1
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Grijalva-Otero I, Doncel-Pérez E. Traumatic Human Spinal Cord Injury: Are Single Treatments Enough to Solve the Problem? Arch Med Res 2024; 55:102935. [PMID: 38157747 DOI: 10.1016/j.arcmed.2023.102935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/17/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
Traumatic spinal cord injury (SCI) results in partial or complete motor deficits, such as paraplegia, tetraplegia, and sphincter control, as well as sensory disturbances and autonomic dysregulation such as arterial hypotension, lack of sweating, and alterations in skin lability. All this has a strong psychological impact on the affected person and his/her family, as well as costs to healthcare institutions with an economic burden in the short, medium, and long terms. Despite at least forty years of experimental animal studies and several clinical trials with different therapeutic strategies, effective therapy is not universally accepted. Most of the published works on acute and chronic injury use a single treatment, such as medication, trophic factor, transplant of a cell type, and so on, to block some secondary injury mechanisms or promote some mechanisms of structural/functional restoration. However, despite significant results in experimental models, the outcome is a moderate improvement in muscle strength, sensation, or eventually in sphincter control, which has been considered non-significant in human clinical trials. Here we present a brief compilation of successful individual treatments that have been applied to secondary mechanisms of action. These studies show limited neuroprotective or neurorestorative approaches in animal models and clinical trials. Thus, the few benefits achieved so far represent a rationale to further explore other strategies that seek better structural and functional restoration of the injured spinal cord.
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Affiliation(s)
- Israel Grijalva-Otero
- Medical Research Unit for Neurological Diseases, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
| | - Ernesto Doncel-Pérez
- Neural Regeneration Group, Hospital Nacional de Parapléjicos de Toledo, Servicios de Salud de Castilla-La Mancha, Toledo, Spain
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2
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Sydney-Smith JD, Koltchev AM, Moon LDF, Warren PM. Delayed viral vector mediated delivery of neurotrophin-3 improves skilled hindlimb function and stability after thoracic contusion. Exp Neurol 2023; 360:114278. [PMID: 36455639 DOI: 10.1016/j.expneurol.2022.114278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/07/2022] [Accepted: 11/19/2022] [Indexed: 11/30/2022]
Abstract
Intramuscular injection of an Adeno-associated viral vector serotype 1 (AAV1) encoding Neurotrophin-3 (NT3) into hindlimb muscles 24 h after a severe T9 spinal level contusion in rats has been shown to induce lumbar spinal neuroplasticity, partially restore locomotive function and reduce spasms during swimming. Here we investigate whether a targeted delivery of NT3 to lumbar and thoracic motor neurons 48 h following a severe contusive injury aids locomotive recovery in rats. AAV1-NT3 was injected bilaterally into the tibialis anterior, gastrocnemius and rectus abdominus muscles 48-h following trauma, persistently elevating serum levels of the neurotrophin. NT3 modestly improved trunk stability, accuracy of stepping during skilled locomotion, and alternation of the hindlimbs during swimming, but it had no effect on gross locomotor function in the open field. The number of vGlut1+ boutons, likely arising from proprioceptive afferents, on gastrocnemius α-motor neurons was increased after injury but normalised following NT3 treatment, suggestive of a mechanism in which functional benefits may be mediated through proprioceptive feedback. Ex vivo MRI revealed substantial loss of grey and white matter at the lesion epicentre but no effect of delayed NT3 treatment to induce neuroprotection. Lower body spasms and hyperreflexia of an intrinsic paw muscle were not reliably induced in this severe injury model suggesting a more complex anatomical or physiological cause to their induction. We have shown that delayed intramuscular AAV-NT3 treatment can promote recovery in skilled stepping and coordinated swimming, supporting a role for NT3 as a therapeutic strategy for spinal injuries potentially through modulation of somatosensory feedback.
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Affiliation(s)
- Jared D Sydney-Smith
- The Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London Bridge, London SE1 1UL, UK
| | - Alice M Koltchev
- The Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London Bridge, London SE1 1UL, UK
| | - Lawrence D F Moon
- The Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London Bridge, London SE1 1UL, UK
| | - Philippa M Warren
- The Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London Bridge, London SE1 1UL, UK.
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3
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Lewis NE, Tabarestani TQ, Cellini BR, Zhang N, Marrotte EJ, Wang H, Laskowitz DT, Abd-El-Barr MM, Faw TD. Effect of Acute Physical Interventions on Pathophysiology and Recovery After Spinal Cord Injury: A Comprehensive Review of the Literature. Neurospine 2022; 19:671-686. [PMID: 36203293 PMCID: PMC9537860 DOI: 10.14245/ns.2244476.238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
Physical rehabilitation is essential for enhancing recovery in individuals with spinal cord injury (SCI); however, aside from early surgical intervention and hemodynamic management, there are no proven interventions for promoting recovery in the acute phase. In general, early rehabilitation is considered beneficial, but optimal parameters and potential contraindications for implementing rehabilitation at very early time points are unclear. Moreover, clinical trials to date are limited to studies initiating rehabilitation 2 weeks after injury and later. To address these gaps, this article reviews the preclinical literature on physical interventions initiated within the first 8 days postinjury. Effects of early rehabilitation on molecular and structural nervous system changes, behavioral function, and body systems are considered. Most studies utilized treadmill or cycle training as the primary intervention. Treadmill training initiated within the first 3 days and terminated by 1 week after injury worsened autonomic function, inflammation, and locomotor outcomes, while swim training during this period increased microvascular dysfunction. In contrast, lower-intensity rehabilitation such as reach training, ladder training, or voluntary wheel or ball training showed benefits when implemented during the first 3 days. Rehabilitation initiated at 4 days postinjury was also associated with enhanced motor recovery. Cycling appears to have the greatest risk-benefit ratio; however, the effects of cycle training in the first 3 days were not investigated. Overall, research suggests that lower intensity or voluntary rehabilitation during the hyperacute phase is more appropriate until at least 4 days postinjury, at which point higher-intensity activity becomes safer and more beneficial for recovery.
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Affiliation(s)
- Nicholle E. Lewis
- Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | | | - Brianna R. Cellini
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Nina Zhang
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Eric J. Marrotte
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Haichen Wang
- Department of Neurology, Duke University, Durham, NC, USA
| | | | | | - Timothy D. Faw
- Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA,Duke Institute for Brain Sciences, Duke University, Durham, NC, USA,Corresponding Author Timothy D. Faw Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University, 311 Research Drive, Durham, NC 21170, USA
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4
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Moukarzel G, Lemay MA, Spence AJ. A MATLAB application for automated H-Reflex measurements and analyses. Biomed Signal Process Control 2021; 66. [PMID: 33815563 PMCID: PMC8011562 DOI: 10.1016/j.bspc.2021.102448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: H-Reflex is a test that is carried out to measure the relative excitability of reflex pathways. Although reliable, conventional methods consist of performing many small steps, which requires a high level of attentiveness, and thus can carry an elevated risk of human error, despite proper training. Equipment that is available to perform those tests with different levels of automation are typically proprietary, inextensible by the user, and expensive. Here we present a novel MATLAB application that can accurately and reliably perform automated H-Reflex measurements, test the stimulating electrodes, and carry out typical subsequent analyses. Methods: This application is a Graphical User Interface that works with inexpensive equipment and offers many important features such as measuring electrode impedance in-situ, automating lengthy measurements like recruitment curves and frequency response trials, standardizing electric stimulation properties, automatic exporting of digital data and metadata, and immediately analyzing acquired data with single-click events. Results: Our new method was validated against conventional H-Reflex measurement methods with 2 anesthetized rats. The difference between acquired data using both methods was negligible (mean difference=0.0038; std=0.0121). Our app also detected electrode impedance with high accuracy (94%). Conclusion: The method presented here allows reliable and efficient automated H-reflex measurements and can accurately analyze the collected data. Significance: The features provided by our app can speed up data collection and reduce human error, and unlike conventional methods, allow the user to analyze data immediately after the record. This can result in higher research quality and give broader access to the technique.
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Affiliation(s)
- George Moukarzel
- Temple University, College of Engineering, Philadelphia, PA, USA
| | - Michel A Lemay
- Temple University, College of Engineering, Philadelphia, PA, USA
| | - Andrew J Spence
- Temple University, College of Engineering, Philadelphia, PA, USA
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5
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Baltin ME, Sabirova DE, Kiseleva EI, Kamalov MI, Abdullin TI, Petrova NV, Ahmetov NF, Sachenkov OA, Baltina TV, Lavrov IA. Comparison of systemic and localized carrier-mediated delivery of methylprednisolone succinate for treatment of acute spinal cord injury. Exp Brain Res 2021; 239:627-638. [PMID: 33388811 DOI: 10.1007/s00221-020-05974-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 10/29/2020] [Indexed: 02/07/2023]
Abstract
Localized carrier-mediated administration of drugs is a promising approach to treatment of acute phase of spinal cord injury (SCI) as it allows enhanced and/or sustained drug delivery to damaged tissues along with minimization of systemic side effects. We studied the effect of locally applied self-assembling micellar formulation of methylprednisolone succinate (MPS) with trifunctional block copolymer of ethylene oxide and propylene oxide (TBC) on functional recovery and tissue drug content after SCI in rats in comparison with local and systemic administration of MPS alone. Variations in the amplitude of motor evoked responses in the hindlimb muscles induced by epidural stimulation during acute phase of SCI and restoration of movements during chronic period after local vs. systemic application of MPS were evaluated in this study. Results demonstrate that local delivery of MPS in combination with TBC facilitates spinal cord sensorimotor circuitry, increasing the excitability. In addition, this formulation was found to be more effective in improvement of locomotion after SCI compared to systemic administration. LC-MS/MS data shows that the use of TBC carrier increases the glucocorticoid content in treated spinal cord by more than four times over other modes of treatment. The results of this study demonstrate that the local treatment of acute SCI with MPS in the form of mixed micelles with TBC can provide improved therapeutic outcome by promoting drug accumulation and functional restoration of the spinal cord.
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Affiliation(s)
- Maxim E Baltin
- Rehabilitation in Movement Disorders Laboratory, Kazan Federal University, 18 Kremlyovskaya Str., Kazan, 420008, Russian Federation
| | - Diana E Sabirova
- Department of Human and Animal Physiology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya Str., Kazan, 420008, Russian Federation
| | - Elvira I Kiseleva
- Rehabilitation in Movement Disorders Laboratory, Kazan Federal University, 18 Kremlyovskaya Str., Kazan, 420008, Russian Federation
| | - Marat I Kamalov
- Laboratory of Bioactive Polymers and Peptides, Institute of Fundamental Medicine and Biology, Kazan Federal University, 9 Parizhskoy Kommuny Str, Kazan, 420021, Russian Federation
| | - Timur I Abdullin
- Laboratory of Bioactive Polymers and Peptides, Institute of Fundamental Medicine and Biology, Kazan Federal University, 9 Parizhskoy Kommuny Str, Kazan, 420021, Russian Federation
| | - Natalia V Petrova
- Kazan Institute of Biochemistry and Biophysics, FRC Kazan Scientific Center of RAS, Lobachevsky Str., 2/31, Kazan, 420111, Russian Federation
| | - Nafis F Ahmetov
- Department of Human and Animal Physiology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya Str., Kazan, 420008, Russian Federation
| | - Oscar A Sachenkov
- Department of Theoretical Mechanics, Institute of Mathematics and Mechanics, Kazan Federal University, 18 Kremlyovskaya Str, Kazan, 420008, Russian Federation
| | - Tatiana V Baltina
- Department of Human and Animal Physiology, Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya Str., Kazan, 420008, Russian Federation.
| | - Igor A Lavrov
- Rehabilitation in Movement Disorders Laboratory, Kazan Federal University, 18 Kremlyovskaya Str., Kazan, 420008, Russian Federation
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6
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Tsuda S, Golam M, Hou J, Nelson R, Bernavil P, Richardson K, Wang KKW, Thompson F, Bose P. Altered monoaminergic levels, spasticity, and balance disability following repetitive blast-induced traumatic brain injury in rats. Brain Res 2020; 1747:147060. [PMID: 32828734 PMCID: PMC10424094 DOI: 10.1016/j.brainres.2020.147060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/28/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022]
Abstract
Spasticity and balance disability are major complications following traumatic brain injury (TBI). Although monoaminergic inputs provide critical adaptive neuromodulations to the motor system, data are not available regarding the levels of monoamines in the brain regions related to motor functions following repetitive blast TBI (bTBI). The objective of this study was to determine if mild, repetitive bTBI results in spasticity/balance deficits and if these are correlated with altered levels of norepinephrine, dopamine, and serotonin in the brain regions related to the motor system. Repetitive bTBI was induced by a blast overpressure wave in male rats on days 1, 4, and 7. Following bTBI, physiological/behavioral tests were conducted and tissues in the central motor system (i.e., motor cortex, locus coeruleus, vestibular nuclei, and lumbar spinal cord) were collected for electrochemical detection of norepinephrine, dopamine, and serotonin by high-performance liquid chromatography. The results showed that norepinephrine was significantly increased in the locus coeruleus and decreased in the vestibular nuclei, while dopamine was significantly decreased in the vestibular nuclei. On the other hand, serotonin was significantly increased in the motor cortex and the lumbar spinal cord. Because these monoamines play important roles in regulating the excitability of neurons, these results suggest that mild, repetitive bTBI-induced dysregulation of monoaminergic inputs in the central motor system could contribute to spasticity and balance disability. This is the first study to report altered levels of multiple monoamines in the central motor system following acute mild, repetitive bTBI.
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Affiliation(s)
- Shigeharu Tsuda
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA; Department of Anesthesiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL 32610-0254, USA
| | - Mustafa Golam
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA; Department of Physiological Sciences, University of Florida, 1333 Center Dr, Gainesville, FL 32603, USA
| | - Jiamei Hou
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA; Department of Anesthesiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL 32610-0254, USA
| | - Rachel Nelson
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA
| | - Phillip Bernavil
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA
| | - Kenneth Richardson
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA
| | - Kevin K W Wang
- Department of Emergency Medicine, University of Florida, 1329 SW 16th Street, Suite 5270, Gainesville, FL 32610, USA
| | - Floyd Thompson
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA; Department of Physiological Sciences, University of Florida, 1333 Center Dr, Gainesville, FL 32603, USA; Department of Neuroscience, University of Florida, 1149 Newell Dr, Gainesville, FL 32610, USA
| | - Prodip Bose
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd, Gainesville 32608-1197, USA; Department of Anesthesiology, College of Medicine, University of Florida, 1600 SW Archer Rd m509, Gainesville, FL 32610-0254, USA; Department of Neurology, University of Florida, 1149 Newell Dr, Gainesville, FL 32611, USA.
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7
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Hou J, Nelson R, Mohammad N, Mustafa G, Plant D, Thompson FJ, Bose P. Effect of Simultaneous Combined Treadmill Training and Magnetic Stimulation on Spasticity and Gait Impairments after Cervical Spinal Cord Injury. J Neurotrauma 2020; 37:1999-2013. [DOI: 10.1089/neu.2019.6961] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Jiamei Hou
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, USA
- BRRC, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Rachel Nelson
- BRRC, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Naweed Mohammad
- BRRC, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Golam Mustafa
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, USA
- BRRC, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Daniel Plant
- Research Service, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
| | - Floyd J. Thompson
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, USA
- BRRC, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
- Department of Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Prodip Bose
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, USA
- BRRC, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA
- Department of Anesthesiology, University of Florida, Gainesville, Florida, USA
- Department of Neurology, University of Florida, Gainesville, Florida, USA
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8
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Vikartovska Z, Kuricova M, Farbakova J, Liptak T, Mudronova D, Humenik F, Madari A, Maloveska M, Sykova E, Cizkova D. Stem Cell Conditioned Medium Treatment for Canine Spinal Cord Injury: Pilot Feasibility Study. Int J Mol Sci 2020; 21:ijms21145129. [PMID: 32698543 PMCID: PMC7404210 DOI: 10.3390/ijms21145129] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022] Open
Abstract
Spinal cord injury (SCI) involves nerve damage and often leads to motor, sensory and autonomic dysfunctions. In the present study, we have designed a clinical protocol to assess the feasibility of systemic delivery of allogenic canine bone marrow tissue-derived mesenchymal stem cell conditioned medium (BMMSC CM) to dogs with SCI. Four client-owned dogs with chronic SCI lasting more than six months underwent neurological and clinical evaluation, MRI imaging and blood tests before being enrolled in this study. All dogs received four intravenous infusions with canine allogenic BMMSC CM within one month. Between the infusions the dogs received comprehensive physiotherapy, which continued for three additional months. No adverse effects or complications were observed during the one, three and six months follow-up periods. Neither blood chemistry panel nor hematology profile showed any significant changes. All dogs were clinically improved as assessed using Olby locomotor scales after one, three and six months of BMMSC CM treatment. Furthermore, goniometric measurements revealed partial improvement in the range of joint motion. Bladder function improved in two disabled dogs. We conclude that multiple delivery of allogenic cell-derived conditioned medium to dogs with chronic SCI is feasible, and it might be clinically beneficial in combination with physiotherapy.
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Affiliation(s)
- Zuzana Vikartovska
- Center of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (Z.V.); (F.H.); (M.M.)
- University Veterinary Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (M.K.); (J.F.); (T.L.); (A.M.)
| | - Maria Kuricova
- University Veterinary Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (M.K.); (J.F.); (T.L.); (A.M.)
| | - Jana Farbakova
- University Veterinary Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (M.K.); (J.F.); (T.L.); (A.M.)
| | - Tomas Liptak
- University Veterinary Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (M.K.); (J.F.); (T.L.); (A.M.)
| | - Dagmar Mudronova
- Department of Microbiology and Immunology, Institute of Immunology, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia;
| | - Filip Humenik
- Center of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (Z.V.); (F.H.); (M.M.)
| | - Aladar Madari
- University Veterinary Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (M.K.); (J.F.); (T.L.); (A.M.)
| | - Marcela Maloveska
- Center of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (Z.V.); (F.H.); (M.M.)
| | - Eva Sykova
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia;
| | - Dasa Cizkova
- Center of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 04181 Kosice, Slovakia; (Z.V.); (F.H.); (M.M.)
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia;
- Correspondence:
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9
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Gallegos C, Carey M, Zheng Y, He X, Cao QL. Reaching and Grasping Training Improves Functional Recovery After Chronic Cervical Spinal Cord Injury. Front Cell Neurosci 2020; 14:110. [PMID: 32536855 PMCID: PMC7266985 DOI: 10.3389/fncel.2020.00110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/08/2020] [Indexed: 12/31/2022] Open
Abstract
Previous studies suggest locomotion training could be an effective non-invasive therapy after spinal cord injury (SCI) using primarily acute thoracic injuries. However, the majority of SCI patients have chronic cervical injuries. Regaining hand function could significantly increase their quality of life. In this study, we used a clinically relevant chronic cervical contusion to study the therapeutic efficacy of rehabilitation in forelimb functional recovery. Nude rats received a moderate C5 unilateral contusive injury and were then divided into two groups with or without Modified Montoya Staircase (MMS) rehabilitation. For the rehabilitation group, rats were trained 5 days a week starting at 8 weeks post-injury (PI) for 6 weeks. All rats were assessed for skilled forelimb functions with MMS test weekly and for untrained gross forelimb locomotion with grooming and horizontal ladder (HL) tests biweekly. Our results showed that MMS rehabilitation significantly increased the number of pellets taken at 13 and 14 weeks PI and the accuracy rates at 12 to 14 weeks PI. However, there were no significant differences in the grooming scores or the percentage of HL missteps at any time point. Histological analyses revealed that MMS rehabilitation significantly increased the number of serotonergic fibers and the amount of presynaptic terminals around motor neurons in the cervical ventral horns caudal to the injury and reduced glial fibrillary acidic protein (GFAP)-immunoreactive astrogliosis in spinal cords caudal to the lesion. This study shows that MMS rehabilitation can modify the injury environment, promote axonal sprouting and synaptic plasticity, and importantly, improve reaching and grasping functions in the forelimb, supporting the therapeutic potential of task-specific rehabilitation for functional recovery after chronic SCI.
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Affiliation(s)
- Chrystine Gallegos
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Matthew Carey
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Summer Undergraduate Research Program, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Yiyan Zheng
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Xiuquan He
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Qi Lin Cao
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States.,Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, Houston, TX, United States
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10
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Yarrow JF, Kok HJ, Phillips EG, Conover CF, Lee J, Bassett TE, Buckley KH, Reynolds MC, Wnek RD, Otzel DM, Chen C, Jiron JM, Graham ZA, Cardozo C, Vandenborne K, Bose PK, Aguirre JI, Borst SE, Ye F. Locomotor training with adjuvant testosterone preserves cancellous bone and promotes muscle plasticity in male rats after severe spinal cord injury. J Neurosci Res 2019; 98:843-868. [PMID: 31797423 DOI: 10.1002/jnr.24564] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 12/15/2022]
Abstract
Loading and testosterone may influence musculoskeletal recovery after spinal cord injury (SCI). Our objectives were to determine (a) the acute effects of bodyweight-supported treadmill training (TM) on hindlimb cancellous bone microstructure and muscle mass in adult rats after severe contusion SCI and (b) whether longer-term TM with adjuvant testosterone enanthate (TE) delivers musculoskeletal benefit. In Study 1, TM (40 min/day, 5 days/week, beginning 1 week postsurgery) did not prevent SCI-induced hindlimb cancellous bone loss after 3 weeks. In Study 2, TM did not attenuate SCI-induced plantar flexor muscles atrophy nor improve locomotor recovery after 4 weeks. In our main study, SCI produced extensive distal femur and proximal tibia cancellous bone deficits, a deleterious slow-to-fast fiber-type transition in soleus, lower muscle fiber cross-sectional area (fCSA), impaired muscle force production, and levator ani/bulbocavernosus (LABC) muscle atrophy after 8 weeks. TE alone (7.0 mg/week) suppressed bone resorption, attenuated cancellous bone loss, constrained the soleus fiber-type transition, and prevented LABC atrophy. In comparison, TE+TM concomitantly suppressed bone resorption and stimulated bone formation after SCI, produced near-complete cancellous bone preservation, prevented the soleus fiber-type transition, attenuated soleus fCSA atrophy, maintained soleus force production, and increased LABC mass. 75% of SCI+TE+TM animals recovered voluntary over-ground hindlimb stepping, while no SCI and only 20% of SCI+TE animals regained stepping ability. Positive associations between testosterone and locomotor function suggest that TE influenced locomotor recovery. In conclusion, short-term TM alone did not improve bone, muscle, or locomotor recovery in adult rats after severe SCI, while longer-term TE+TM provided more comprehensive musculoskeletal benefit than TE alone.
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Affiliation(s)
- Joshua F Yarrow
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.,Brain Rehabilitation Research Center, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.,Division of Endocrinology, Diabetes, and Metabolism, University of Florida College of Medicine, Gainesville, FL, USA
| | - Hui Jean Kok
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.,Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Ean G Phillips
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Christine F Conover
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Jimmy Lee
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Taylor E Bassett
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Kinley H Buckley
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Michael C Reynolds
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Russell D Wnek
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Dana M Otzel
- Brain Rehabilitation Research Center, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Cong Chen
- Divison of Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jessica M Jiron
- Department of Physiological Sciences, University of Florida, Gainesville, FL, USA
| | - Zachary A Graham
- National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.,Departments of Medicine, Icahn School of Medicine, New York, NY, USA
| | - Christopher Cardozo
- National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA.,Departments of Medicine, Icahn School of Medicine, New York, NY, USA.,Rehabilitation Medicine, Icahn School of Medicine, New York, NY, USA
| | - Krista Vandenborne
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Prodip K Bose
- Brain Rehabilitation Research Center, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.,Department of Physiological Sciences, University of Florida, Gainesville, FL, USA.,Division of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jose Ignacio Aguirre
- Department of Physiological Sciences, University of Florida, Gainesville, FL, USA
| | - Stephen E Borst
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Fan Ye
- Research Service, Malcom Randall Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
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11
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Treadmill Training Effect on Kinematics: An Aging Study in Rats. J Med Biol Eng 2019. [DOI: 10.1007/s40846-019-00490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Quilgars C, Bertrand SS. Activity-dependent synaptic dynamics in motor circuits of the spinal cord. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2018.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Loy K, Bareyre FM. Rehabilitation following spinal cord injury: how animal models can help our understanding of exercise-induced neuroplasticity. Neural Regen Res 2019; 14:405-412. [PMID: 30539806 PMCID: PMC6334617 DOI: 10.4103/1673-5374.245951] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Spinal cord injury is a devastating condition that is followed by long and often unsuccessful recovery after trauma. The state of the art approach to manage paralysis and concomitant impairments is rehabilitation, which is the only strategy that has proven to be effective and beneficial for the patients over the last decades. How rehabilitation influences the remodeling of spinal axonal connections in patients is important to understand, in order to better target these changes and define the optimal timing and onset of training. While clinically the answers to these questions remain difficult to obtain, rodent models of rehabilitation like bicycling, treadmill training, swimming, enriched environments or wheel running that mimic clinical rehabilitation can be helpful to reveal the axonal changes underlying motor recovery. This review will focus on the different animal models of spinal cord injury rehabilitation and the underlying changes in neuronal networks that are improved by exercise and rehabilitation.
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Affiliation(s)
- Kristina Loy
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Florence M Bareyre
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians Universität München; Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
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14
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Phadke CP, Vierira L, Mathur S, Cipriano G, Ismail F, Boulias C. Impact of Passive Leg Cycling in Persons With Spinal Cord Injury: A Systematic Review. Top Spinal Cord Inj Rehabil 2018; 25:83-96. [PMID: 30774292 DOI: 10.1310/sci18-00020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Passive leg cycling is an important clinical tool available for rehabilitation after spinal cord injury (SCI). Passive cycling can be used to derive exercise-related benefits in patients with poor motor control. There have been a number of studies examining the effects of passive cycling on a variety of outcomes. There is need for a systematic assessment of the cycling parameters and the associated clinical changes in cardiovascular, neuromuscular, and musculoskeletal outcomes after passive cycling. Objectives: To assess the effectiveness of passive leg cycling interventions on cardiovascular, neuromuscular, and musculoskeletal outcomes post SCI, and to describe intensity, duration, and type of passive leg cycling post SCI. Methods: PRISMA guided systematic review of literature based on searches in the following databases: PubMed/MEDLINE, PEDro, EMBASE, Cochrane Library, and Google Scholar. Peer-reviewed publications that were written in English were included if they described the effects of a single session or multiple sessions of passive leg cycling in persons post SCI. Results: Eleven papers were included: two were randomized controlled trials (RCTs), one was a crossover trial, and the rest were pre-post single-group designs. Three studies (including two RCTs) reported statistically significant benefits of multiple sessions of passive cycling on leg blood flow velocity, spasticity, reflex excitability and joint range of motion, and markers of muscle hypertrophy. About half of the single session studies showed statistically significant improvement in acute responses. Conclusion: Multiple sessions of passive leg cycling showed benefits in three categories - cardiovascular, musculoskeletal, and neurological - with medium to large effect sizes.
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Affiliation(s)
- Chetan P Phadke
- Spasticity Research Program, West Park Healthcare Centre, Toronto, Ontario, Canada.,Faculty of Health, York University, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Luciana Vierira
- Health Sciences and Technologies PhD Program, University of Brasilia, Brasilia, Brazil
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Gerson Cipriano
- Division of Physical Therapy - Ceilandia College, University of Brasilia, Brasilia, Brazil
| | - Farooq Ismail
- Spasticity Research Program, West Park Healthcare Centre, Toronto, Ontario, Canada.,Division of Physiatry, University of Toronto, Toronto, Ontario, Canada
| | - Chris Boulias
- Spasticity Research Program, West Park Healthcare Centre, Toronto, Ontario, Canada.,Division of Physiatry, University of Toronto, Toronto, Ontario, Canada
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15
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Zhou R, Parhizi B, Assh J, Alvarado L, Ogilvie R, Chong SL, Mushahwar VK. Effect of cervicolumbar coupling on spinal reflexes during cycling after incomplete spinal cord injury. J Neurophysiol 2018; 120:3172-3186. [DOI: 10.1152/jn.00509.2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Spinal networks in the cervical and lumbar cord are actively coupled during locomotion to coordinate arm and leg activity. The goals of this project were to investigate the intersegmental cervicolumbar connectivity during cycling after incomplete spinal cord injury (iSCI) and to assess the effect of rehabilitation training on improving reflex modulation mediated by cervicolumbar pathways. Two studies were conducted. In the first, 22 neurologically intact (NI) people and 10 people with chronic iSCI were recruited. The change in H-reflex amplitude in flexor carpi radialis (FCR) during leg cycling and H-reflex amplitude in soleus (SOL) during arm cycling were investigated. In the second study, two groups of participants with chronic iSCI underwent 12 wk of cycling training: one performed combined arm and leg cycling (A&L) and the other legs only cycling (Leg). The effect of training paradigm on the amplitude of the SOL H-reflex was assessed. Significant reduction in the amplitude of both FCR and SOL H-reflexes during dynamic cycling of the opposite limbs was found in NI participants but not in participants with iSCI. Nonetheless, there was a significant reduction in the SOL H-reflex during dynamic arm cycling in iSCI participants after training. Substantial improvements in SOL H-reflex properties were found in the A&L group after training. The results demonstrate that cervicolumbar modulation during rhythmic movements is disrupted in people with chronic iSCI; however, this modulation is restored after cycling training. Furthermore, involvement of the arms simultaneously with the legs during training may better regulate the leg spinal reflexes.NEW & NOTEWORTHY This work systematically demonstrates the disruptive effect of incomplete spinal cord injury on cervicolumbar coupling during rhythmic locomotor movements. It also shows that the impaired cervicolumbar coupling could be significantly restored after cycling training. Actively engaging the arms in rehabilitation paradigms for the improvement of walking substantially regulates the excitability of the lumbar spinal networks. The resulting regulation may be better than that obtained by interventions that focus on training of the legs only.
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Affiliation(s)
- R. Zhou
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, Alberta, Canada
| | - B. Parhizi
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, Alberta, Canada
| | - J. Assh
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - L. Alvarado
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, Alberta, Canada
| | - R. Ogilvie
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, Alberta, Canada
| | - S. L. Chong
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, Alberta, Canada
| | - V. K. Mushahwar
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, Alberta, Canada
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16
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Jeffrey-Gauthier R, Josset N, Bretzner F, Leblond H. Facilitation of Locomotor Spinal Networks Activity by Buspirone after a Complete Spinal Cord Lesion in Mice. J Neurotrauma 2018; 35:2208-2221. [DOI: 10.1089/neu.2017.5476] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Renaud Jeffrey-Gauthier
- Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Québec, Canada
- CogNAC Research Group, Université du Québec à Trois-Rivières (UQTR), Québec, Canada
| | | | - Frédéric Bretzner
- CHU de Québec-Université Laval, Québec, Canada
- Faculty of Medicine, Department of Psychiatry and Neurosciences, Université Laval, Québec, Canada
| | - Hugues Leblond
- Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Québec, Canada
- CogNAC Research Group, Université du Québec à Trois-Rivières (UQTR), Québec, Canada
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17
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Otzel DM, Lee J, Ye F, Borst SE, Yarrow JF. Activity-Based Physical Rehabilitation with Adjuvant Testosterone to Promote Neuromuscular Recovery after Spinal Cord Injury. Int J Mol Sci 2018; 19:ijms19061701. [PMID: 29880749 PMCID: PMC6032131 DOI: 10.3390/ijms19061701] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 12/22/2022] Open
Abstract
Neuromuscular impairment and reduced musculoskeletal integrity are hallmarks of spinal cord injury (SCI) that hinder locomotor recovery. These impairments are precipitated by the neurological insult and resulting disuse, which has stimulated interest in activity-based physical rehabilitation therapies (ABTs) that promote neuromuscular plasticity after SCI. However, ABT efficacy declines as SCI severity increases. Additionally, many men with SCI exhibit low testosterone, which may exacerbate neuromusculoskeletal impairment. Incorporating testosterone adjuvant to ABTs may improve musculoskeletal recovery and neuroplasticity because androgens attenuate muscle loss and the slow-to-fast muscle fiber-type transition after SCI, in a manner independent from mechanical strain, and promote motoneuron survival. These neuromusculoskeletal benefits are promising, although testosterone alone produces only limited functional improvement in rodent SCI models. In this review, we discuss the (1) molecular deficits underlying muscle loss after SCI; (2) independent influences of testosterone and locomotor training on neuromuscular function and musculoskeletal integrity post-SCI; (3) hormonal and molecular mechanisms underlying the therapeutic efficacy of these strategies; and (4) evidence supporting a multimodal strategy involving ABT with adjuvant testosterone, as a potential means to promote more comprehensive neuromusculoskeletal recovery than either strategy alone.
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Affiliation(s)
- Dana M Otzel
- Brain Rehabilitation Research Center, Malcom Randall Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA.
| | - Jimmy Lee
- Research Service, Malcom Randall Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA.
| | - Fan Ye
- Research Service, Malcom Randall Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA.
| | - Stephen E Borst
- Department of Applied Physiology, Kinesiology and University of Florida College of Health and Human Performance, Gainesville, FL 32603, USA.
| | - Joshua F Yarrow
- Research Service, Malcom Randall Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA.
- Division of Endocrinology, Diabetes and Metabolism, University of Florida College of Medicine, Gainesville, FL 32610, USA.
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18
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Hou J, Nelson R, Wilkie Z, Mustafa G, Tsuda S, Thompson FJ, Bose P. Mild and Mild-to-Moderate Traumatic Brain Injury-Induced Significant Progressive and Enduring Multiple Comorbidities. J Neurotrauma 2017; 34:2456-2466. [PMID: 28376701 DOI: 10.1089/neu.2016.4851] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) can produce life-long disabilities, including anxiety, cognitive, balance, and motor deficits. The experimental model of closed head TBI (cTBI) induced by weight drop/impact acceleration is known to produce hallmark TBI injuries. However, comprehensive long-term characterization of comorbidities induced by graded mild-to- mild/moderate intensities using this experimental cTBI model has not been reported. The present study used two intensities of weight drop (1.0 m and 1.25 m/450 g) to produce cTBI in a rat model to investigate initial and long-term disability of four comorbidities: anxiety, cognitive, vestibulomotor, and spinal reflex that related to spasticity. TBI and sham injuries were produced under general anesthesia. Time for righting recoveries post-TBI recorded to estimate duration of unconsciousness, revealed that the TBI mild/moderate group required a mean of 1 min 27 sec longer than the values observed for noninjured sham animals. Screening magnetic resonance imaging images revealed no anatomical changes, mid-line shifts, or hemorrhagic volumes. However, compared to sham injuries, significant long-term anxiety, cognitive, balance, and physiological changes in motor reflex related to spasticity were observed post-TBI for both TBI intensities. The longitudinal trajectory of anxiety and balance disabilities tested at 2, 4, 8, and 18 weeks revealed progressively worsening disabilities. In general, disability magnitudes were proportional to injury intensity for three of the four measures. A natural hypothesis would pose that all disabilities would increase incrementally relative to injury severity. Surprisingly, anxiety disability progressed over time to be greater in the mildest injury. Collectively, translational implications of these observations suggest that patients with mild TBI should be evaluated longitudinally at multiple time points, and that anxiety disorder could potentially have a particularly low threshold for appearance and progressively worsen post-injury.
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Affiliation(s)
- Jiamei Hou
- 1 Department of Physiological Sciences at the University of Florida , Gainesville, Florida.,2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Rachel Nelson
- 2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Zachary Wilkie
- 2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Golam Mustafa
- 1 Department of Physiological Sciences at the University of Florida , Gainesville, Florida.,2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Shigeharu Tsuda
- 1 Department of Physiological Sciences at the University of Florida , Gainesville, Florida.,2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Floyd J Thompson
- 1 Department of Physiological Sciences at the University of Florida , Gainesville, Florida.,2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida.,3 Department of Neuroscience, University of Florida , Gainesville, Florida
| | - Prodip Bose
- 1 Department of Physiological Sciences at the University of Florida , Gainesville, Florida.,2 BRRC , North Florida/South Georgia Veterans Health System, Gainesville, Florida.,4 Department of Neurology, University of Florida , Gainesville, Florida
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19
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Wilson S, Abode-Iyamah KO, Miller JW, Reddy CG, Safayi S, Fredericks DC, Jeffery ND, DeVries-Watson NA, Shivapour SK, Viljoen S, Dalm BD, Gibson-Corley KN, Johnson MD, Gillies GT, Howard MA. An ovine model of spinal cord injury. J Spinal Cord Med 2017; 40:346-360. [PMID: 27759502 PMCID: PMC5472023 DOI: 10.1080/10790268.2016.1222475] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To develop a large animal model of spinal cord injury (SCI), for use in translational studies of spinal cord stimulation (SCS) in the treatment of spasticity. We seek to establish thresholds for the SCS parameters associated with reduction of post-SCI spasticity in the pelvic limbs, with implications for patients. STUDY DESIGN The weight-drop method was used to create a moderate SCI in adult sheep, leading to mild spasticity in the pelvic limbs. Electrodes for electromyography (EMG) and an epidural spinal cord stimulator were then implanted. Behavioral and electrophysiological data were taken during treadmill ambulation in six animals, and in one animal with and without SCS at 0.1, 0.3, 0.5, and 0.9 V. SETTING All surgical procedures were carried out at the University of Iowa. The gait measurements were made at Iowa State University. MATERIAL AND METHODS Nine adult female sheep were used in these institutionally approved protocols. Six of them were trained in treadmill ambulation prior to SCI surgeries, and underwent gait analysis pre- and post-SCI. Stretch reflex and H-reflex measurements were also made in conscious animals. RESULTS Gait analysis revealed repeatable quantitative differences in 20% of the key kinematic parameters of the sheep, pre- and post-SCI. Hock joint angular velocity increased toward the normal pre-injury baseline in the animal with SCS at 0.9 V. CONCLUSION The ovine model is workable as a large animal surrogate suitable for translational studies of novel SCS therapies aimed at relieving spasticity in patients with SCI.
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Affiliation(s)
- Saul Wilson
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA,Correspondence to: Saul Wilson, Assistant Professor, Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Road, Iowa City, IA 52242-1086, USA.
| | | | - John W. Miller
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Chandan G. Reddy
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Sina Safayi
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
| | - Douglas C. Fredericks
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Nicholas D. Jeffery
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
| | - Nicole A. DeVries-Watson
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Sara K. Shivapour
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA
| | - Stephanus Viljoen
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Brian D. Dalm
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Katherine N. Gibson-Corley
- Division of Comparative Pathology, Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - George T. Gillies
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
| | - Matthew A. Howard
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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20
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Osuna-Carrasco LP, López-Ruiz JR, Mendizabal-Ruiz EG, De la Torre-Valdovinos B, Bañuelos-Pineda J, Jiménez-Estrada I, Dueñas-Jiménez SH. Quantitative analysis of hindlimbs locomotion kinematics in spinalized rats treated with Tamoxifen plus treadmill exercise. Neuroscience 2016; 333:151-61. [PMID: 27450566 DOI: 10.1016/j.neuroscience.2016.07.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/27/2016] [Accepted: 07/08/2016] [Indexed: 11/25/2022]
Abstract
Locomotion recovery after a spinal cord injury (SCI) includes axon regeneration, myelin preservation and increased plasticity in propriospinal and descending spinal circuitries. The combined effects of tamoxifen and exercise after a SCI were analyzed in this study to determine whether the combination of both treatments induces the best outcome in locomotion recovery. In this study, the penetrating injury was provoked by a sharp projectile that penetrates through right dorsal and ventral portions of the T13-L1 spinal segments, affecting propriospinal and descending/ascending tracts. Intraperitoneal application of Tamoxifen and a treadmill exercise protocol, as rehabilitation therapies, separately or combined, were used. To evaluate the functional recovery, angular patterns of the hip, knee and ankle joints as well as the leg pendulum-like movement (PLM) were measured during the unrestricted gait of treated and untreated (UT) animals, previously and after the traumatic injury (15 and 30days post-injury (dpi)). A pattern (curve) comparison analysis was made by using a locally designed Matlab script that determines the Frechet dissimilarity. The SCI magnitude was assessed by qualitative and quantitative histological analysis of the injury site 30days after SCI. Our results showed that all treated groups had an improvement in hindlimbs kinematics compared to the UT group, which showed a poor gait locomotion recovery throughout the rehabilitation period. The group with the combined treatment (tamoxifen+exercise (TE)) presented the best outcome. In conclusion, tamoxifen and treadmill exercise treatments are complementary therapies for the functional recovery of gait locomotion in hemi-spinalized rats.
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Affiliation(s)
- L P Osuna-Carrasco
- Department of Neuroscience, CUCS, Universidad de Guadalajara, Guadalajara, Mexico
| | - J R López-Ruiz
- Department of Neuroscience, CUCS, Universidad de Guadalajara, Guadalajara, Mexico
| | | | | | - J Bañuelos-Pineda
- Department of Veterinary Medicine, CUCBA, Universidad de Guadalajara, Mexico
| | - I Jiménez-Estrada
- Department of Physiology, Biophysics and Neurosciences, CINVESTAV, IPN, México City, Mexico
| | - S H Dueñas-Jiménez
- Department of Neuroscience, CUCS, Universidad de Guadalajara, Guadalajara, Mexico.
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21
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Mustafa G, Hou J, Tsuda S, Nelson R, Sinharoy A, Wilkie Z, Pandey R, Caudle RM, Neubert JK, Thompson FJ, Bose P. Trigeminal neuroplasticity underlies allodynia in a preclinical model of mild closed head traumatic brain injury (cTBI). Neuropharmacology 2016; 107:27-39. [PMID: 26972829 DOI: 10.1016/j.neuropharm.2016.03.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 01/10/2023]
Abstract
Post-traumatic headache (PTH) following TBI is a common and often persisting pain disability. PTH is often associated with a multimodal central pain sensitization on the skin surface described as allodynia. However, the particular neurobiology underlying cTBI-induced pain disorders are not known. These studies were performed to assess trigeminal sensory sensitization and to determine if sensitization measured behaviorally correlated with detectable changes in portions of the trigeminal sensory system (TSS), particularly trigeminal nucleus, thalamus, and sensory cortex. Thermal stimulation is particularly well suited to evaluate sensitization and was used in these studies. Recent advances in the use of reward/conflict paradigms permit use of operant measures of behavior, versus reflex-driven response behaviors, for thermal sensitization studies. Thus, to quantitate facial thermal sensitization (allodynia) in the setting of acute TBI, the current study utilized an operant orofacial pain reward/conflict testing paradigm to assess facial thermal sensitivity in uninjured control animals compared with those two weeks after cTBI in a rodent model. Significant reductions in facial contact/lick behaviors were observed in the TBI animals using either cool or warm challenge temperatures compared with behaviors in the normal animals. These facial thermal sensitizations correlated with detectable changes in multiple levels of the TSS. The immunohistochemical (IHC) studies revealed significant alterations in the expression of the serotonin (5-HT), neurokinin 1 receptor (NK1R), norepinephrine (NE), and gamma-aminobutyric acid (GABA) in the caudal trigeminal nucleus, thalamic VPL/VPM nucleus, and sensory cortex of the orofacial pain pathways. There was a strong correlation between increased expression of certain IHC markers and increased behavioral markers for facial sensitization. The authors conclude that TBI-induced changes observed in the TSS are consistent with the expression of generalized facial allodynia following cTBI. To our knowledge, this is the first report of orofacial sensitization correlated with changes in selected neuromodulators/neurotransmitters in the TSS following experimental mild TBI.
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Affiliation(s)
- Golam Mustafa
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA; Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0144, USA
| | - Jiamei Hou
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA; Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0144, USA
| | - Shigeharu Tsuda
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0144, USA
| | - Rachel Nelson
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA
| | - Ankita Sinharoy
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA
| | - Zachary Wilkie
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA
| | - Rahul Pandey
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA
| | - Robert M Caudle
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, FL 32610-0244, USA
| | - John K Neubert
- Department of Orthodontics, College of Dentistry, University of Florida, Gainesville, FL 32610-0244, USA
| | - Floyd J Thompson
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA; Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0144, USA; Department of Neuroscience, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL 32610-0244, USA
| | - Prodip Bose
- Brain Rehabilitation Research Center of Excellence, Malcom Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA; Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0144, USA; Department of Neurology, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL 32610-0236, USA.
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22
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Bespalov A, Mus L, Zvartau E. Preclinical models of muscle spasticity: valuable tools in the development of novel treatment for neurological diseases and conditions. Naunyn Schmiedebergs Arch Pharmacol 2016; 389:457-66. [PMID: 26861550 DOI: 10.1007/s00210-016-1215-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/01/2016] [Indexed: 01/08/2023]
Abstract
Poor validity of preclinical animal models is one of the most commonly discussed explanations for the failures to develop novel drugs in general and in neuroscience in particular. However, there are several areas of neuroscience such as injury-induced spasticity where etiological factor can be adequately recreated and models can focus on specific pathophysiological mechanisms that likely contribute to spasticity syndrome in humans (such as motoneuron hyperexcitability and spinal hyperreflexia). Methods used to study spasticity in preclinical models are expected to have a high translational value (e.g., electromyogram (EMG)-based electrophysiological tools) and can efficiently assist clinical development programs. However, validation of these models is not complete yet. First, true predictive validity of these models is not established as clinically efficacious drugs have been used to reverse validate preclinical models while newly discovered mechanisms effective in preclinical models are yet to be fully explored in humans (e.g., 5-HT2C receptor inverse agonists, fatty acid amid hydrolase inhibitors). Second, further efforts need to be invested into cross-laboratory validation of study protocols and tools, adherence to the highest quality standards (blinding, randomization, pre-specified study endpoints, etc.), and systematic efforts to replicate key sets of data. These appear to be readily achievable tasks that will enable development not only of symptomatic but also of disease-modifying therapy of spasticity, an area that seems to be currently not in focus of research efforts.
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Affiliation(s)
- Anton Bespalov
- Institute of Pharmacology, Pavlov Medical University, St. Petersburg, Russia.
- Partnership for Assessment and Accreditation of Scientific Practice, Heidelberg, Germany.
| | - Liudmila Mus
- Institute of Pharmacology, Pavlov Medical University, St. Petersburg, Russia
| | - Edwin Zvartau
- Institute of Pharmacology, Pavlov Medical University, St. Petersburg, Russia
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23
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Prosser-Loose EJ, Hassan A, Mitchell GS, Muir GD. Delayed Intervention with Intermittent Hypoxia and Task Training Improves Forelimb Function in a Rat Model of Cervical Spinal Injury. J Neurotrauma 2015; 32:1403-12. [DOI: 10.1089/neu.2014.3789] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Erin J. Prosser-Loose
- Biomedical Sciences, WCVM, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Atiq Hassan
- Biomedical Sciences, WCVM, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gordon S. Mitchell
- Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Gillian D. Muir
- Biomedical Sciences, WCVM, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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24
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Sandrow-Feinberg HR, Houlé JD. Exercise after spinal cord injury as an agent for neuroprotection, regeneration and rehabilitation. Brain Res 2015; 1619:12-21. [PMID: 25866284 PMCID: PMC4540698 DOI: 10.1016/j.brainres.2015.03.052] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 12/17/2022]
Abstract
Spinal cord injury (SCI) is a traumatic event from which there is limited recovery of function, despite the best efforts of many investigators to devise realistic therapeutic treatments. Partly this is due to the multifaceted nature of SCI, where there is considerable disarray and dysfunction secondary to the initial injury. Contributing to this secondary degeneration is neurotoxicity, vascular dysfunction, glial scarring, neuroinflammation, apoptosis and demyelination. It seems logical that addressing the need for neuroprotection, regeneration and rehabilitation will require different treatment strategies that may be applied at varied stages of the post-injury response. Here we focus on a single strategy, exercise/physical training, which appears to have multiple applications and benefits for an acute or chronic SCI. Exercise has been demonstrated to be advantageous at cellular and biochemical levels, as well as being of benefit for the whole animal or human subject. Data from our lab and others will be discussed to further elucidate the many positive aspects of implementing exercise following injury and to suggest that rehabilitation is not the sole target of a training regimen following SCI. This article is part of a Special Issue entitled SI: Spinal cord injury.
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Affiliation(s)
- Harra R Sandrow-Feinberg
- Department of Neurobiology and Anatomy, Spinal Cord Research Center, Drexel University College of Medicine, 2900 Queen Lane, PA 19129, Philadelphia, United States
| | - John D Houlé
- Department of Neurobiology and Anatomy, Spinal Cord Research Center, Drexel University College of Medicine, 2900 Queen Lane, PA 19129, Philadelphia, United States.
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25
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Hedegaard A, Lehnhoff J, Moldovan M, Grøndahl L, Petersen NC, Meehan CF. Postactivation depression of the Ia EPSP in motoneurons is reduced in both the G127X SOD1 model of amyotrophic lateral sclerosis and in aged mice. J Neurophysiol 2015; 114:1196-210. [PMID: 26084911 DOI: 10.1152/jn.00745.2014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 06/17/2015] [Indexed: 12/14/2022] Open
Abstract
Postactivation depression (PActD) of Ia afferent excitatory postsynaptic potentials (EPSPs) in spinal motoneurons results in a long-lasting depression of the stretch reflex. This phenomenon (PActD) is of clinical interest as it has been shown to be reduced in a number of spastic disorders. Using in vivo intracellular recordings of Ia EPSPs in adult mice, we demonstrate that PActD in adult (100-220 days old) C57BL/6J mice is both qualitatively and quantitatively similar to that which has been observed in larger animals with respect to both the magnitude (with ∼20% depression of EPSPs at 0.5 ms after a train of stimuli) and the time course (returning to almost normal amplitudes by 5 ms after the train). This validates the use of mouse models to study PActD. Changes in such excitatory inputs to spinal motoneurons may have important implications for hyperreflexia and/or glutamate-induced excitotoxicity in the neurodegenerative disease amyotrophic lateral sclerosis (ALS). With the use of the G127X SOD1 mutant mouse, an ALS model with a prolonged asymptomatic phase and fulminant symptom onset, we observed that PActD is significantly reduced at both presymptomatic (16% depression) and symptomatic (17.3% depression) time points compared with aged-matched controls (22.4% depression). The PActD reduction was not markedly altered by symptom onset. Comparing these PActD changes at the EPSP with the known effect of the depression on the monosynaptic reflex, we conclude that this is likely to have a much larger effect on the reflex itself (a 20-40% difference). Nevertheless, it should also be accounted that in aged (580 day old) C57BL/6J mice there was also a reduction in PActD although, aging is not usually associated with spasticity.
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Affiliation(s)
- A Hedegaard
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; and
| | - J Lehnhoff
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; and
| | - M Moldovan
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; and
| | - L Grøndahl
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; and
| | - N C Petersen
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; and Department of Nutrition, Exercise and Sports, University of Copenhagen, Panum Institute, Copenhagen, Denmark
| | - C F Meehan
- Department of Neuroscience and Pharmacology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; and
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26
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Abstract
In recent years, several investigators have successfully regenerated axons in animal spinal cords without locomotor recovery. One explanation is that the animals were not trained to use the regenerated connections. Intensive locomotor training improves walking recovery after spinal cord injury (SCI) in people, and >90% of people with incomplete SCI recover walking with training. Although the optimal timing, duration, intensity, and type of locomotor training are still controversial, many investigators have reported beneficial effects of training on locomotor function. The mechanisms by which training improves recovery are not clear, but an attractive theory is available. In 1949, Donald Hebb proposed a famous rule that has been paraphrased as “neurons that fire together, wire together.” This rule provided a theoretical basis for a widely accepted theory that homosynaptic and heterosynaptic activity facilitate synaptic formation and consolidation. In addition, the lumbar spinal cord has a locomotor center, called the central pattern generator (CPG), which can be activated nonspecifically with electrical stimulation or neurotransmitters to produce walking. The CPG is an obvious target to reconnect after SCI. Stimulating motor cortex, spinal cord, or peripheral nerves can modulate lumbar spinal cord excitability. Motor cortex stimulation causes long-term changes in spinal reflexes and synapses, increases sprouting of the corticospinal tract, and restores skilled forelimb function in rats. Long used to treat chronic pain, motor cortex stimuli modify lumbar spinal network excitability and improve lower extremity motor scores in humans. Similarly, epidural spinal cord stimulation has long been used to treat pain and spasticity. Subthreshold epidural stimulation reduces the threshold for locomotor activity. In 2011, Harkema et al. reported lumbosacral epidural stimulation restores motor control in chronic motor complete patients. Peripheral nerve or functional electrical stimulation (FES) has long been used to activate sacral nerves to treat bladder and pelvic dysfunction and to augment motor function. In theory, FES should facilitate synaptic formation and motor recovery after regenerative therapies. Upcoming clinical trials provide unique opportunities to test the theory.
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Affiliation(s)
- Wise Young
- W. M. Keck Center for Collaborative Neuroscience, Rutgers, State University of New Jersey, Piscataway, NJ, USA
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27
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Yarrow JF, Ye F, Balaez A, Mantione JM, Otzel DM, Chen C, Beggs LA, Baligand C, Keener JE, Lim W, Vohra RS, Batra A, Borst SE, Bose PK, Thompson FJ, Vandenborne K. Bone loss in a new rodent model combining spinal cord injury and cast immobilization. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2014; 14:255-266. [PMID: 25198220 PMCID: PMC8349504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Characterize bone loss in our newly developed severe contusion spinal cord injury (SCI) plus hindlimb immobilization (IMM) model and determine the influence of muscle contractility on skeletal integrity after SCI. METHODS Female Sprague-Dawley rats were randomized to: (a) intact controls, (b) severe contusion SCI euthanized at Day 7 (SCI-7) or (c) Day 21 (SCI-21), (d) 14 days IMM-alone, (e) SCI+IMM, or (f) SCI+IMM plus 14 days body weight supported treadmill exercise (SCI+IMM+TM). RESULTS SCI-7 and SCI-21 exhibited a >20% reduction in cancellous volumetric bone mineral density (vBMD) in the hindlimbs (p⋜0.01), characterized by reductions in cancellous bone volume (cBV/TV%), trabecular number (Tb.N), and trabecular thickness. IMM-alone induced no observable bone loss. SCI+IMM exacerbated cancellous vBMD deficits with values being >45% below Controls (p⋜0.01) resulting from reduced cBV/TV% and Tb.N. SCI+IMM also produced the greatest cortical bone loss with distal femoral cortical area and cortical thickness being 14-28% below Controls (p⋜0.01) and bone strength being 37% below Controls (p⋜0.01). SCI+IMM+TM partially alleviated bone deficits, but values remained below Controls. CONCLUSIONS Residual and/or facilitated muscle contractility ameliorate bone decrements after severe SCI. Our novel SCI+IMM model represents a clinically-relevant means of assessing strategies to prevent SCI-induced skeletal deficits.
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Affiliation(s)
- J F Yarrow
- Research Service, Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, United States, 32608
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28
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Côté MP, Gandhi S, Zambrotta M, Houlé JD. Exercise modulates chloride homeostasis after spinal cord injury. J Neurosci 2014; 34:8976-87. [PMID: 24990918 PMCID: PMC6608257 DOI: 10.1523/jneurosci.0678-14.2014] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/20/2014] [Accepted: 05/24/2014] [Indexed: 01/09/2023] Open
Abstract
Activity-based therapies are routinely integrated in spinal cord injury (SCI) rehabilitation programs because they result in a reduction of hyperreflexia and spasticity. However, the mechanisms by which exercise regulates activity in spinal pathways to reduce spasticity and improve functional recovery are poorly understood. Persisting alterations in the action of GABA on postsynaptic targets is a signature of CNS injuries, including SCI. The action of GABA depends on the intracellular chloride concentration, which is determined largely by the expression of two cation-chloride cotransporters (CCCs), KCC2 and NKCC1, which serve as chloride exporters and importers, respectively. We hypothesized that the reduction in hyperreflexia with exercise after SCI relies on a return to chloride homeostasis. Sprague Dawley rats received a spinal cord transection at T12 and were assigned to SCI-7d, SCI-14d, SCI-14d+exercise, SCI-28d, SCI-28d+exercise, or SCI-56d groups. During a terminal experiment, H-reflexes were recorded from interosseus muscles after stimulation of the tibial nerve and the low-frequency-dependent depression (FDD) was assessed. We provide evidence that exercise returns spinal excitability and levels of KCC2 and NKCC1 toward normal levels in the lumbar spinal cord. Acutely altering chloride extrusion using the KCC2 blocker DIOA masked the effect of exercise on FDD, whereas blocking NKCC1 with bumetanide returned FDD toward intact levels after SCI. Our results indicate that exercise contributes to reflex recovery and restoration of endogenous inhibition through a return to chloride homeostasis after SCI. This lends support for CCCs as part of a pathway that could be manipulated to improve functional recovery when combined with rehabilitation programs.
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Affiliation(s)
- Marie-Pascale Côté
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129
| | - Sapan Gandhi
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129
| | - Marina Zambrotta
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129
| | - John D Houlé
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129
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29
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Hou J, Nelson R, Nissim N, Parmer R, Thompson FJ, Bose P. Effect of combined treadmill training and magnetic stimulation on spasticity and gait impairments after cervical spinal cord injury. J Neurotrauma 2014; 31:1088-106. [PMID: 24552465 DOI: 10.1089/neu.2013.3096] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Spasticity and gait impairments are two common disabilities after cervical spinal cord injury (C-SCI). In this study, we tested the therapeutic effects of early treadmill locomotor training (Tm) initiated at postoperative (PO) day 8 and continued for 6 weeks with injury site transcranial magnetic stimulation (TMSsc) on spasticity and gait impairments after low C6/7 moderate contusion C-SCI in a rat model. The combined treatment group (Tm+TMSsc) showed the most robust decreases in velocity-dependent ankle torques and triceps surae electromyography burst amplitudes that were time locked to the initial phase of lengthening, as well as the most improvement in limb coordination quantitated using three-dimensional kinematics and CatWalk gait analyses, compared to the control or single-treatment groups. These significant treatment-associated decreases in measures of spasticity and gait impairment were also accompanied by marked treatment-associated up-regulation of dopamine beta-hydroxylase, glutamic acid decarboxylase 67, gamma-aminobutyric acid B receptor, and brain-derived neurotrophic factor in the lumbar spinal cord (SC) segments of the treatment groups, compared to tissues from the C-SCI nontreated animals. We propose that the treatment-induced up-regulation of these systems enhanced the adaptive plasticity in the SC, in part through enhanced expression of pre- and postsynaptic reflex regulatory processes. Further, we propose that locomotor exercise in the setting of C-SCI may decrease aspects of the spontaneous maladaptive segmental and descending plasticity. Accordingly, TMSsc treatment is characterized as an adjuvant stimulation that may further enhance this capacity. These data are the first to suggest that a combination of Tm and TMSsc across the injury site can be an effective treatment modality for C-SCI-induced spasticity and gait impairments and provided a pre-clinical demonstration for feasibility and efficacy of early TMSsc intervention after C-SCI.
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Affiliation(s)
- Jiamei Hou
- 1 Department of Physiological Sciences, University of Florida , Gainesville, Florida
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30
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Petruska JC, Hubscher CH, Rabchevsky AG. Challenges and opportunities of sensory plasticity after SCI. Front Physiol 2013; 4:231. [PMID: 23986722 PMCID: PMC3753431 DOI: 10.3389/fphys.2013.00231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 08/07/2013] [Indexed: 12/30/2022] Open
Affiliation(s)
- Jeffrey C Petruska
- Department of Anatomical Sciences and Neurobiology, Kentucky Spinal Cord Injury Research Center, University of Louisville Louisville, KY, USA
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31
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Bose P, Hou J, Nelson R, Nissim N, Parmer R, Keener J, Wacnik PW, Thompson FJ. Effects of Acute Intrathecal Baclofen in an Animal Model of TBI-Induced Spasticity, Cognitive, and Balance Disabilities. J Neurotrauma 2013; 30:1177-91. [DOI: 10.1089/neu.2012.2740] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Prodip Bose
- Brain Rehabilitation Research Center (151), North Florida/South Georgia VA Health System, Gainesville, Florida
- Department of Physiological Sciences, University of Florida, Gainesville, Florida
- Department of Neurology, University of Florida, Gainesville, Florida
| | - Jiamei Hou
- Department of Physiological Sciences, University of Florida, Gainesville, Florida
| | - Rachel Nelson
- Brain Rehabilitation Research Center (151), North Florida/South Georgia VA Health System, Gainesville, Florida
| | - Nicole Nissim
- Brain Rehabilitation Research Center (151), North Florida/South Georgia VA Health System, Gainesville, Florida
| | - Ron Parmer
- Brain Rehabilitation Research Center (151), North Florida/South Georgia VA Health System, Gainesville, Florida
| | - Jonathon Keener
- Department of Physiological Sciences, University of Florida, Gainesville, Florida
| | - Paul W. Wacnik
- Neuromodulation Targeted Drug Delivery, Medtronic Inc., Minneapolis, Minnesota
| | - Floyd J. Thompson
- Brain Rehabilitation Research Center (151), North Florida/South Georgia VA Health System, Gainesville, Florida
- Department of Physiological Sciences, University of Florida, Gainesville, Florida
- Department of Neuroscience, University of Florida, Gainesville, Florida
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