitation program in Sri Lanka  

PubMed Central

Background The final months of the conflict in Sri Lanka in 2009 resulted in massive displacement of the civilian population and a high volume of orthopedic trauma including spinal cord injury. In response to this need, Médecins Sans Frontières implemented a multidisciplinary rehabilitation program. Methods Patients were admitted to the program if they had a spinal cord injury, a stable spine and absence of a high-grade pressure ulcer. All patients were assessed on admission with a standardized functional scale the Spinal Cord Independence Measure II (SCIM) and the American Spinal Injury Association Impairment Scale (ASIA). A multidisciplinary team provided nursing care, physiotherapy, bowel and bladder training, mental health care, and vocational rehabilitation. Patients were discharged from the program when medically stable and able to perform activities of daily living independently or with assistance of a caregiver. The primary outcome measures were discharge to the community, and change in SCIM score on discharge. Secondary outcome measures were measured at 6-12 weeks post-discharge, and included SCIM score and presence of complications (pressure ulcers, urinary tract infections and bowel problems). Results 89 patients were admitted. The majority of injuries were to the thoracic region or higher (89%). The injuries were classified as ASIA grade A in 37 (43%), grade B in 17(20%), grade C in 15 (17%) and grade D in 17(20%). 83.2% met the criteria for discharge, with a further 7.9% patients requiring transfer to hospital for surgical care of pressure ulcers. There was a significant change in SCIM score from 55 on admission to 71 on discharge (p?spinal cord injury complications from those experienced either at or during admission. A further 79% of SCIM scores were stable or improved compared to the score on discharge. Conclusions Provision of effective rehabilitation for spinal cord injury is possible in complex humanitarian emergency situations. A multidisciplinary approach, including psychological support along with partnerships with local and international organizations with specialized expertise, was key to the program’s success. PMID:24650231

2014-01-01

397

Sclerostin Inhibition Prevents Spinal Cord Injury Induced Cancellous Bone Loss.  

PubMed

Spinal cord injury (SCI) results in rapid and extensive sublesional bone loss. Sclerostin, an osteocyte-derived glycoprotein that negatively regulates intraskeletal Wnt-signaling, is elevated after SCI and may represent a mechanism underlying this excessive bone loss. However, it remains unknown whether pharmacologic sclerostin inhibition ameliorates bone loss subsequent to SCI. Our primary purposes were to determine whether a sclerostin antibody (Scl-Ab) prevents hindlimb cancellous bone loss in a rodent SCI model and to compare the effects of a Scl-Ab to that of testosterone-enanthate (TE), an agent that we have previously shown prevents SCI-induced bone loss. Fifty-five (n?=?11-19/group) skeletally-mature male Sprague-Dawley rats were randomized to receive: (A) SHAM surgery (T8 laminectomy), (B) moderate-severe (250 kilodyne) SCI, (C) 250 kilodyne SCI?+?TE (7.0mg/week, i.m.), or (D) 250 kilodyne SCI?+?Scl-Ab (25mg/kg, twice weekly, s.c.) for three weeks. Twenty-one days post-injury, SCI animals exhibited reduced hindlimb cancellous bone volume at the proximal tibia (via µCT and histomorphometry) and distal femur (via µCT), characterized by reduced trabecular number and thickness. SCI also reduced trabecular connectivity and plate-like trabecular structures, indicating diminished structural integrity of the remaining cancellous network, and produced deficits in cortical bone (femoral diaphysis) strength. Scl-Ab and TE both prevented SCI-induced cancellous bone loss, albeit via differing mechanisms. Specifically, Scl-Ab increased osteoblast surface and bone formation, indicating direct bone anabolic effects, whereas TE reduced osteoclast surface with minimal effect on bone formation, indicating antiresorptive effects. The deleterious microarchitectural alterations in the trabecular network were also prevented in SCI?+?Scl-Ab and SCI?+?TE animals, while only Scl-Ab completely prevented the reduction in cortical bone strength. Our findings provide the first evidence indicating that sclerostin inhibition represents a viable treatment to prevent SCI-induced cancellous and cortical bone deficits and provides preliminary rationale for future clinical trials focused on evaluating whether Scl-Ab prevents osteoporosis in the SCI population. © 2014 American Society for Bone and Mineral Research. PMID:25359699

Beggs, Luke A; Ye, Fan; Ghosh, Payal; Beck, Darren T; Conover, Christine F; Balaez, Alexander; Miller, Julie R; Phillips, Ean G; Zheng, Nigel; Williams, Alyssa A; Aguirre, J Ignacio; Wronski, Thomas J; Bose, Prodip K; Borst, Stephen E; Yarrow, Joshua F

2014-10-31

398

Characteristics of Neuropathic Pain in Patients With Spinal Cord Injury  

PubMed Central

Objective To characterize neuropathic pain in patients with spinal cord injury (SCI) according to classification used in the study by Baron et al. (Baron classification), a classification of neuropathic pain based on the mechanism. To also compare the patterns of neuropathic pain in SCI patients with those in patients with other etiologies and to determine the differences in patterns of neuropathic pain between the etiologies. Methods This was a descriptive cross-sectional study. We used the Baron classification to investigate the characteristics of neuropathic pain in SCI. Sixty-one SCI patients with neuropathic pain (The Leeds assessment of neuropathic symptoms and signs score ?12) were enrolled in this study between November 2012 and August 2013, after excluding patients <20 of age, patients with visual analog scale (VAS) score <3, pregnant patients, and patients with systemic disease or pain other than neuropathic pain. Results The most common pain characteristic was pricking pain followed by electrical pain and numbness. The mean VAS score of at-level neuropathic pain was 7.51 and that of below-level neuropathic pain was 6.83. All of the patients suffered from rest pain, but 18 (54.6%) patients with at-level neuropathic pain and 20 (50.0%) patients with below-level neuropathic pain suffered from evoked pain. There was no significant difference in between at-level and below-level neuropathic pains. Conclusion The result was quite different from the characteristics of post-herpetic neuralgia, but it was similar to the characteristics of diabetic neuropathy as shown in the study by Baron et al., which means that sensory nerve deafferentation may be the most common pathophysiologic mechanism of neuropathic pain after SCI. Since in our study, we included short and discrete symptoms and signs based on diverse mechanisms, our results could be helpful for determining further evaluation and treatment. PMID:25024955

Jang, Joon Young; Lee, Seung Hoon; Kim, MinYoung

2014-01-01

399

Patient evaluation of prone carts used in spinal cord injury.  

PubMed

Prone carts are used for mobility by individuals with spinal cord injury who cannot use a wheelchair due to the risk of aggravating existing pressure ulcers. A prone cart is a flat/horizontal cart with a fixed height, propelled by the user while laying in a prone position. Patients reported that prolonged use of a prone cart resulted in chronic neck, shoulder and back pain. Additionally the existing prone carts lack user accessible angle adjustability, chest support area, as well as a storage, eating or working area. An interdisciplinary research team collaborated to address these concerns. Three prone carts were evaluated: E&J, Gendron, and a newly developed prototype, MIAD/PVA. Questionnaires were administered to caregivers and patients regarding usage and effectiveness of the prone carts as well as the features of an ideal cart. This data led to the design and refinement of a prototype prone cart which was tested on 20 patients and 19 caregivers at the SCI Centers of the Milwaukee and Tampa VAMC's from 1994-1995. The new prone cart enables the user to lie at an angle rather than laying flat. This position has been found to relieve back and neck pressure. With an hydraulic system, the the user can adjust both the front and rear angles of the cart to achieve desired comfort. In addition, a front deck provides an eating and working area. This study resulted in research-based information and criteria for the design of new prone carts. Findings of this pilot study will be incorporated in a development merit review proposal to the VA Rehabilitation Research & Development service for the design of a new manual and motorized prone cart. The researchers are collaborating with Ortho-Kinetics Inc. to promote ease in manufacturing. PMID:8900708

Nelson, A; Malassigné, P; Cors, M; Amerson, T L; Bonifay, R; Schnurr, E

1996-06-01

400

Development of a database for translational spinal cord injury research.  

PubMed

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

401

Pure traumatic upper cervical disc herniation causing spinal cord injury: a case report and review of literature  

PubMed Central

Abstract: One third of all spinal injuries involve cervical vertebrae, and the impact of injury to the cervical spinal cord is profound and requires systemic treatment. The role and timing of surgical decompression after an acute spinal cord injury (SCI) remains one of the most controversial topics pertaining to spinal surgery. Lack of controlled, prospective, multicenter clinical studies has contributed to confusion in optimal treatment methods for patients with injuries of the cervical spinal cord. Clinically, the question of whether surgical decompression improves motor recovery following SCI remains surrounded by controversy. Case: Two cases with a 32-year-old man who developed right -sided Brown-Séquard Syndrome Following a motor to car accident with the large right paramedian C3–C4 disc herniation, and ipsilateral spinal cord compression and a 30-year-old man with the syndrome of acute central cervical spinal cord injury with motor impairment involving only upper extremities due to central C2–C3 disc herniation following a pedestrian accident are reported. Discectomy and anterior cervical fusion with the polyetheretherketone (PEEK) cage were performed. A complete motor deficit recovery and a marked sensitive deficit improvement were obtained. The need for and timing of surgical decompression in post traumatic spinal cord injury is controversial. Surgery may expedite neurological recovery in some patients and may provide additional neurological recovery when clinical improvement has plateaued or worsened. In our patient a complete motor deficit recovery was observed. Keywords: Cervical, Disc herniation, Spinal cord injury

Sharifi, Guive; Mosavi, Seyed Ali; Shafieezad, Misagh; Asgari Nosari, Massoud

2012-01-01

402

Regulation of nitric oxide generation by up-regulated arginase I in rat spinal cord injury  

PubMed Central

Recently, arginase is suggested to regulate nitric oxide production by competing with nitric oxide synthase for the same substrate, L-arginine, in experimental asthma. We investigated the role of arginase and its relationship to nitric oxide production after spinal cord injury. Rats were subjected to laminectomy and complete transection of their spinal cords (injury group) or laminectomy only (sham group). In the injury group, arginase I was increased in the macrophages at the transection edge, and the peak was observed 48 h after spinal cord injury. However, nitric oxide production decreased significantly in the injury group despite increased nitric oxide synthase2 mRNA expression compared with the sham group. We also demonstrated the reduction in L-arginine concentrations, which was inversely associated with changes in arginase activity. Therefore, arginase appeared to regulate nitric oxide production by consuming L-arginine. The regulation of arginase activity and L-arginine levels may improve nitroxidative stress and reduce tissue damage in spinal cord injury. PMID:22798716

Imagama, Takashi; Ogino, Keiki; Takemoto, Kei; Kato, Yoshihiko; Kataoka, Hideo; Suzuki, Hidenori; Ran, Zhang; Setiawan, Heri; Fujikura, Yoshihisa; Taguchi, Toshihiko

2012-01-01

403

P2X7 receptor inhibition improves recovery after spinal cord injury  

Microsoft Academic Search

Secondary injury exacerbates the extent of spinal cord insults, yet the mechanistic basis of this phenomenon has largely been unexplored. Here we report that broad regions of the peritraumatic zone are characterized by a sustained process of pathologic, high ATP release. Spinal cord neurons expressed P2X7 purine receptors (P2X7R), and exposure to ATP led to high-frequency spiking, irreversible increases in

Xiaohai Wang; Gregory Arcuino; Takahiro Takano; Jane Lin; Wei Guo Peng; Pinglan Wan; Pingjia Li; Qiwu Xu; Qing Song Liu; Steven A Goldman; Maiken Nedergaard

2004-01-01

404

Three-dimensional Alteration of Microvasculature in a Rat Model of Traumatic Spinal Cord Injury  

Microsoft Academic Search

Acute spinal cord injury (SCI) always leads to severe destruction of the microvascular networks. To investigate the three-dimensional (3D) alterations of microvasculature following SCI, we utilized an established rat SCI model. Based on the hypothesis that the spinal cord would undergo reorganization and postinjury modification of the vascular networks after SCI, we reconstructed the normal and injured angioarchitecture using micro-CT

Jian-zhong Hu; Tian-ding Wu; Tao Zhang; Yong-fang Zhao; Jian Pang; Hong-bin Lu

405

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

406

Effects of Manual Therapy on Bowel Function of Patients with Spinal Cord Injury  

PubMed Central

[Purpose] The purpose of this study was to observe the effects of manual therapy on bowel function of patients with spinal cord injury. [Subjects] The participants were 20 patients with spinal cord injury. [Methods] Manual therapy was applied to the intestine and along the colon ascendens, transverse colon, colon descendens and colon sigmoidem on the surface of abdomen. The results before and after 60 sessions (5 times/week, continued for 12 weeks) of manual therapy were compared. [Results] It was found that there were significant effects both on shortening of bowel time and decreasing dosage of glycerine enema every time patients needed to excrete. [Conclusion] Manual therapy had significant effects on bowel function of patients with spinal cord injury. PMID:24259830

Hu, Chunying; Ye, Miao; Huang, Qiuchen

2013-01-01

407

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

408

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

409

Motoneuron intrinsic properties, but not their receptive fields, recover in chronic spinal injury.  

PubMed

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

Johnson, Michael D; Kajtaz, Elma; Cain, Charlette M; Heckman, C J

2013-11-27

410

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

411

Brain-Computer Interface Driven Functional Electrical Stimulation System for Overground Walking in Spinal Cord Injury Participant  

E-print Network

in Spinal Cord Injury Participant Christine E. King1, Po T. Wang1, Colin M. McCrimmon1, Cathy C.Y. Chou2, An H. Do3, and Zoran Nenadic1,4 Abstract-- The current treatment for ambulation after spinal cord cord injury (SCI) is to substitute the lost motor behavior with a wheelchair [1]. However, prolonged

Nenadic, Zoran

412

AN INTERNATIONAL COMPARATIVE STUDY ASSESSING IMPAIRMENT, ACTIVITIES, AND PARTICIPATION IN SPINAL CORD INJURY REHABILITATION - A PILOT STUDY  

Microsoft Academic Search

This qualitative comparative cross-sectional study attempted to identify existing gaps and differences in health care processes and societal structures supporting the spinal cord injury population in two countries with different socioeconomic profiles, Nepal and Canada, by looking at incidence of preventable complications, and measures of activities and participation. Subjects were recruited from two comparably sized spinal cord injury rehabilitation units

Joy Y. M. Wee; Richard Schwarz

413

Corticosteroids Reduce Glial Fibrillary Acidic Protein Expression in Response to Spinal Cord Injury in a Fetal Rat Model of Dysraphism  

Microsoft Academic Search

Background: Exposure of the spinal cord in myelomeningocele (MM) throughout gestation increases spinal injury. Astrocyte activation evidenced by glial fibrillary acidic proteins (GFAP) indicates the extent of injury. Corticosteroids modulate GFAP synthesis, but their effect in MM is unclear. The purpose of this study was to evaluate the GFAP expression in a fetal rat model of dysraphism and the effect

Antônio Aldo Melo-Filho; Maria Weber Guimarães Barreto; Azize Cristina Capelli Nassr; Fábio Rogério; Francesco Langone; Luis Antonio Violin Pereira; Lourenço Sbragia

2009-01-01

414

The effect of aging and duration of disability on long term health outcomes following spinal cord injury  

Microsoft Academic Search

The purpose of the study was to discover the independent and combined effects of age and duration of injury on selected long term health outcomes of 83 spinal cord injured (SCI) men (age range 21–79 years; duration of spinal cord injury 3–52 years). Specifically, the study examined a multivariate model which specified that age, duration, the interaction of age and

W Pentland; M A McColl; C Rosenthal

1995-01-01

415

Measurement Structure of the Trait Hope Scale in Persons with Spinal Cord Injury: A Confirmatory Factor Analysis  

ERIC Educational Resources Information Center

Objective: To evaluate the measurement structure of the Trait Hope Scale (THS) among individuals with spinal cord injury. Design: Confirmatory factor analysis and reliability and validity analyses were performed. Participants: 242 individuals with spinal cord injury. Results: Results support the two-factor measurement model for the THS with agency…

Smedema, Susan Miller; Pfaller, Joseph; Moser, Erin; Tu, Wei-Mo; Chan, Fong

2013-01-01

416

The Adjustment Process for Individuals with Spinal Cord Injury: The Effect of Perceived Premorbid Sense of Coherence  

ERIC Educational Resources Information Center

This study investigated the relationship between perceived changes in sense of coherence from pre- to postinjury and adjustment for a group of individuals with spinal cord injury. It was hypothesized that after a spinal cord injury, an individual's belief that he or she had significantly reduced his or her sense of coherence would be associated…

Lustig, Daniel C.

2005-01-01

417

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

418

Melatonin treatment protects against acute spinal cord injury-induced disruption of blood spinal cord barrier in mice.  

PubMed

The spinal cord microcirculation plays a critically important role in maintaining the normal function of spinal cord neurons, glial cells, and axons. Previous researches were largely focused on improved neurological manifestations of spinal cord injury (SCI) while ignoring to improve spinal cord microcirculation disorder after melatonin treatment. Therefore, the mechanism of melatonin that affects blood spinal cord barrier (BSCB) integrity and microcirculation in SCI remains unclear. The present study was performed to investigate the effect of melatonin on the BSCB in a SCI mice model. Melatonin (5, 10, 25, 50, 100 mg/kg i.p.) was administered to mice immediately following SCI. Compared to the 48 h post-SCI group, mice treated with melatonin (50 mg/kg) exhibited significantly reduced BSCB permeability. Additionally, melatonin treatment restrained microvessel loss; attenuated edema; protected the tight junction proteins, endothelial cells, and pericytes; decreased the number of cell apoptosis; and reduced MMP3/AQP4/HIF-1?/VEGF/VEGFR2 expression after SCI. Above all, our results clearly demonstrated that melatonin could stabilize microvascular barrier function and microcirculation of SCI, whose mechanism was to promote the repair of the damaged BSCB. PMID:25303856

Wu, Qingbin; Jing, Yingli; Yuan, Xiaochen; Zhang, Xiaoyan; Li, Bingwei; Liu, Mingming; Wang, Bing; Li, Hongwei; Liu, Shuying; Xiu, Ruijuan

2014-12-01

419

Activity-Dependent Increase in Neurotrophic Factors Is Associated with an Enhanced Modulation of Spinal Reflexes after Spinal Cord Injury  

PubMed Central

Abstract Activity-based therapies such as passive bicycling and step-training on a treadmill contribute to motor recovery after spinal cord injury (SCI), leading to a greater number of steps performed, improved gait kinematics, recovery of phase-dependent modulation of spinal reflexes, and prevention of decrease in muscle mass. Both tasks consist of alternating movements that rhythmically stretch and shorten hindlimb muscles. However, the paralyzed hindlimbs are passively moved by a motorized apparatus during bike-training, whereas locomotor movements during step-training are generated by spinal networks triggered by afferent feedback. Our objective was to compare the task-dependent effect of bike- and step-training after SCI on physiological measures of spinal cord plasticity in relation to changes in levels of neurotrophic factors. Thirty adult female Sprague-Dawley rats underwent complete spinal transection at a low thoracic level (T12). The rats were assigned to one of three groups: bike-training, step-training, or no training. The exercise regimen consisted of 15?min/d, 5 days/week, for 4 weeks, beginning 5 days after SCI. During a terminal experiment, H-reflexes were recorded from interosseus foot muscles following stimulation of the tibial nerve at 0.3, 5, or 10?Hz. The animals were sacrificed and the spinal cords were harvested for Western blot analysis of the expression of neurotrophic factors in the lumbar spinal cord. We provide evidence that bike- and step-training significantly increase the levels of brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and NT-4 in the lumbar enlargement of SCI rats, whereas only step-training increased glial cell-derived neurotrophic factor (GDNF) levels. An increase in neurotrophic factor protein levels that positively correlated with the recovery of H-reflex frequency-dependent depression suggests a role for neurotrophic factors in reflex normalization. PMID:21083432

Côté, Marie-Pascale; Azzam, Gregory A.; Lemay, Michel A.; Zhukareva, Victoria

2011-01-01

420

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)

2008-10-18

421

An experimental spinal cord injury rat model using customized impact device: A cost-effective approach.  

PubMed

Till date, NYU MASCIS (New York University, Multicenter Animal Spinal Cord Injury Study) impactor and Ohio State University electromagnetic spinal cord injury device impactor were under use for simulating an experimental spinal cord injury in rodents; functional recovery being assessed through Basso, Beattie and Bresnahan (BBB) scoring method which is an open field behavior based scoring system. Although, the cited impactors are state-of-art devices, affordability to scientists in developing and under developed countries is questionable. Since the acquisition of these impact devices are expensive, we designed a customized impact device based on the requirement, satisfying all the parameters to withstand a standard animal model for contusion type of spinal cord injury at the thoracic level without compromising the lesion reproducibility. Here, a spinal cord contusion is created using a blunt-force impactor in male Wistar rats. Our method gave consistent lesion effects as evaluated by behavior scoring methods. All the animals showed equal degree of performance in tests like narrow beam, inclined plane and horizontal ladder and in BBB scores (open field locomotor test). The aim of presenting our experience is to reinstate the fact that lack of affordability to get sophisticated instrumentation need not be a hurdle in the pursuit of science. PMID:23960429

Vijayaprakash, K M; Sridharan, N

2013-07-01

422

Below is a brief listing of the most frequently asked for research categories for training applications: Bioengineering Brain and Spinal Cord Injury Channels, Synapses and Circuits  

E-print Network

applications: Bioengineering Brain and Spinal Cord Injury Channels, Synapses and Circuits Cognitive, nanotechnology Top Brain and Spinal Cord Injury Ramona Hicks (hicksra@ninds.nih.gov) ­ Basic, translation@ninds.nih.gov) ­ Spinal Cord Injury Top Channels, Synapses and Circuits Shai Silberberg (silberbs@ninds.nih.gov)­ Channels

423

Brain vs. Spinal Cord A Directed Case Study in CNS Injury  

NSDL National Science Digital Library

In this case study, students read about the injuries sustained by a young man hurt in a serious diving accident. To solve the case, they must determine the type of central nervous system injury described using their knowledge of the differences between symptoms and signs of brain and spinal cord injury. The case was developed for upper-level neuroscience courses and rehabilitation courses that cover the neuroanatomy of the central nervous system and the symptoms of different types of central nervous system injury.

Patrick R. Field

2001-01-01

424

Differential Gene Expression in the EphA4 Knockout Spinal Cord and Analysis of the Inflammatory Response Following Spinal Cord Injury  

PubMed Central

Mice lacking the axon guidance molecule EphA4 have been shown to exhibit extensive axonal regeneration and functional recovery following spinal cord injury. To assess mechanisms by which EphA4 may modify the response to neural injury a microarray was performed on spinal cord tissue from mice with spinal cord injury and sham injured controls. RNA was purified from spinal cords of adult EphA4 knockout and wild-type mice four days following lumbar spinal cord hemisection or laminectomy only and was hybridised to Affymetrix All-Exon Array 1.0 GeneChips™. While subsequent analyses indicated that several pathways were altered in EphA4 knockout mice, of particular interest was the attenuated expression of a number of inflammatory genes, including Arginase 1, expression of which was lower in injured EphA4 knockout compared to wild-type mice. Immunohistological analyses of different cellular components of the immune response were then performed in injured EphA4 knockout and wildtype spinal cords. While numbers of infiltrating CD3+ T cells were low in the hemisection model, a robust CD11b+ macrophage/microglial response was observed post-injury. There was no difference in the overall number or spread of macrophages/activated microglia in injured EphA4 knockout compared to wild-type spinal cords at 2, 4 or 14 days post-injury, however a lower proportion of Arginase-1 immunoreactive macrophages/activated microglia was observed in EphA4 knockout spinal cords at 4 days post-injury. Subtle alterations in the neuroinflammatory response in injured EphA4 knockout spinal cords may contribute to the regeneration and recovery observed in these mice following injury. PMID:22629434

Munro, Kathryn M.

2012-01-01

425

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

426

Plasma membrane calcium ATPase deficiency causes neuronal pathology in the spinal cord: a potential mechanism for neurodegeneration in multiple sclerosis and spinal cord injury  

Microsoft Academic Search

Dysfunction and death of spinal cord neurons are critical determinants of neurological deficits in various pathological conditions, including multiple sclerosis (MS) and spinal cord injury. Yet, the molecular mechanisms underlying neuronal\\/axonal damage remain undefined. Our previous studies raised the possibility that a decrease in the levels of plasma membrane calcium ATPase isoform 2 (PMCA2), a major pump extruding calcium from

Michael P. Kurnellas; Arnaud Nicot; Gary E. Shull; Stella Elkabes

2004-01-01

427

Expansion of formalin-evoked Fos-immunoreactivity in rats with a spinal cord injury  

PubMed Central

Peripheral tissue injury as well as spinal cord injury (SCI) may lead to sensitization of dorsal horn neurons and alterations in nociceptive processing. Thus, peripheral injuries experienced by SCI patients, even if not initially perceived, could result in a persistent and widespread activation of dorsal horn neurons and emerge as chronic pain with interventive repair or modest recovery from SCI. To visualize the spinal neuron response to peripheral tissue injury following complete SCI in rats, the neural transcription factor Fos was quantitated in the spinal cord. Two weeks following either a complete transection of the spinal cord at the level of T8 or a sham surgery (laminectomy), rats were injected with formalin into the left hind paw. Sham-operated rats demonstrated biphasic hind paw pain-related behavior following formalin injection, but transected rats displayed fewer behaviors in the second (tonic) phase. Stereological analysis of the sham group revealed that the extent of formalin-induced Fos expression was within the lumbar dorsal horn, with numerous Fos-like immunoreactive profiles in the ipsilateral dorsal horn and some contralateral immunoreactive profiles. In contrast, the level of Fos-like immunoreactivity in the transected group was significantly elevated and expanded in range compared to the sham group, with increases observed in the normal laminar distribution regions, as well as multisegmentally through sacral levels and increases in the contralateral dorsal horn segments. The data demonstrate that widespread activation of spinal, especially dorsal horn, neurons following peripheral insult can occur in the injured spinal cord, despite reduced pain responsiveness, and suggests that exaggerated pain may emerge as spinal recovery or repair progresses. PMID:17531342

Castellanos, Daniel A.; Daniels, Linda A.; Morales, Mena P.; Hama, Aldric T.; Sagen, Jacqueline

2007-01-01

428

Effects of polarization in low-level laser therapy of spinal cord injury in rats  

NASA Astrophysics Data System (ADS)

Low-level laser therapy (LLLT) is a promising approach to treat the spinal cord injury (SCI). Since nerve fibers have optical anisotropy, propagation of light in the spinal tissue might be affected by its polarization direction. However, the effect of polarization on the efficacy of LLLT has not been elucidated. In the present study, we investigated the effect of polarization on the efficacy of near-infrared LLLT for SCI. Rat spinal cord was injured with a weight-drop device. The lesion site was irradiated with an 808-nm diode laser beam that was transmitted through a polarizing filter immediately after injury and daily for five consecutive days. The laser power at the injured spinal cord surface was 25 mW, and the dosage per day was 9.6 J/cm2 (spot diameter, 2 cm; irradiation duration, 1200 s). Functional recovery was assessed daily by an open-field test. The results showed that the functional scores of the SCI rats that were treated with 808-nm laser irradiation were significantly higher than those of the SCI alone group (Group 1) from day 5 after injury, regardless of the polarization direction. Importantly, as compared to the locomotive function of the SCI rats that were treated with the perpendicularly-polarized laser parallel to the spinal column (Group 2), that of the SCI rats that were irradiated with the linearly aligned polarization (Group 3) was significantly improved from day 10 after injury. In addition, the ATP contents in the injured spinal tissue of Group 3, which were measured immediately after laser irradiation, were moderately higher than those of Group 2. These observations are attributable to the deeper penetration of the parallelpolarized light in the anisotropic spinal tissue, suggesting that polarization direction significantly affects the efficacy of LLLT for SCI.

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

2012-03-01

429

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

430

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. PMID:25278785

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

2014-01-01

431

International Standards for Neurological Classification of Spinal Cord Injury: cases with classification challenges.  

PubMed

The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) is routinely used to determine the levels of injury and to classify the severity of the injury. Questions are often posed to the International Standards Committee of the American Spinal Injury Association regarding the classification. The committee felt that disseminating some of the challenging questions posed, as well as the responses, would be of benefit for professionals utilizing the ISNCSCI. Case scenarios that were submitted to the committee are presented with the responses as well as the thought processes considered by the committee members. The importance of this documentation is to clarify some points as well as update the SCI community regarding possible revisions that will be needed in the future based upon some rules that require clarification. PMID:24559416

Kirshblum, S C; Biering-Sorensen, F; Betz, R; Burns, S; Donovan, W; Graves, D E; Johansen, M; Jones, L; Mulcahey, M J; Rodriguez, G M; Schmidt-Read, M; Steeves, J D; Tansey, K; Waring, W

2014-03-01

432

International standards for neurological classification of spinal cord injury: cases with classification challenges.  

PubMed

The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) is routinely used to determine levels of injury and to classify the severity of the injury. Questions are often posed to the International Standards Committee of the American Spinal Injury Association (ASIA) regarding the classification. The committee felt that disseminating some of the challenging questions posed, as well as the responses, would be of benefit for professionals utilizing the ISNCSCI. Case scenarios that were submitted to the committee are presented with the responses as well as the thought processes considered by the committee members. The importance of this documentation is to clarify some points as well as update the SCI community regarding possible revisions that will be needed in the future based upon some rules that require clarification. PMID:25477729

Kirshblum, S C; Biering-Sørensen, F; Betz, R; Burns, S; Donovan, W; Graves, D E; Johansen, M; Jones, L; Mulcahey, M J; Rodriguez, G M; Schmidt-Read, M; Steeves, J D; Tansey, K; Waring, W

2014-01-01

433

International Standards for Neurological Classification of Spinal Cord Injury: Cases With Classification Challenges  

PubMed Central

The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) is routinely used to determine levels of injury and to classify the severity of the injury. Questions are often posed to the International Standards Committee of the American Spinal Injury Association (ASIA) regarding the classification. The committee felt that disseminating some of the challenging questions posed, as well as the responses, would be of benefit for professionals utilizing the ISNCSCI. Case scenarios that were submitted to the committee are presented with the responses as well as the thought processes considered by the committee members. The importance of this documentation is to clarify some points as well as update the SCI community regarding possible revisions that will be needed in the future based upon some rules that require clarification. PMID:25477729

Biering-Sørensen, F.; Betz, R.; Burns, S.; Donovan, W.; Graves, D.E.; Johansen, M.; Jones, L.; Mulcahey, M.J.; Rodriguez, G.M.; Schmidt-Read, M.; Steeves, J.D.; Tansey, K.; Waring, W.

2014-01-01

434

Prediction of severe neurogenic bowel dysfunction in persons with spinal cord injury  

Microsoft Academic Search

Study design:Cross-sectional study.Objective:To analyze the predictors of severe neurogenic bowel dysfunction (NBD) in persons with spinal cord injury (SCI).Setting:The Kaohsiung Medical University Hospital, Taiwan.Methods:Two questionnaires—the NBD score and the Beck Depression Inventory second edition—were sent to 232 persons with SCI by mail. The demographic factors and injury-related factors were recorded to evaluate any relationships with severe NBD. The associations between

C-W Liu; C-C Huang; C-H Chen; Y-H Yang; T-W Chen; M-H Huang

2010-01-01

435

The association between regional body composition and metabolic outcomes in athletes with spinal cord injury  

Microsoft Academic Search

Study design:Cross-sectional study comparing athletes with spinal cord injury (SCI) and age and body mass index matched able-bodied controls (AB).Objective:To examine the impact of exercise training on the relation between whole body, regional and intermuscular adipose tissue (IMAT) and glucose tolerance, insulin action and lipid profile.Setting:University Research Laboratory, USA.Methods:Fourteen college-aged athletes with SCI (seven men; duration of injury 16.5±5.7 years,

M C Mojtahedi; R J Valentine; S A Arngrímsson; K R Wilund; E M Evans; EM Evans

2008-01-01

436

Traumatic Spinal Cord Injury Induces Nuclear Factor-kB Activation  

Microsoft Academic Search

Inflammatory responses are a major component of secondary injury and play a central role in mediating the pathogenesis of acute and chronic spinal cord injury (SCI). The nuclear factor-kB (NF-kB) family of transcription factors is required for the transcriptional activation of a variety of genes regulating inflammatory, proliferative, and cell death responses of cells. In this study we examined the

John R. Bethea; Marcia Castro; Robert W. Keane; Thomas T. Lee; W. Dalton Dietrich; Robert P. Yezierski

437

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

438

Epidemiology of traumatic spinal cord injury in Asia: A systematic review  

PubMed Central

Study design A systematic review. Background The number of traumatic spinal cord injury (TSCI) reports grows annually, especially in China and Korea. The epidemiological characteristics of TSCI in Asia differ from those in other countries. Thus, we compiled epidemiological factors from Asia to compare with those from other countries. Method We searched articles published in any language between January 1980 to December 2011 using the terms “spinal cord injury”, “traumatic spinal cord injury”, “epidemiology”, and “Asia”. The articles were reviewed for information regarding TSCI incidence, total cases, case criteria, case source, causes of injury, male/female ratio, mean age, prospective or retrospective, neurological level of injury, extent of injury, and America Spinal Injury Association Impairment Scale (AIS)/grade. Results Epidemiological data were extracted from 39 reports in the published literature that met the inclusion criteria. Only two studies reported prevalence rates. Incidence rates ranged from 12.06 to 61.6 per million. The average age ranged from 26.8 to 56.6 years old. Men were at higher risk than women. Motor vehicle collisions (MVCs) and falls were the main causes of TSCI. However, several countries reported war wounds as the major cause. The neurological level and extent of injury were mixed, and most patients were categorized as AIS/Frankel grade A. Conclusion TSCI is an important public health problem and a major cause of paralysis. We must understand the epidemiology to implement appropriate preventative measures. Asian epidemiology is different from that in other regions, so intervention measures must be established according to population-specific characteristics. PMID:22925749

Ning, Guang-Zhi; Wu, Qiang; Li, Yu-Lin; Feng, Shi-Qing

2012-01-01

439

Recovery from spinal cord injury mediated by antibodies to neurite growth inhibitors  

Microsoft Academic Search

THERE is little axonal growth after central nervous system (CNS) injury in adult mammals. The administration of antibodies (IN-1) to neutralize the myelin-associated neurite growth inhibitory proteins leads to long-distance regrowth of a proportion of CNS axons after injury1-5. Our aim was: to determine if spinal cord lesion in adult rats, followed by treatment with antibodies to neurite growth inhibitors,

Barbara S. Bregman; Ellen Kunkel-Bagden; Lisa Schnell; Hai Ning Dai; Da Gao; Martin E. Schwab

1995-01-01

440

Return to work after spinal cord injury: factors related to time to first job  

Microsoft Academic Search

Study design:Cross-sectional survey.Objectives:To investigate factors related to length of time between spinal cord injury (SCI) onset and start of first post-injury employment.Setting:Persons living with SCI in the community who are members of a disability support organization.Methods:Participants were randomly selected from the membership list of a non-governmental voluntary organization. They met the following four criteria: traumatic SCI, minimum of 15 years

K Ramakrishnan; M Mazlan; P E Julia; L Abdul Latif

2011-01-01

441

Bridging the gap: a reticulo-propriospinal detour bypassing an incomplete spinal cord injury.  

PubMed

Anatomically incomplete spinal cord injuries are often followed by considerable functional recovery in patients and animal models, largely because of processes of neuronal plasticity. In contrast to the corticospinal system, where sprouting of fibers and rearrangements of circuits in response to lesions have been well studied, structural adaptations within descending brainstem pathways and intraspinal networks are poorly investigated, despite the recognized physiological significance of these systems across species. In the present study, spontaneous neuroanatomical plasticity of severed bulbospinal systems and propriospinal neurons was investigated following unilateral C4 spinal hemisection in adult rats. Injection of retrograde tracer into the ipsilesional segments C3-C4 revealed a specific increase in the projection from the ipsilesional gigantocellular reticular nucleus in response to the injury. Substantial regenerative fiber sprouting of reticulospinal axons above the injury site was demonstrated by anterograde tracing. Regrowing reticulospinal fibers exhibited excitatory, vGLUT2-positive varicosities, indicating their synaptic integration into spinal networks. Reticulospinal fibers formed close appositions onto descending, double-midline crossing C3-C4 propriospinal neurons, which crossed the lesion site in the intact half of the spinal cord and recrossed to the denervated cervical hemicord below the injury. These propriospinal projections around the lesion were significantly enhanced after injury. Our results suggest that severed reticulospinal fibers, which are part of the phylogenetically oldest motor command system, spontaneously arborize and form contacts onto a plastic propriospinal relay, thereby bypassing the lesion. These rearrangements were accompanied by substantial locomotor recovery, implying a potential physiological relevance of the detour in restoration of motor function after spinal injury. PMID:25274818

Filli, Linard; Engmann, Anne Katrin; Zörner, Björn; Weinmann, Oliver; Moraitis, Timoleon; Gullo, Miriam; Kasper, Hansjörg; Schneider, Regula; Schwab, Martin E

2014-10-01