scholarly journals Nicotinic signaling is required for motor learning but not rehabilitation after spinal cord injury

2022 ◽  
Author(s):  
Yue Li ◽  
Edmund Hollis
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Learning ◽  
Molecular Mechanisms ◽  
Motor Behavior ◽  
Cervical Spinal Cord ◽  
Compensatory Strategies ◽  
Nicotinic Acetylcholine ◽  
Motor Circuits ◽  
Cord Injury

Currently, therapeutic intervention for spinal cord injury is limited. Many approaches rely on strengthening the remaining substrate and driving recovery through rehabilitative training. As compared to learning novel compensatory strategies, rehabilitation focuses on restoring movements lost to injury. Whether rehabilitation of previously learned movements after spinal cord injury requires the molecular mechanisms of motor learning, or if it engages previously trained motor circuits without requiring novel learning. Our findings implicate the latter mechanism, as we demonstrate that nicotinic acetylcholine signaling is required for motor learning but is dispensable for the recovery of previously trained motor behavior after cervical spinal cord injury.

Electrical epidural stimulation of the cervical spinal cord: Implications for spinal respiratory neuroplasticity after spinal cord injury

2021 ◽  
Author(s):  
Ian G Malone ◽  
Rachel L Nosacka ◽  
Marissa A Nash ◽  
Kevin J Otto ◽  
Erica A Dale
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neural Plasticity ◽  
Molecular Mechanisms ◽  
Cervical Spinal Cord ◽  
Motor Nucleus ◽  
Epidural Stimulation ◽  
Locomotor Function ◽  
Lumbosacral Spinal Cord ◽  
Cord Injury

Traumatic cervical spinal cord injury (cSCI) can lead to damage of bulbospinal pathways to the respiratory motor nuclei and consequent life-threatening respiratory insufficiency due to respiratory muscle paralysis/paresis. Reports of electrical epidural stimulation (EES) of the lumbosacral spinal cord to enable locomotor function after SCI are encouraging, with some evidence of facilitating neural plasticity. Here, we detail the development and success of EES in recovering locomotor function with consideration of stimulation parameters and safety measures to develop effective EES protocols. EES is just beginning to be applied in other motor, sensory, and autonomic systems; however, there has only been moderate success in preclinical studies aimed at improving breathing function after cSCI. Thus, we explore rationale for applying EES to the cervical spinal cord, targeting the phrenic motor nucleus for the restoration of breathing. We also suggest cellular/molecular mechanisms by which EES may induce respiratory plasticity including a brief examination of sex-related differences in these mechanisms. Finally, we suggest more attention be paid to the effects of specific electrical parameters that have been used in the development of EES protocols and how that can impact the safety and efficacy for those receiving this therapy. Ultimately, we aim to inform readers about the potential benefits of EES in the phrenic motor system and encourage future studies in this area.

scholarly journals Restoration of breathing after opioid overdose and spinal cord injury using temporal interference stimulation

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael D. Sunshine ◽  
Antonino M. Cassarà ◽  
Esra Neufeld ◽  
Nir Grossman ◽  
Thomas H. Mareci ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Neurons ◽  
Drug Overdose ◽  
Cervical Spinal Cord ◽  
Opioid Overdose ◽  
Electrode Position ◽  
Spinal Motor Neurons ◽  
Cord Injury ◽  
Low Amplitude

AbstractRespiratory insufficiency is a leading cause of death due to drug overdose or neuromuscular disease. We hypothesized that a stimulation paradigm using temporal interference (TI) could restore breathing in such conditions. Following opioid overdose in rats, two high frequency (5000 Hz and 5001 Hz), low amplitude waveforms delivered via intramuscular wires in the neck immediately activated the diaphragm and restored ventilation in phase with waveform offset (1 Hz or 60 breaths/min). Following cervical spinal cord injury (SCI), TI stimulation via dorsally placed epidural electrodes uni- or bilaterally activated the diaphragm depending on current and electrode position. In silico modeling indicated that an interferential signal in the ventral spinal cord predicted the evoked response (left versus right diaphragm) and current-ratio-based steering. We conclude that TI stimulation can activate spinal motor neurons after SCI and prevent fatal apnea during drug overdose by restoring ventilation with minimally invasive electrodes.

scholarly journals An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1057
Author(s):  
Riccardo Bravi ◽  
Stefano Caputo ◽  
Sara Jayousi ◽  
Alessio Martinelli ◽  
Lorenzo Biotti ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Setting ◽  
Cervical Spinal Cord ◽  
Wearable Sensors ◽  
Cervical Spinal Cord Injury ◽  
Measurement Unit ◽  
Innovative Technology ◽  
Inertial Measurement ◽  
Cord Injury

Residual motion of upper limbs in individuals who experienced cervical spinal cord injury (CSCI) is vital to achieve functional independence. Several interventions were developed to restore shoulder range of motion (ROM) in CSCI patients. However, shoulder ROM assessment in clinical practice is commonly limited to use of a simple goniometer. Conventional goniometric measurements are operator-dependent and require significant time and effort. Therefore, innovative technology for supporting medical personnel in objectively and reliably measuring the efficacy of treatments for shoulder ROM in CSCI patients would be extremely desirable. This study evaluated the validity of a customized wireless wearable sensors (Inertial Measurement Units—IMUs) system for shoulder ROM assessment in CSCI patients in clinical setting. Eight CSCI patients and eight healthy controls performed four shoulder movements (forward flexion, abduction, and internal and external rotation) with dominant arm. Every movement was evaluated with a goniometer by different testers and with the IMU system at the same time. Validity was evaluated by comparing IMUs and goniometer measurements using Intraclass Correlation Coefficient (ICC) and Limits of Agreement (LOA). inter-tester reliability of IMUs and goniometer measurements was also investigated. Preliminary results provide essential information on the accuracy of the proposed wireless wearable sensors system in acquiring objective measurements of the shoulder movements in CSCI patients.

scholarly journals Permanent diaphragmatic deficits and spontaneous respiratory plasticity in a mouse model of incomplete cervical spinal cord injury

2021 ◽  
Vol 284 ◽  
pp. 103568
Author(s):  
Pauline Michel-Flutot ◽  
Arnaud Mansart ◽  
Therese B. Deramaudt ◽  
Isley Jesus ◽  
Kun-Ze Lee ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mouse Model ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Cord Injury ◽  
Respiratory Plasticity

scholarly journals Trending Racial and Socioeconomic Inequality in the Surgical Management and Outcome of Traumatic Cervical Spinal Cord Injury With Fracture In the USA From 1998 to 2009

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alexander Dru ◽  
Dan Neal ◽  
W Christopher Fox ◽  
Brian Lim Hoh ◽  
Daniel J Hoh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Socioeconomic Status ◽  
Hospital Mortality ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Lower Odds ◽  
Discharge Disposition ◽  
Treatment Type ◽  
Cord Injury

Abstract INTRODUCTION Advances in treatment of traumatic cervical spinal cord injury with fracture (TCSCIF) have led to significant improvements in clinical outcomes; however, progress in healthcare is seldom ubiquitous across demographic groups. We explored if disparities in treatment and outcome after TCSCIF exist across race and socioeconomic status. METHODS We queried the Nationwide Inpatient Sample database from 1998 to 2009 for TCSCIF hospitalizations. Multivariate analysis was used to identify the correlation between socioeconomic status and race to treatment type and outcome. RESULTS There were 21 985 admissions for TCSCIF. In all 66.9% had a favorable discharge disposition. In-hospital mortality rate was 12.5%. In all 43.7% underwent surgery. Overall, surgery was associated with lower in-hospital mortality (OR 0.30, 95% CI 0.27-0.34, P < .01) and better discharge disposition (OR 0.68, 95% CI 0.62-0.74, P < .01) vs nonsurgical or no intervention. Controlling for race and socioeconomic status demonstrated higher status (HS) non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.89, 95% CI 0.81-0.97, P = .01). LSES non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.83, 95% CI 0.73-0.94, P < .01). HS non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.87, 95% CI 0.77-0.99, P = .03). LSES non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.82, 95% CI 0.71-0.94, P = .01). For favorable discharge status HS non-Caucasians, LSES non-Caucasians, and LSES Caucasians all had lower odds of favorable discharge compared to HS Caucasians (OR 0.83, 95% CI 0.73-0.95, P = .01/OR 0.69, 95% CI 0.59-0.81, P < .01/OR 0.75, 95% CI 0.66-0.85, P < .01), respectively. CONCLUSION In our multivariate model that controlled for race and socioeconomic status in the setting of TCSCIF, race (but not socioeconomic status) was a factor in receiving surgery and both race and LSES impacted favorable discharge.

Sign in / Sign up

Export Citation Format

Share Document