Journal of neurotrauma
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Journal of neurotrauma · Mar 2015
Randomized Controlled TrialSELECTIVE ALPHA ADRENERGIC ANTAGONIST REDUCES SEVERITY OF TRANSIENT HYPERTENSION DURING SEXUAL STIMULATION AFTER SPINAL CORD INJURY.
On a daily basis, the majority of those with high-level spinal cord injury have autonomic dysreflexia, which describes a life-threatening episode of transient extreme hypertension (i.e., as high as 300 mm Hg) as many as 90% of people living with this condition. Unfortunately, ejaculation is a major initiating factor for autonomic dysreflexia, which discourages sexual activity. In order to obtain a sperm specimen, or for initial assessment of fertility, penile vibrostimulation is clinically performed. ⋯ The increase in systolic blood pressure was mitigated during vibrostimulation in subjects administered prazosin as compared with those administered placebo (+140±19 mm Hg vs. +96±14 mmHg; p<0.05). On average, the peak in systolic blood pressure was 46 mm Hg lower during penile vibrostimulation when patients were administered prazosin (p<0.05), whereas resting blood pressure was not affected. Prazosin appears to be effective at reducing the severity of autonomic dysreflexia during sexual stimulation in patients with spinal cord injury, without exacerbating resting hypotension in high-level spinal cord injury.
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Journal of neurotrauma · Mar 2015
Preserved sensory-motor function despite large-scale morphological alterations in a series of patients with holocord syringomyelia.
Although the central nervous system has a limited capacity for regeneration after acute brain and spinal cord injuries, it can reveal extensive morphological changes. Occasionally, the formation of an extensive syrinx in the spinal cord can be observed that causes no or only limited signs of functional impairment. This condition creates a unique opportunity to evaluate the mismatch between substantial morphological changes and functional outcomes. ⋯ Despite extensive anatomical changes of the cervical cord (on average 26% reduction of residual spinal cord area and intrusion of almost the entire cervical spinal cord), a clinically relevant impairment of upper-limb motor function was absent while only subtle sensory deficits could be detected. dCHEPs revealed the highest sensitivity by disclosing impairments of spinothalamic pathways. Comparable to that of the brain, extensive anatomical changes of the spinal cord can occur with only subtle functional impairment. The time scale of slowly-emerging morphological alterations is essential to permit an enormous capacity for plasticity of the spinal cord.
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Journal of neurotrauma · Mar 2015
The relative contribution of edema and hemorrhage to raised intrathecal pressure following traumatic spinal cord injury.
Raised intrathecal pressure (ITP) after traumatic spinal cord injury (SCI) is a critically important aspect of injury development that may result in significantly greater tissue damage and worsened functional outcome. Raised ITP is caused by the accumulation of blood and/or water (edema), and while their occurrence after traumatic SCI has been well established, the relative contribution of both processes to the development of ITP after SCI has not yet been determined. Accordingly, the current study investigates the temporal profile of raised ITP after traumatic SCI in relation to both hemorrhage and edema development. ⋯ Early increases in ITP at 5 h post-injury were associated with significant increases in blood volume. ITP, however, was maximal at 3 days post-SCI, at which time there was an associated significant increase in edema that persisted for 1 week. We conclude that raised ITP after traumatic SCI is initially driven by volumetric increases in hemorrhage, while edema becomes the primary driver of ITP at 3 days post-injury.
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Journal of neurotrauma · Mar 2015
Immunosuppression of allogenic mesenchymal stem cells transplantation after spinal cord injury improves graft survival and beneficial outcomes.
Cell therapy for spinal cord injury (SCI) is a promising strategy for clinical application. Mesenchymal stem cells (MSC) have demonstrated beneficial effects following transplantation in animal models of SCI. However, despite the immunoprivilege properties of the MSC, their survival in the injured spinal cord is reduced due to the detrimental milieu in the damaged tissue and immune rejection of the cells. ⋯ A cell-dose effect was found regarding locomotion recovery and tissue protection independent of immunosuppression. Nevertheless, immunosuppression enhanced the electrophysiological outcomes and allowed filling of the cavity formed after injury by new regenerative tissue and axons. These results indicate that MSC transplantation combined with immunosuppression prolongs the survival of engrafted cells and improves functional and morphological outcomes after SCI.
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Journal of neurotrauma · Mar 2015
Review Meta AnalysisNeurological Recovery and Antioxidant Effects of Curcumin for Spinal Cord Injury in the Rat: A Network Meta-Analysis and Systematic Review.
Spinal cord injury (SCI) is a devastating condition affecting young, healthy individuals worldwide. Existing agents have inadequate therapeutic efficacy, and some are associated with side effects. Our objective is to summarize and critically assess the neurological recovery and antioxidant effects of curcumin for treatment of SCI in rat models. ⋯ Effect size, assessed using the BBB scale, increased gradually with increasing curcumin dosage. The difference between low- and high-dose curcumin using the BBB scale was statistically significant. Neurological recovery and antioxidant effects of curcumin were observed in rats with SCI despite poor study methodological quality.