Journal of neurotrauma
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Journal of neurotrauma · Dec 2015
A cervical hemi-contusion spinal cord injury model for the investigation of novel therapeutics targeting proximal and distal forelimb functional recovery.
Cervical spinal cord contusion is the most common human spinal cord injury, yet few rodent models replicate the pathophysiological and functional sequela of this injury. Here, we modified an electromechanical injury device and characterized the behavioral and histological changes occurring in response to a lateralized C4 contusion injury in rats. A key feature of the model includes a non-injurious touch phase where the spinal cord surface is dimpled with a consistent starting force. ⋯ Significant differences in loss of ipsilateral unmyelinated and myelinated white matter was detected between injury severities. Demyelination was primarily localized to the dorsolateral region of the hemicord and extended further rostral following 0.8 mm injury. These findings establish the C4 hemi-contusion injury as a consistent, graded model for testing novel treatments targeting forelimb functional recovery.
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Journal of neurotrauma · Dec 2015
Review Meta AnalysisThe Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury：A Systematic Review and Meta-analysis.
Spinal cord injury (SCI) has become a significant social and economic burden for patients and their families. The effect of acupuncture on neurological recovery in individuals with SCI remains inconclusive despite previous studies and meta-analyses. The aim of the current study was to perform a more rigorous systematic review and bias-adjusted meta-analysis of studies so that the overall impact of acupuncture on neurological recovery in SCI can be determined. ⋯ Sensitivity analyses suggested that the smaller studies (sample size <30), those with acute disease, and studies that used varying acupuncture sessions demonstrated a larger magnitude of effect. However, studies were generally of poor quality and publication bias favoring positive studies was evident. Therefore, the benefit of acupuncture we report is by no means definitive and well-designed future studies are recommended to confirm this.
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Journal of neurotrauma · Dec 2015
Noninvasive Reactivation of Motor Descending Control after Paralysis.
The present prognosis for the recovery of voluntary control of movement in patients diagnosed as motor complete is generally poor. Herein we introduce a novel and noninvasive stimulation strategy of painless transcutaneous electrical enabling motor control and a pharmacological enabling motor control strategy to neuromodulate the physiological state of the spinal cord. This neuromodulation enabled the spinal locomotor networks of individuals with motor complete paralysis for 2-6 years American Spinal Cord Injury Association Impairment Scale (AIS) to be re-engaged and trained. ⋯ We also observed on-command selective activation of the gastrocnemius and soleus muscles when attempting to plantarflex. At the end of 18 weeks of weekly interventions the mean changes in the amplitude of voluntarily controlled movement without stimulation was as high as occurred when combined with electrical stimulation. Additionally, spinally evoked motor potentials were readily modulated in the presence of voluntary effort, providing electrophysiological evidence of the re-establishment of functional connectivity among neural networks between the brain and the spinal cord.
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Journal of neurotrauma · Dec 2015
Contribution of interoceptive information to emotional processing: evidence from individuals with spinal cord injury.
There is much evidence to suggest that recognizing and sharing emotions with others require a first-hand experience of those emotions in our own body which, in turn, depends on the adequate perception of our own internal state (interoception) through preserved sensory pathways. Here we explored the contribution of interoception to first-hand emotional experiences and to the recognition of others' emotions. For this aim, 10 individuals with sensory deafferentation as a consequence of high spinal cord injury (SCI; five males and five females; mean age, 48 ± 14.8 years) and 20 healthy subjects matched for age, sex, and education were included in the study. ⋯ A two-way mixed analysis of variance and post hoc comparisons were used to test differences among emotions and groups. Compared with healthy subjects, individuals with SCI, when asked to judge emotionally evocative scenes, had difficulties in judging their own emotional response to complex scenes eliciting fear and anger, while they were able to recognize the same emotions when conveyed by facial expressions. Our findings endorse a simulative view of emotional processing according to which the proper perception of our own internal state (interoception), through preserved sensory pathways, is crucial for first-hand experiences of the more primordial emotions, such as fear and anger.
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Journal of neurotrauma · Dec 2015
Traumatic Spinal Cord Injury Emergency Service Triage Patterns and the Associated Emergency Department Outcomes.
Paralysis is an indication for trauma patients to be preferentially triaged by emergency services to designated level I or II trauma centers (TC). We sought to describe triage practices for patients with acute traumatic spinal cord injury (TSCI) and its associated emergency department (ED) outcomes. Adults ages ≥ 18 years with a diagnosis of acute TSCI (International Classification of Diseases-9: 806 and 952) in the 2006-2011 United States Nationwide Emergency Department Sample were included in these analyses. ⋯ In conclusion, under-triage of adults with acute TSCI occurred in at least one-third of the cases. Patients triaged to NTC rather than TC-I experienced higher likelihood of death in the ED even after controlling for personal and injury characteristics. Further research is necessary to elucidate detailed clinical and logistical factors that may be associated with under-triage of acute TSCI, to facilitate interventions aimed at improving patient experience and outcomes.