Journal of neurotrauma
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Journal of neurotrauma · Aug 2017
Compression Decreases Anatomical and Functional Recovery and Alters Inflammation after Contusive Spinal Cord Injury.
Experimental models of spinal cord injury (SCI) typically utilize contusion or compression injuries. Clinically, however, SCI is heterogeneous and the primary injury mode may affect secondary injury progression and neuroprotective therapeutic efficacy. Specifically, immunomodulatory agents are of therapeutic interest because the activation state of SCI macrophages may facilitate pathology but also improve repair. ⋯ To determine whether the recovery plateau is indicative of compression-specific inflammatory responses, we examined macrophage activation with immunohistochemical markers of purportedly pathological (CD86 and macrophage receptor with collagenous structure [MARCO]) and reparative macrophages (arginase [Arg1] and CD206). We detected significant increases in macrophages expression of MARCO and decreases in macrophage Arg1 expression with compression, suggesting a biomechanical-dependent shift in SCI macrophage activation. Collectively, compression-induced alterations in tissue and functional recovery and inflammation highlight the need to consider the primary SCI biomechanics in the design and clinical implementation of immunomodulatory therapies.
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Journal of neurotrauma · Aug 2017
Clinical TrialEffect of locomotor training on exhaustion of leg muscle activity in chronic complete spinal cord injury.
The aim of this study was to evaluate the effect of a continuous locomotor training on leg muscle electromyographic (EMG) exhaustion during assisted stepping movements in a patient with motor complete spinal cord injury (SCI). EMG exhaustion and loss of potentials starts to develop in untrained patients at ∼6 months after injury. ⋯ At this time (12 years after injury) a basic locomotor pattern of leg muscle activity of reduced amplitude could still be elicited, but it was resistant to exhaustion and unchanged in amplitude after 12 min of assisted stepping. It is suggested that fatigue-resistant motor units prevail at this stage and can still be activated during stepping as a result of the training.
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Journal of neurotrauma · Aug 2017
Prevalence of Fatigue and Associated Factors in a SCI population: data from an Internet Based and Face-to-Face surveys.
Fatigue has a profound impact on patients with spinal cord injury (SCI), but only limited treatments are available. The aim of this study was to determine the prevalence of fatigue in SCI and its association with clinical and demographic factors. We used an internet-based survey and a face-to-face interview to estimate the prevalence of fatigue in a SCI population. ⋯ Moreover, the online survey and the standard face-to-face interview showed similar results concerning fatigue evaluation. Several factors may contribute to fatigue, however. Future studies should be conducted to clarify which are the most relevant ones and, if possible, to determine which factors are modifiable.
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Journal of neurotrauma · Jul 2017
Applying systems biology methodology to identify genetic factors possibly associated with recovery after traumatic brain injury.
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality worldwide. It is linked with a number of medical, neurological, cognitive, and behavioral sequelae. The influence of genetic factors on the biology and related recovery after TBI is poorly understood. ⋯ Overall, this study demonstrates the use of a systems biology-based approach to identify unique/novel genes or sets of genes important to the recovery process. Findings from this systems biology-based approach provide additional insight into the potential impact of genetic variants on the underlying complex biological processes important to TBI recovery and may inform the development of empirical genetic-related studies for TBI. Future studies that combine systems biology methodology and genomic, proteomic, and epigenetic approaches are needed in TBI.
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Journal of neurotrauma · Jul 2017
Directions for use of intracranial pressure monitoring in treatment of severe traumatic brain injury using data from the Japan Neurotrauma Data Bank.
Neuromonitoring can be used to observe intracranial pathological conditions in neurointensive care; however, use of intracranial pressure (ICP) monitoring is low in Japan. In this study, we retrospectively investigated the effects of ICP monitoring in the treatment of severe traumatic brain injury (TBI), using data from the Japan Neurotrauma Data Bank (JNTDB). The study was conducted in 1091 subjects enrolled in the JNTDB (Project 2009) from July 2009 to June 2011. ⋯ In multivariate analysis, age, GCS, pupillary abnormalities, perimesencephalic cistern disappearance or compression, and ICP were associated with a favorable outcome, but the therapeutic method did not affect outcome. We conclude that ICP monitoring and management of ICP are both important for management and care of severe TBI. However, current therapies do not control ICP sufficiently, and more effective therapies are needed.