Poster (Knowledge Generation) ID 1985240

IF 2.4 Q1 REHABILITATION Topics in Spinal Cord Injury Rehabilitation Pub Date : 2023-09-01 DOI:10.46292/sci23-1985240s
Jessica M. D’Amico, Camilo Castillo, David Rouffet, Monica Gorassini, Lalith E. Satkunam
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Abstract

Following a spinal cord injury, there is a significant loss of monoamines below the lesion. In the rat model, exogenous administration of the serotonin precursor, 5-hydroxytryptophan (5HTP), increases neural excitability through augmentation of spinal serotonin levels. To determine whether this compensatory mechanism can be harnessed to restore serotonergic modulation in humans after SCI, participants visited the lab on four occasions where they received i) placebo, ii) carbidopa, iii) 50mg 5HTP+carbidopa, or iv) 100mg 5HTP+carbidopa in a randomized, crossover design. Cutaneomuscular reflexes (CMR) were obtained pre-drug and 30, 60, 90 and 120-min post-drug intake. Surface electromyography was also recorded during a pedalling movement pre- and post-drug. Nine participants with chronic, complete SCI (35.3±5.5 years) and four participants with chronic, incomplete SCI (47.0±19.7years) were enrolled. Following ingestion of 100mg 5HTP only, the short polysynaptic and long-lasting reflex components of the CMR were significantly increased by ∼ 86±61% and 58±17% respectively in individuals with complete SCI. No significant changes were noted in the cohort of individuals with incomplete SCI. Integrated EMG during pedalling was increased in multiple lower extremity muscles during the extension and flexion phases of the cycle following both 50-mg (82±15% and 51±7%) and 100-mg 5HTP (140±27% and 130±16%) in individuals with more severe injuries, but not in those with incomplete injuries. Ingestion of 5HTP facilitates neural excitability and induces rhythmic muscle activity in previously inactive muscles during an assisted pedalling movement in individuals with chronic, complete SCI. This has significant clinical implications for rehabilitation after SCI.
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海报(知识生成) ID 1985240
脊髓损伤后,病变部位下方的单胺类物质会大量流失。在大鼠模型中,外源性给药血清素前体 5-hydroxytryptophan (5HTP) 可通过提高脊髓血清素水平来增加神经兴奋性。为了确定是否可以利用这种代偿机制来恢复人在脊髓损伤后的血清素能调节能力,参与者四次来到实验室,以随机交叉设计的方式接受了 i) 安慰剂、ii) 卡比多巴、iii) 50 毫克 5HTP+ 卡比多巴或 iv) 100 毫克 5HTP+ 卡比多巴治疗。在服药前、服药后 30、60、90 和 120 分钟采集切肌反射(CMR)。在服药前和服药后,还记录了蹬车运动时的表面肌电图。 九名参与者患有慢性完全性 SCI(35.3±5.5 岁),四名参与者患有慢性不完全性 SCI(47.0±19.7 岁)。在完全性 SCI 患者中,仅在摄入 100 毫克 5HTP 后,CMR 的短多突触和长效反射成分分别显著增加了 ∼ 86±61% 和 58±17%。在不完全性 SCI 患者群中未发现明显变化。在受伤较严重的患者中,服用 50 毫克(82±15% 和 51±7%)和 100 毫克 5HTP 后(140±27% 和 130±16%),多块下肢肌肉在周期的伸展和屈曲阶段的蹬踏过程中的综合肌电图均有增加,但在受伤不完全的患者中则没有增加。 摄入 5HTP 可促进神经兴奋性,并在慢性完全性 SCI 患者的辅助蹬踏运动中诱导先前不活动的肌肉进行有节奏的肌肉活动。这对脊髓损伤后的康复具有重要的临床意义。
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来源期刊
CiteScore
3.20
自引率
3.40%
发文量
33
期刊介绍: Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning
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