Epidural Electrical Stimulation of the Lumbosacral Spinal Cord Improves Trunk Stability During Seated Reaching in Two Humans With Severe 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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Drastic Decrease in Isoflurane Minimum Alveolar Concentration and Limb Movement Forces after Thoracic Spinal Cooling and Chronic Spinal Transection in Rats

Anesthesiology ◽

10.1097/00000542-200503000-00022 ◽

2005 ◽

Vol 102 (3) ◽

pp. 624-632 ◽

Cited By ~ 12

Author(s):

Steven L. Jinks ◽

Carmen L. Dominguez ◽

Joseph F. Antognini

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Minimum Alveolar Concentration ◽

Tail Flick ◽

Noxious Stimulation ◽

Partial Recovery ◽

Spinal Transection ◽

Thoracic Spinal ◽

Cord Injury ◽

Stimulation Of

Background Individuals with spinal cord injury may undergo multiple surgical procedures; however, it is not clear how spinal cord injury affects anesthetic requirements and movement force under anesthesia during both acute and chronic stages of the injury. Methods The authors determined the isoflurane minimum alveolar concentration (MAC) necessary to block movement in response to supramaximal noxious stimulation, as well as tail-flick and hind paw withdrawal latencies, before and up to 28 days after thoracic spinal transection. Tail-flick and hind paw withdrawal latencies were measured in the awake state to test for the presence of spinal shock or hyperreflexia. The authors measured limb forces elicited by noxious mechanical stimulation of a paw or the tail at 28 days after transection. Limb force experiments were also conducted in other animals that received a reversible spinal conduction block by cooling the spinal cord at the level of the eighth thoracic vertebra. Results A large decrease in MAC (to </= 40% of pretransection values) occurred after spinal transection, with partial recovery (to approximately 60% of control) at 14-28 days after transection. Awake tail-flick and hind paw withdrawal latencies were facilitated or unchanged, whereas reflex latencies under isoflurane were depressed or absent. However, at 80-90% of MAC, noxious stimulation of the hind paw elicited ipsilateral limb withdrawals in all animals. Hind limb forces were reduced (by >/= 90%) in both chronic and acute cold-block spinal animals. Conclusions The immobilizing potency of isoflurane increases substantially after spinal transection, despite the absence of a baseline motor depression, or "spinal shock." Therefore, isoflurane MAC is determined by a spinal depressant action, possibly counteracted by a supraspinal facilitatory action. The partial recovery in MAC at later time points suggests that neuronal plasticity after spinal cord injury influences anesthetic requirements.

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Thoracic spinal cord injury without major bone injury associated with ossification of the ligamentum flavum

Journal of Orthopaedic Science ◽

10.1016/j.jos.2016.10.002 ◽

2019 ◽

Vol 24 (1) ◽

pp. 174-177 ◽

Cited By ~ 1

Author(s):

Masaaki Machino ◽

Shiro Imagama ◽

Keigo Ito ◽

Kei Ando ◽

Kazuyoshi Kobayashi ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Ligamentum Flavum ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Bone Injury ◽

Cord Injury

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Late Breaking Abstract - Neuromuscular electrical stimulation of the respiratory muscles based on breathing modelization in a mouse model of cervical spinal cord injury

10.1183/13993003.congress-2021.pa617 ◽

2021 ◽

Author(s):

Thibaut Coustillet ◽

Florence Cayetanot ◽

Laurence Bodineau ◽

Isabelle Vivodtzev

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Mouse Model ◽

Cervical Spinal Cord ◽

Neuromuscular Electrical Stimulation ◽

Respiratory Muscles ◽

Cervical Spinal Cord Injury ◽

Cord Injury ◽

Stimulation Of

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Epidural electrical stimulation to facilitate locomotor recovery after spinal cord injury

Journal of Neurophysiology ◽

10.1152/jn.00261.2021 ◽

2021 ◽

Author(s):

Johannie Audet ◽

Charly G. Lecomte

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Clinical Implementation ◽

Preclinical Models ◽

Lumbosacral Region ◽

Locomotor Recovery ◽

Promising Therapeutic Approach ◽

Cord Injury ◽

Stimulation Of

Tonic or phasic electrical epidural stimulation of the lumbosacral region of the spinal cord facilitates locomotion and standing in a variety of preclinical models with severe spinal cord injury. However, the mechanisms of epidural electrical stimulation that facilitate sensorimotor functions remain largely unknown. This review aims to address how epidural electrical stimulation interacts with spinal sensorimotor circuits and discusses the limitations that currently restrict the clinical implementation of this promising therapeutic approach.

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