Posters

Discipline Track

Biomedical Science

Abstract

Introduction: Spinal cord injuries affect about 300,000 individuals in the United States and cause varying degrees of motor and sensory impairment. The standard of care for those with a spinal cord injury typically involves traditional rehabilitation. Unfortunately, over a year of rehabilitation is often required to achieve meaningful improvements in motor or sensory function. In order to improve rehabilitative efforts for those with spinal cord injury, it is critical to identify biomarkers that could serve as indicators for those who would respond to standard rehabilitation efforts.

Objective: Following spinal cord injury, edema forms around the area of injury in the spinal cord. Recent work has suggested that the characteristics of the edema and neighboring tissue bridges in the spinal cord can influence both baseline function and functional recovery potential. The objective of our project is to assess magnetic resonance imaging (MRI) of the spinal cord and relate observed properties of the spinal edema and tissue bridges with functional recovery of the patient.

Methods: T2-weighted MRI images were collected in seven subjects with chronic cervical spinal cord injury (C2 to C7). Following MRI collection, all patients then participated in two weeks of rehabilitation. We assessed changes in motor function before and after rehabilitation using the nine-hole peg test and muscle grading. We defined the physical properties of the spinal scar using the open-source software, FSLview. We related the length, size and location of the spinal scar to functional recovery metrics using regression analysis. Statistical Package for the Social Sciences (SPSS) software was used for all statistical comparisons.

Results: We observed varying sizes of spinal edema in our patient population (0.1 mm3 to 3 mm3). Spinal edema varied substantially in length between patients, with some patients demonstrating spinal edema that spanned several cervical vertebrae levels. We observed that baseline function was related to dorsal and ventral tissue bridge sparing (r = .930 p = .007). We observed that more intensive stimulation was needed to produce a muscle twitch in patients with smaller tissue bridge (r= 0.55).

Conclusions: Identification of biomarkers could aid clinicians in determining what rehabilitation approaches to employ in a specific patient. Our work has found that properties of the spinal edema and neighboring tissue bridges are directly related to baseline function and recovery potential. Our findings encourage future research to evaluate mechanisms to improve the viability of tissue bridges in individuals with spinal cord injury, such as through use of stem cells, in order to improve functional recovery.

Presentation Type

Poster

Academic Level

Staff

Mentor/PI Department

Molecular Science

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Spinal Cord Injury: Tissue Bridge Influence on Neurophysiology and Functional Recovery

Introduction: Spinal cord injuries affect about 300,000 individuals in the United States and cause varying degrees of motor and sensory impairment. The standard of care for those with a spinal cord injury typically involves traditional rehabilitation. Unfortunately, over a year of rehabilitation is often required to achieve meaningful improvements in motor or sensory function. In order to improve rehabilitative efforts for those with spinal cord injury, it is critical to identify biomarkers that could serve as indicators for those who would respond to standard rehabilitation efforts.

Objective: Following spinal cord injury, edema forms around the area of injury in the spinal cord. Recent work has suggested that the characteristics of the edema and neighboring tissue bridges in the spinal cord can influence both baseline function and functional recovery potential. The objective of our project is to assess magnetic resonance imaging (MRI) of the spinal cord and relate observed properties of the spinal edema and tissue bridges with functional recovery of the patient.

Methods: T2-weighted MRI images were collected in seven subjects with chronic cervical spinal cord injury (C2 to C7). Following MRI collection, all patients then participated in two weeks of rehabilitation. We assessed changes in motor function before and after rehabilitation using the nine-hole peg test and muscle grading. We defined the physical properties of the spinal scar using the open-source software, FSLview. We related the length, size and location of the spinal scar to functional recovery metrics using regression analysis. Statistical Package for the Social Sciences (SPSS) software was used for all statistical comparisons.

Results: We observed varying sizes of spinal edema in our patient population (0.1 mm3 to 3 mm3). Spinal edema varied substantially in length between patients, with some patients demonstrating spinal edema that spanned several cervical vertebrae levels. We observed that baseline function was related to dorsal and ventral tissue bridge sparing (r = .930 p = .007). We observed that more intensive stimulation was needed to produce a muscle twitch in patients with smaller tissue bridge (r= 0.55).

Conclusions: Identification of biomarkers could aid clinicians in determining what rehabilitation approaches to employ in a specific patient. Our work has found that properties of the spinal edema and neighboring tissue bridges are directly related to baseline function and recovery potential. Our findings encourage future research to evaluate mechanisms to improve the viability of tissue bridges in individuals with spinal cord injury, such as through use of stem cells, in order to improve functional recovery.

 

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