Journal of neurotrauma
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Journal of neurotrauma · Jun 2019
Earlier Decompression (< 8 hours) Results in Better Neurological and Functional Outcome After Traumatic Thoracolumbar Spinal Cord Injury.
The optimal timing of surgical intervention following spinal cord injury (SCI) remains under debate. Recent studies indicate a potential neurological and functional benefit of early surgery (< 8 h) after cervical SCI. For thoracolumbar SCI syndromes, fewer studies exist. ⋯ Here, we observed improved bladder outcome (i.e., SCIM-6 sub-item; p < 0.021) and a trend towards better functional bowel management (i.e., SCIM-7; p < 0.090). Linear regression models showed that early surgery was an independent predictor for higher AIS shifts and improved total SCIM difference. Our data suggests that prompt surgical management after thoracolumbar SCI might have a positive impact on the functional and neurological outcome.
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Spinal cord injury (SCI) interrupts the brain-body input-output exchange and modifies the mental representation of disconnected body parts, with decreased reliance on sensorimotor aspects of body representation and increased weighting of visuospatial ones. We hypothesized that physiotherapy-related benefits might extend to the re-establishment of the typical interplay between these two types of strategies. ⋯ Results showed that only after physiotherapy the individuals with SCI showed the sensorimotor biomechanical effect (orientation-dependent modulation of response times) for the mental rotation of foot images (absent in pre-physiotherapy). This highlights that body representation is adaptable to contingent conditions, in that the reliance on sensorimotor or visuospatial strategies can be altered and, at least partially, restored as a function of physiotherapy.
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Journal of neurotrauma · Jun 2019
Altered amniotic fluid levels of hyaluronic acid in fetal rats with myelomeningocele: understanding spinal cord injury.
Myelomeningocele (MMC) is a devastating congenital neural tube defect that results in the exposure of spinal cord to the intrauterine environment, leading to secondary spinal cord injury and severe impairment. Although the mechanisms underlying the secondary pathogenesis are clinically relevant, the exact cause of in utero-acquired spinal cord damage remains unclear. The objective of this study was to determine whether the hyaluronic acid (HA) concentration in amniotic fluid (AF) in the retinoic acid-induced model of MMC is different from that in normal controls and whether these differences could have an impact on the viscosity of AF. ⋯ No HA-degrading activity was detected in MMC-AF. In summary, we identified a deficiency in the AF level of HA and the viscosity of AF in fetal rats with MMC. These data are discussed in relation to a potential role the reduction in the AF viscosity due to the low level of HA may play in the exacerbating effects of mechanical trauma on spinal cord damage at the MMC lesion site.
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Journal of neurotrauma · Jun 2019
Spinal cord injury in rats dysregulates diurnal rhythms of fecal output and liver metabolic indicators.
Spinal cord injury (SCI) dysregulates metabolic homeostasis. Metabolic homeostasis is optimized across the day by the circadian system. Despite the prevalence of metabolic pathologies after SCI, post-SCI circadian regulation of metabolism remains understudied. ⋯ Further, SCI disrupted liver clock gene expression and suppressed inflammatory gene rhythms. Together, our novel data suggest that SCI disrupts typical metabolic and circadian function. Improving post-SCI metabolic function could enhance recovery of homeostasis.
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Journal of neurotrauma · Jun 2019
Peripheral inflammation accelerates the onset of mechanical hypersensitivity after spinal cord injury and engages TNFα signaling mechanisms.
Previously, we showed that noxious stimulation of the tail produces numerous detrimental effects after spinal cord injury (SCI), including an earlier onset and increased magnitude of mechanical hypersensitivity. Expanding on these observations, this study sought to determine whether localized peripheral inflammation similarly impacts the expression of mechanical hypersensitivity after SCI. Adult rats received a moderate contusion injury at the thoracic level (Tl0) or sham surgery, and were administered complete Freund's adjuvant (CFA) or vehicle in one hindpaw 24 hours later. ⋯ Expression levels of c-fos, tumor necrosis factor α (TNFα), TNF receptors, and members of the TNFα signaling pathway such as caspase 8 and phosphorylated extracellular related kinase (pERK) were preferentially upregulated in the lumbar spinal cord of SCI-CFA rats. Meanwhile, c-jun was significantly increased in both CFA-treated groups. Overall, these results together with our previous reports, suggest that peripheral noxious input after SCI facilitates the development of pain by mechanisms that may require TNFα signaling.