Journal of neurotrauma
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Journal of neurotrauma · May 2024
Machine learning web application for predicting functional outcomes in patients with traumatic spinal cord injury following inpatient rehabilitation.
Accurately predicting functional outcomes in patients with spinal cord injury (SCI) helps clinicians set realistic functional recovery goals and improve the home environment after discharge. The present study aimed to develop and validate machine learning (ML) models to predict functional outcomes in patients with SCI and deploy the models within a web application. The study included data from the Japan Association of Rehabilitation Database from January 1, 1991, to December 31, 2015. ⋯ The final models were deployed in a web application to provide functional predictions. The application can be found at http://3.138.174.54:8501. In conclusion, our prediction models developed using ML successfully predicted functional outcomes in patients with SCI and were deployed in an open-access web application.
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Journal of neurotrauma · May 2024
Chemogenetic attenuation of acute nociceptive signaling enhances functional outcomes following spinal cord injury.
Identifying novel therapeutic approaches to promote recovery of neurological functions following spinal cord injury (SCI) remains a great unmet need. Nociceptive signaling in the acute phase of SCI has been shown to inhibit recovery of locomotor function and promote the development of chronic neuropathic pain. We therefore hypothesized that inhibition of nociceptive signaling in the acute phase of SCI might improve long-term functional outcomes in the chronic phase of injury. ⋯ However, treatment did not impact the development of cold allodynia or mechanical hyperalgesia. Histological assessments of spinal cord tissue suggested trends toward reduced lesion volume, increased neuronal sparing and increased CGRP+ axon sprouting in hM4Di-treated animals. Together, these findings suggest that nociceptor silencing early after SCI may promote beneficial plasticity in the acute phase of injury that can impact long-term functional outcomes, and support previous work highlighting primary nociceptors as possible therapeutic targets for pain management after SCI.
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Journal of neurotrauma · May 2024
Impact of Upper Limb Motor Recovery on Functional Independence after Traumatic Low Cervical Spinal Cord Injury.
Cervical spinal cord injury (SCI) causes devastating loss of upper limb function and independence. Restoration of upper limb function can have a profound impact on independence and quality of life. In low-cervical SCI (level C5-C8), upper limb function can be restored via reinnervation strategies such as nerve transfer surgery. ⋯ Age 60 years (OR = 0.44, p = 0.01), and complete SCI (OR = 0.43, p = 0.002) were associated with reduced odds of gaining independence in ADLs. After cervical SCI, finger flexion (C8) and elbow extension (C7) recovery translate into greater independence in eating, bladder management, and transfers. These results can be used to design individualized reinnervation plans to reanimate upper limb function and maximize independence in patients with low cervical SCI.
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Journal of neurotrauma · May 2024
Genetic or pharmacological ablation of ASIC1a is not neuroprotective in a mouse model of spinal cord injury.
Acid-sensing ion channel 1a (ASIC1a) is a proton-activated channel that is expressed ubiquitously throughout the central nervous system and in various types of immune cells. Its role in spinal cord injury (SCI) is controversial; inhibition of ASIC1a has been reported to improve SCI pathology in vivo, but conversely, gene ablation increased kainite-mediated excitotoxic cell death in vitro. Here, we re-examined the role of ASIC1a in a mouse model of SCI. ⋯ Next, we explored pharmacological antagonism of this ion channel by administering the potent ASIC1a inhibitor, Hi1a. Consistent with a role for ASIC1a to attenuate excitotoxicity, accelerated neuronal cell loss was found at the lesion site in SCI mice treated with Hi1a, but there were no differences in locomotor recovery. Moreover, ASIC1a inhibition did not cause significant alterations to neutrophil migration, microglial density, or blood-spinal cord barrier integrity.
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Journal of neurotrauma · May 2024
Wallerian degeneration assessed by multimodal MRI of cervical spinal cord is associated with neurological impairment after spinal cord injury.
While Wallerian degeneration (WD) is a crucial pathological process induced with spinal cord injury (SCI), its underlying mechanisms is still understudied. In this study, we aim to assess structural alterations and clinical significance of WD in the cervical cord following SCI using multi-modal magnetic resonance imaging (MRI), which combines T2*-weighted imaging and diffusion tensor imaging (DTI). T2*-weighted images allow segmentation of anatomical structures and the detection of WD on macrostructural level. ⋯ Smaller total and dorsal tissue bridges were related to greater mean CSA and lower fractional anisotropy values in WD (p < 0.05), respectively. Moreover, SCI participants with significantly larger CSAs and significantly lower microstructural integrity had worse sensory outcomes (p < 0.05). This comprehensive evaluation of WD can help us better understand the mechanisms of WD, monitor progression, and assess the effectiveness of therapeutic interventions after SCI.