Behavioral recovery from spinal cord injury following delayed application of polyethylene glycol

2002 ◽  
Vol 205 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Richard B. Borgens ◽  
Riyi Shi ◽  
Debra Bohnert
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Polyethylene Glycol ◽  
Guinea Pig ◽  
Topical Application ◽  
Spinal Cord Injuries ◽  
Thoracic Vertebrae ◽  
Behavioral Recovery ◽  
Thoracic Spinal Cord ◽  
Cord Injury

SUMMARY Topical application of the hydrophilic polymer polyethylene glycol (PEG) to isolated adult guinea pig spinal cord injuries has been shown to lead to the recovery of both the anatomical integrity of the tissue and the conduction of nerve impulses through the lesion. Furthermore, a brief (2 min) application of the fusogen (Mr 1800, 50 % w/v aqueous solution) to the exposed spinal cord injury in vivo can also cause rapid recovery of nerve impulse conduction through the lesion in association with functional recovery. Behavioral recovery was demonstrated using a long-tract, spinal-cord-dependent behavior in rodents known as the cutaneus trunci muscle (CTM) reflex. This reflex is observed as a contraction of the skin of the back in response to tactile stimulation. Here, we confirm and extend these preliminary observations. A severe compression/contusion injury to the exposed thoracic spinal cord of the guinea pig was performed between thoracic vertebrae 10 and 11. Approximately 7 h later, a topical application of PEG was made to the injury (dura removed) for 2 min in 15 experimental animals, and levels of recovery were compared with those of 13 vehicle-treated control animals. In PEG-treated animals, 93 % recovered variable levels of CTM functioning and all recovered some level of conduction through the lesion, as measured by evoked potential techniques. The recovered reflex was relatively normal compared with the quantitative characteristics of the reflex prior to injury with respect to the direction, distance and velocity of skin contraction. Only 23 % of the control population showed any spontaneous CTM recovery (P=0.0003) and none recovered conduction through the lesion during the 1 month period of observation (P=0.0001). These results suggest that repair of nerve membranes by polymeric sealing can provide a novel means for the rapid restoration of function following spinal cord injury.

scholarly journals A complex case of neuro-muscular rehabilitation with favorable evolution, in a patient with incomplete tetraplegia post cervical and thoracic spinal cord injury - surgically treated, in a politraumatic context, by car accident

2020 ◽  
pp. 524-526
Author(s):  
Andreea DUMITRASCU ◽  
Ioana ANDONE ◽  
Aura SPÎNU ◽  
Carmen CHIPĂRUȘ ◽  
Cristina POPESCU ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Complex Case ◽  
Urinary Catheterization ◽  
Functional Evaluation ◽  
Thoracic Spinal Cord ◽  
Cord Injury ◽  
Car Accident

Introduction: Spinal cord injuries (SCI) are major conditions that usually determine severe and permanent dysfunctions, or even important loss of basic functions, generating severe or rather permanent sequels. They can have important chronic consequences such as: tetraplegia or paraplegia.(1). Materials and Methods: This paper presents the case of a young 19-year-old patient who suffered in March 2019, a car accident (passenger) with spinal cord injury (SCI) at cervical and thoracic level in a politraumatic context, hospitalized at the Neurosurgery Clinic (NS) II of TEHBA in a severe condition, for complete AIS/Frankel A tetraplegia, with a C7 fracture, T3, T4, T5 cominutive fractures with fragments in the medullary channel, minor traumatic brain injury, multiple costal fractures, abdominal trauma and respiratory failure. When the patient became hemodynamic and respiratory stable it was decided a neuro-surgical intervention, initially at cervical level through an anterior approach, with mixed osteo-sinthesis and C7 discectomy. Because of the spine instability, thoracic surgical treatment was delayed with 11 days, when he suffers a neurosurgery for medullary decompression, drainage and stabilization of the spine. In our clinical division, the patient was admitted with an incomplete AIS/Frankel B tetraplegia and initially followed a rehabilitation nursing program and subsequently continued with a recovery therapy according to clinical stages. The patient was assessed functionally using the following scales: AIS/Frankel, modified Ashworth, Functional Independence Measure (FIM), Life Quality Assessment (QOL), FAC International Scale, Independence Assessment Scale in Daily Activities (ADL / IADL), Walking Scale for Spinal Cord Injury (WISCI). Results: The patient benefited from a complex neuro-muscular rehabilitation program, having a favorable evolution, with an increase in the evaluated scales scores – passing from AIS/Frankel B classification to a severe AIS/Frankel C stage, and thus, at the moment he is performing walking on short distances, through parallel bars, with long left leg orthosis and support from another person. It was tried a sphincter re-education, but, after urologic examination, because of the important spasticity in the lower limbs and of the urinary catheterization discomfort, it was decided that for a while the patient to remain with fixed urinary catheterization. Conclusions: Even if there is still no cure for SCI sequels, the accurate clinical-functional evaluation, the neurosurgical prompt therapeutic approach, adding complex nursing measures, personalized rehabilitative and kinetotherapy programs, in a young patient with SCI by car accident, determined neuro-locomotor improvements with an increase in patient’s quality of life.(1),(2). Keywords: spinal cord injuries, tetraplegia, traumatism, rehabilitation,

Spinal Cord Injury: Lessons from Locomotor Recovery and Axonal Regeneration in Lower Vertebrates

1998 ◽  
Vol 4 (4) ◽  
pp. 250-263 ◽  
Author(s):  
Andrew D. McClellan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neural Development ◽  
Axonal Regeneration ◽  
Spinal Cord Injuries ◽  
Axonal Guidance ◽  
Behavioral Recovery ◽  
Locomotor Function ◽  
Cord Injury ◽  
Lower Vertebrates

After severe spinal cord injury in adult higher vertebrates (birds and mammals), there normally is little or no axonal regeneration and virtually no recovery of voluntary locomotor function below the lesion. In contrast, certain lower vertebrates, including lamprey, fish, and some amphibians, exhibit robust axonal regeneration and substantial recovery of locomotor function after spinal cord injury. The remarkable behavioral recovery of lower vertebrates with spinal cord injuries is due to at least three factors: 1) minimal hemorrhagic necrosis at the injury site and the lack of a neurite growth–inhibiting astrocytic scar, 2) an environment in the spinal cord that is permissive for axonal regeneration, and 3) mechanisms for directed axonal elongation and selection of appropriate postsynaptic targets. The latter two features probably represent developmental mechanisms for axonal guidance and synaptogenesis that persist in the nervous systems of these animals well beyond the main phase of neural development. In the injured spinal cords of higher vertebrates, the full complement of manipulations necessary to promote functional regeneration and behavioral recovery is unknown. An understanding of the mechanisms that result in repair of spinal cord injuries in lower vertebrates may provide guidelines for identifying the requirements for functional spinal cord regeneration in higher vertebrates, including humans.

Three-dimensional morphometry of spinal cord injury following polyethylene glycol treatment

2002 ◽  
Vol 205 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Bradley S. Duerstock ◽  
Richard B. Borgens
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Polyethylene Glycol ◽  
Three Dimensional ◽  
Companion Paper ◽  
Behavioral Recovery ◽  
Post Injury ◽  
Cord Injury ◽  
Peg Treatment ◽  
Spinal Cord Injured

SUMMARY We are developing a novel means of restoring function after severe acute spinal cord injury. This involves a brief application of polyethylene glycol (PEG) to the site of injury. In the companion paper, we have shown that a delayed application of PEG can produce strikingly significant physiological and behavioral recovery in 90–100 % of spinal-cord-injured guinea pigs. In the present paper, we used three-dimensional computer reconstructions of PEG-treated and sham-treated spinal cords to determine whether the pathological character of a 1-month-old injury is ameliorated by application of PEG. Using a novel isocontouring algorithm, we show that immediate PEG treatment and treatment delayed by up to 7 h post-injury statistically increased the volume of intact spinal parenchyma and reduced the amount of cystic cavitation. Furthermore, in PEG-treated animals, the lesion was more focal and less diffuse throughout the damaged segment of the spinal cord, so that control cords showed a significantly extended lesion surface area. This three-dimensional computer evaluation showed that the functional recovery produced by topical application of a hydrophilic polymer is accompanied by a reduction in spinal cord damage.

scholarly journals NT3-chitosan elicits robust endogenous neurogenesis to enable functional recovery after spinal cord injury

2015 ◽  
Vol 112 (43) ◽  
pp. 13354-13359 ◽  
Author(s):  
Zhaoyang Yang ◽  
Aifeng Zhang ◽  
Hongmei Duan ◽  
Sa Zhang ◽  
Peng Hao ◽  
...  
Keyword(s):  
Neural Networks ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neural Regeneration ◽  
Cns Injury ◽  
Behavioral Recovery ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Cord Injury ◽  
Novel Strategy

Neural stem cells (NSCs) in the adult mammalian central nervous system (CNS) hold the key to neural regeneration through proper activation, differentiation, and maturation, to establish nascent neural networks, which can be integrated into damaged neural circuits to repair function. However, the CNS injury microenvironment is often inhibitory and inflammatory, limiting the ability of activated NSCs to differentiate into neurons and form nascent circuits. Here we report that neurotrophin-3 (NT3)-coupled chitosan biomaterial, when inserted into a 5-mm gap of completely transected and excised rat thoracic spinal cord, elicited robust activation of endogenous NSCs in the injured spinal cord. Through slow release of NT3, the biomaterial attracted NSCs to migrate into the lesion area, differentiate into neurons, and form functional neural networks, which interconnected severed ascending and descending axons, resulting in sensory and motor behavioral recovery. Our study suggests that enhancing endogenous neurogenesis could be a novel strategy for treatment of spinal cord injury.

scholarly journals Exoskeletons, Rehabilitation and Bodily Capacities

2021 ◽  
pp. 1357034X2110256
Author(s):  
Denisa Butnaru
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Crucial Role ◽  
Spinal Cord Injuries ◽  
Main Task ◽  
Cerebrovascular Accidents ◽  
Complex Processes ◽  
Cord Injury ◽  
Neurological Conditions

Motility impairments resulting from spinal cord injuries and cerebrovascular accidents are increasingly prevalent in society, leading to the growing development of rehabilitative robotic technologies, among them exoskeletons. This article outlines how bodies with neurological conditions such as spinal cord injury and stroke engage in processes of re-appropriation while using exoskeletons and some of the challenges they face. The main task of exoskeletons in rehabilitative environments is either to rehabilitate or ameliorate anatomic functions of impaired bodies. In these complex processes, they also play a crucial role in recasting specific corporeal phenomenologies. For the accomplishment of these forms of corporeal re-appropriation, the role of experts is crucial. This article explores how categories such as bodily resistance, techno-inter-corporeal co-production of bodies and machines, as well as body work mark the landscape of these contemporary forms of impaired corporeality. While defending corporeal extension rather than incorporation, I argue against the figure of the ‘cyborg’ and posit the idea of ‘residual subjectivity’.

scholarly journals Sonic Hedgehog modulates the inflammatory response and improves functional recovery after spinal cord injury in a thoracic contusion–compression model

2021 ◽  
Author(s):  
Hao Zhang ◽  
Alexander Younsi ◽  
Guoli Zheng ◽  
Mohamed Tail ◽  
Anna-Kathrin Harms ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sonic Hedgehog ◽  
Functional Recovery ◽  
Intrathecal Administration ◽  
Neuroprotective Effects ◽  
Thoracic Spinal Cord ◽  
Shh Pathway ◽  
Thoracic Spinal ◽  
Cord Injury

Abstract Purpose The Sonic Hedgehog (Shh) pathway has been associated with a protective role after injury to the central nervous system (CNS). We, therefore, investigated the effects of intrathecal Shh-administration in the subacute phase after thoracic spinal cord injury (SCI) on secondary injury processes in rats. Methods Twenty-one Wistar rats were subjected to thoracic clip-contusion/compression SCI at T9. Animals were randomized into three treatment groups (Shh, Vehicle, Sham). Seven days after SCI, osmotic pumps were implanted for seven-day continuous intrathecal administration of Shh. Basso, Beattie and Bresnahan (BBB) score, Gridwalk test and bodyweight were weekly assessed. Animals were sacrificed six weeks after SCI and immunohistological analyses were conducted. The results were compared between groups and statistical analysis was performed (p < 0.05 was considered significant). Results The intrathecal administration of Shh led to significantly increased polarization of macrophages toward the anti-inflammatory M2-phenotype, significantly decreased T-lymphocytic invasion and significantly reduced resident microglia six weeks after the injury. Reactive astrogliosis was also significantly reduced while changes in size of the posttraumatic cyst as well as the overall macrophagic infiltration, although reduced, remained insignificant. Finally, with the administration of Shh, gain of bodyweight (216.6 ± 3.65 g vs. 230.4 ± 5.477 g; p = 0.0111) and BBB score (8.2 ± 0.2 vs. 5.9 ± 0.7 points; p = 0.0365) were significantly improved compared to untreated animals six weeks after SCI as well. Conclusion Intrathecal Shh-administration showed neuroprotective effects with attenuated neuroinflammation, reduced astrogliosis and improved functional recovery six weeks after severe contusion/compression SCI.

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