Pub Date : 2024-09-11DOI: 10.1038/s41393-024-01034-0
Tomasz Tasiemski, Piotr Kazimierz Urbański, Sophie Jörgensen, Dawid Feder, Katarzyna Trok, Anestis Divanoglou
Prospective cohort study. To evaluate the effects of wheelchair skills training (WSTR) for participants with spinal cord injury (SCI) during peer-led Active Rehabilitation Camps (ARC) in Poland. We hypothesized that participation in ARC will improve wheelchair skill performance and self-efficacy in individuals with SCI. We also aimed to determine demographic and injury-related factors associated with greater improvements in wheelchair skill performance and self-efficacy. Thirteen consecutive ARCs in Poland. Participants (n = 122) with traumatic or nontraumatic SCI older than 16 years were evaluated at the beginning (T1) and completion (T2) of ARC and at 3-month follow-up (T3) through the Queensland Evaluation of Wheelchair Skills (QEWS) and the Wheelchair Skills Test Questionnaire (WST-Q). At T2, 43% of participants reached the threshold for substantial clinically meaningful change in QEWS, 73% in WST-Q capacity, and 67% in confidence, with approximately half of those reporting such gains at T3. At a group level, participants achieved small effect-size improvements (QEWS) at T2; large effects in wheelchair skills capacity at T2 and T3; large effects in wheelchair skill confidence at T2, and low effects at T3. Prior attendance to ARC was the only independent variable that explained 10% of variance in wheelchair capacity gains. Peer-led WSTR during ARCs is highly effective at improving wheelchair skills in individuals with SCI. These improvements are largely retained after three months. Persons with SCI should have a chance to participate in more than one camp to maintain and further improve their wheelchair skills.
{"title":"Effects of wheelchair skills training during peer-led Active Rehabilitation Camps for people with spinal cord injury in Poland: a cohort study","authors":"Tomasz Tasiemski, Piotr Kazimierz Urbański, Sophie Jörgensen, Dawid Feder, Katarzyna Trok, Anestis Divanoglou","doi":"10.1038/s41393-024-01034-0","DOIUrl":"10.1038/s41393-024-01034-0","url":null,"abstract":"Prospective cohort study. To evaluate the effects of wheelchair skills training (WSTR) for participants with spinal cord injury (SCI) during peer-led Active Rehabilitation Camps (ARC) in Poland. We hypothesized that participation in ARC will improve wheelchair skill performance and self-efficacy in individuals with SCI. We also aimed to determine demographic and injury-related factors associated with greater improvements in wheelchair skill performance and self-efficacy. Thirteen consecutive ARCs in Poland. Participants (n = 122) with traumatic or nontraumatic SCI older than 16 years were evaluated at the beginning (T1) and completion (T2) of ARC and at 3-month follow-up (T3) through the Queensland Evaluation of Wheelchair Skills (QEWS) and the Wheelchair Skills Test Questionnaire (WST-Q). At T2, 43% of participants reached the threshold for substantial clinically meaningful change in QEWS, 73% in WST-Q capacity, and 67% in confidence, with approximately half of those reporting such gains at T3. At a group level, participants achieved small effect-size improvements (QEWS) at T2; large effects in wheelchair skills capacity at T2 and T3; large effects in wheelchair skill confidence at T2, and low effects at T3. Prior attendance to ARC was the only independent variable that explained 10% of variance in wheelchair capacity gains. Peer-led WSTR during ARCs is highly effective at improving wheelchair skills in individuals with SCI. These improvements are largely retained after three months. Persons with SCI should have a chance to participate in more than one camp to maintain and further improve their wheelchair skills.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 11","pages":"651-657"},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1038/s41393-024-01026-0
Tim Damgaard Nielsen, Thomas Munk Laursen, Bodil Hammer Bech, Mikkel Mylius Rasmussen
Nationwide epidemiological open cohort study. To evaluate whether individuals with traumatic spinal cord injury (TSCI) are more prone to develop autoimmune diseases compared to a general non-TSCI population. Danish public national registries. An open nationwide cohort, including individuals born in Denmark from or alive during 1945-2018 was collected and the study period was 1980-2018. Poissons Log-linear regression estimated the incidence rate ratio (IRR) for developing eight groups of autoimmune diseases. A dose-response relationship based on the cervical/thoracic level of injury was assessed by stratification. The cohort included 3,272 individuals with TSCI and 4.8 million background individuals, accounting for 50,865 and 140 million person-years respectively. The TSCI population had an overall IRR of 1.81 (95% CI, 1.59 to 2.05) of getting any autoimmune disease. Subgroup analysis found positive associations for; a) Other neurologic IRR 5.19 (95% CI, 2.79 to 9.65), b) multiple sclerosis IRR 3.70 (95% CI, 2.54 to 5.40), c) Dermatologic IRR 2.57 (95% CI, 1.86 to 3.55), d) Type 1 diabetes mellitus IRR 2.01 (95% CI, 1.54 to 2.61), e) Systemic 1.92 (95% CI, 1.44 to 2.55), and f) Gastroenterologic IRR 1.42 (95% CI, 1.05 to 1.92). Cervical levels of TSCI showed an IRR of 1.70 (95% CI, 1.43 to 2.02), while thoracic levels had an IRR 1.98 (95% CI, 1.63 to 2.39). TSCI may be an individual risk factor of developing an autoimmune disease. There does not appear to exist a dose-response relationship from the level of injury. None.
{"title":"Traumatic spinal cord injury and its correlation to risk of autoimmune/-inflammatory disease","authors":"Tim Damgaard Nielsen, Thomas Munk Laursen, Bodil Hammer Bech, Mikkel Mylius Rasmussen","doi":"10.1038/s41393-024-01026-0","DOIUrl":"10.1038/s41393-024-01026-0","url":null,"abstract":"Nationwide epidemiological open cohort study. To evaluate whether individuals with traumatic spinal cord injury (TSCI) are more prone to develop autoimmune diseases compared to a general non-TSCI population. Danish public national registries. An open nationwide cohort, including individuals born in Denmark from or alive during 1945-2018 was collected and the study period was 1980-2018. Poissons Log-linear regression estimated the incidence rate ratio (IRR) for developing eight groups of autoimmune diseases. A dose-response relationship based on the cervical/thoracic level of injury was assessed by stratification. The cohort included 3,272 individuals with TSCI and 4.8 million background individuals, accounting for 50,865 and 140 million person-years respectively. The TSCI population had an overall IRR of 1.81 (95% CI, 1.59 to 2.05) of getting any autoimmune disease. Subgroup analysis found positive associations for; a) Other neurologic IRR 5.19 (95% CI, 2.79 to 9.65), b) multiple sclerosis IRR 3.70 (95% CI, 2.54 to 5.40), c) Dermatologic IRR 2.57 (95% CI, 1.86 to 3.55), d) Type 1 diabetes mellitus IRR 2.01 (95% CI, 1.54 to 2.61), e) Systemic 1.92 (95% CI, 1.44 to 2.55), and f) Gastroenterologic IRR 1.42 (95% CI, 1.05 to 1.92). Cervical levels of TSCI showed an IRR of 1.70 (95% CI, 1.43 to 2.02), while thoracic levels had an IRR 1.98 (95% CI, 1.63 to 2.39). TSCI may be an individual risk factor of developing an autoimmune disease. There does not appear to exist a dose-response relationship from the level of injury. None.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 11","pages":"642-650"},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01026-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1038/s41393-024-01029-x
Jishi Ye, Jingli Chen, Juan Wang, Juan Ren, Yifan Jia, Zhongyuan Xia
Qualitative studies. Spinal cord injury (SCI) is one of the most devastating injuries to the central nervous system that places a major burden on society. Neuromodulation technology involving spinal cord stimulation (SCS) and sacral nerve modulation (SNM) is a promising technique for patients with SCI. However, there has been no bibliometric analysis of research in this field to date. Not applicable. Systematic analyses of countries, institutions, authors, journals, co-cited documents, keywords, genes and diseases were performed. Related gene and disease data from the citexs platform were also reviewed. A total of 7437 articles on SCS and SNM in SCI were retrieved from the Web of Science database. The search time was limited to 1985-01-01 to 2022-12-31. We identified a significant increase in research output on SCS and SNM in SCI in recent years, with a concentrated period of high publication activity. Multiple publications were identified on neuropathic pain, electronic stimulation, TNF, BDNF and STAT3 gene expression, indicating that complications and potential therapeutic strategies for SCI are a key focus in the field. Our study provides insights that may help to advance scientific research and potentially improve outcomes in patients with SCI.
{"title":"Bibliometric analysis of research on spinal cord and sacral neuromodulation in spinal cord injury","authors":"Jishi Ye, Jingli Chen, Juan Wang, Juan Ren, Yifan Jia, Zhongyuan Xia","doi":"10.1038/s41393-024-01029-x","DOIUrl":"10.1038/s41393-024-01029-x","url":null,"abstract":"Qualitative studies. Spinal cord injury (SCI) is one of the most devastating injuries to the central nervous system that places a major burden on society. Neuromodulation technology involving spinal cord stimulation (SCS) and sacral nerve modulation (SNM) is a promising technique for patients with SCI. However, there has been no bibliometric analysis of research in this field to date. Not applicable. Systematic analyses of countries, institutions, authors, journals, co-cited documents, keywords, genes and diseases were performed. Related gene and disease data from the citexs platform were also reviewed. A total of 7437 articles on SCS and SNM in SCI were retrieved from the Web of Science database. The search time was limited to 1985-01-01 to 2022-12-31. We identified a significant increase in research output on SCS and SNM in SCI in recent years, with a concentrated period of high publication activity. Multiple publications were identified on neuropathic pain, electronic stimulation, TNF, BDNF and STAT3 gene expression, indicating that complications and potential therapeutic strategies for SCI are a key focus in the field. Our study provides insights that may help to advance scientific research and potentially improve outcomes in patients with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 11","pages":"634-641"},"PeriodicalIF":2.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retrospective multicenter study. To evaluate how preoperative neck pain influences clinical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Fourteen medical institutions in Japan. We enrolled 90 patients with cervical OPLL who underwent posterior decompression and were followed for a minimum of two years. We collected demographic data, medical history, and imaging findings. Patients were divided into two groups based on preoperative neck pain presence (Pre-op. neck pain (−) and (+) groups), and their outcomes were compared. There were no significant differences in patient demographics between the Pre-op. neck pain (−) and (+) groups. Both groups showed similar distributions of ossification types and K-line positivity. Perioperative complications were comparable between the two groups. Radiographic analysis revealed no significant differences in C2–7 angles or cervical range of motion, pre- and postoperatively. Both groups demonstrated significant improvement in postoperative Japanese orthopedic association (JOA) scores, but there were no significant differences in scores or recovery rates. In the Pre-op. neck pain (−) group, factors associated with appearance of postoperative neck pain included pre- and postoperative lower JOA scores and larger C2–7 angles in neutral and extension positions. It emerges that lower pre- and postoperative JOA scores or larger C2–7 angles in neutral and extension positions predispose to postoperative neck pain even in those patients without preoperative neck pain. Therefore, this is worth discussing at the time of consenting patients for surgical decompression and fixation.
{"title":"Does the presence of preoperative neck pain impact clinical outcomes after posterior decompression in patients with cervical ossification of the posterior longitudinal ligament?: Retrospective multicenter cohort study","authors":"Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Takashi Tsuji, Yosuke Horiuchi, Kazuya Kitamura, Kenshi Daimon, Haruki Funao, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Osahiko Tsuji, Morio Matsumoto, Masaya Nakamura, Kota Watanabe, Ken Ishii, Junichi Yamane","doi":"10.1038/s41393-024-01027-z","DOIUrl":"10.1038/s41393-024-01027-z","url":null,"abstract":"Retrospective multicenter study. To evaluate how preoperative neck pain influences clinical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Fourteen medical institutions in Japan. We enrolled 90 patients with cervical OPLL who underwent posterior decompression and were followed for a minimum of two years. We collected demographic data, medical history, and imaging findings. Patients were divided into two groups based on preoperative neck pain presence (Pre-op. neck pain (−) and (+) groups), and their outcomes were compared. There were no significant differences in patient demographics between the Pre-op. neck pain (−) and (+) groups. Both groups showed similar distributions of ossification types and K-line positivity. Perioperative complications were comparable between the two groups. Radiographic analysis revealed no significant differences in C2–7 angles or cervical range of motion, pre- and postoperatively. Both groups demonstrated significant improvement in postoperative Japanese orthopedic association (JOA) scores, but there were no significant differences in scores or recovery rates. In the Pre-op. neck pain (−) group, factors associated with appearance of postoperative neck pain included pre- and postoperative lower JOA scores and larger C2–7 angles in neutral and extension positions. It emerges that lower pre- and postoperative JOA scores or larger C2–7 angles in neutral and extension positions predispose to postoperative neck pain even in those patients without preoperative neck pain. Therefore, this is worth discussing at the time of consenting patients for surgical decompression and fixation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 11","pages":"619-624"},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1038/s41393-024-01028-y
Inge E. Eriks-Hoogland, Lea Studer, Lorena L. Müller, Benjamin Hirsch, Jürgen Pannek, Armin Gemperli, Cristina Ehrmann
Retrospective cohort study. This study aims to identify the prevalence, causes, time pattern and risk profile of rehospitalizations in persons with spinal cord injury (SCI) within a 10-year period following primary rehabilitation and identify most common secondary health conditions (SHCs) and risk profile leading to rehospitalizations. Specialized hospital and rehabilitation center for SCI in Switzerland. A retrospective analysis was conducted on clinical data from persons with SCI, discharged from initial rehabilitation between January 1, 2010, and December 31, 2012, and followed up over a period of ten years post-discharge. Descriptive statistical methods were utilized to compute the rehospitalization prevalence and to identify the primary reasons. 225 participants were included, 70% were male (n = 179), and the mean age was 50 years (SD 19, Range 17–88). 54% were classified as having paraplegia (n = 122), and 77% incomplete injuries (n = 180). Over the 10-year observation period post-discharge, 120 were readmitted at least once, (prevalence 53%). In total, 66 persons (29%) were rehospitalized once or twice, while 54 persons (24%) were rehospitalized three or more times, with a maximum of 14 times. In the 10-year period, the most common SHCs leading to rehospitalization were infections (19%), pressure injuries (18%), and gastrointestinal problems (16%). During the study period, 57 persons (25%) passed away. Rehospitalization after primary rehabilitation is frequent and in the majority of the cases due to SHCs. The study findings are valuable for resource planning in healthcare and can guide the implementation of preventive measures to avoid SHCs.
{"title":"Prevalence, causes, and risk profile of rehospitalizations in persons with spinal cord injury within the first 10 years after primary rehabilitation","authors":"Inge E. Eriks-Hoogland, Lea Studer, Lorena L. Müller, Benjamin Hirsch, Jürgen Pannek, Armin Gemperli, Cristina Ehrmann","doi":"10.1038/s41393-024-01028-y","DOIUrl":"10.1038/s41393-024-01028-y","url":null,"abstract":"Retrospective cohort study. This study aims to identify the prevalence, causes, time pattern and risk profile of rehospitalizations in persons with spinal cord injury (SCI) within a 10-year period following primary rehabilitation and identify most common secondary health conditions (SHCs) and risk profile leading to rehospitalizations. Specialized hospital and rehabilitation center for SCI in Switzerland. A retrospective analysis was conducted on clinical data from persons with SCI, discharged from initial rehabilitation between January 1, 2010, and December 31, 2012, and followed up over a period of ten years post-discharge. Descriptive statistical methods were utilized to compute the rehospitalization prevalence and to identify the primary reasons. 225 participants were included, 70% were male (n = 179), and the mean age was 50 years (SD 19, Range 17–88). 54% were classified as having paraplegia (n = 122), and 77% incomplete injuries (n = 180). Over the 10-year observation period post-discharge, 120 were readmitted at least once, (prevalence 53%). In total, 66 persons (29%) were rehospitalized once or twice, while 54 persons (24%) were rehospitalized three or more times, with a maximum of 14 times. In the 10-year period, the most common SHCs leading to rehospitalization were infections (19%), pressure injuries (18%), and gastrointestinal problems (16%). During the study period, 57 persons (25%) passed away. Rehospitalization after primary rehabilitation is frequent and in the majority of the cases due to SHCs. The study findings are valuable for resource planning in healthcare and can guide the implementation of preventive measures to avoid SHCs.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 11","pages":"625-633"},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1038/s41393-024-01019-z
Tristan W. Dorey, Tom E. Nightingale, Abdullah A. Alrashidi, Stefan Thomas, Katharine D. Currie, Michèle Hubli, Shane J. T. Balthazaar, Andrei V. Krassioukov
Secondary analysis of a clinical trial. To assess the impact of 6 months of arm cycle ergometry training (ACET), or body weight-supported treadmill training (BWSTT), on autonomic cardiovascular responses to a laboratory sit-up test (SUT) in individuals with chronic (≥1-year post-injury) spinal cord injury (SCI). Tertiary Rehabilitation Centre, Vancouver, Canada. Sixteen individuals with motor-complete (American Spinal Injury Association Impairment Scale A-B) SCI between the fourth cervical and sixth thoracic spinal cord segments, aged 39 ± 11 years, were assessed. Participants were randomized to receive 72 sessions of moderate-to-vigorous intensity ACET (n = 8) or passive BWSTT (n = 8). Changes in mean arterial pressure (finger plethysmography), hemodynamics (Modelflow® method), and heart rate/heart rate variability (HR/HRV; electrocardiography) were measured in response to a SUT before and after 6 months of exercise training. Spontaneous cardiovagal baroreflex sensitivity (cvBRS) was assessed using the sequence method. Neither ACET nor BWSTT impacted hemodynamic responses to SUT or the incidence of orthostatic hypotension (all P > 0.36). ACET increased HR (P < 0.01, ηp2 = 0.34) and high frequency (HF) power HRV responses (P < 0.01, ηp2 = 0.42) to SUT following 6 months of training while BWSTT did not. Consistent with this, cvBRS improved (P < 0.05, ηp2 = 0.16) only following ACET. Improvements in cvBRS were correlated with both the HR (r = 0.726, P < 0.0001) and HF power (r = −0.484, P < 0.01) responses to SUT. Six months of ACET, but not BWSTT, improved cardiovagal baroreflex control of HR but had no effect on BP responses to SUT in individuals with chronic, motor-complete SCI. Canadian Institutes of Health Research (CIHR) NCT01718977
{"title":"Effects of exercise on autonomic cardiovascular control in individuals with chronic, motor-complete spinal cord injury: an exploratory randomised clinical trial","authors":"Tristan W. Dorey, Tom E. Nightingale, Abdullah A. Alrashidi, Stefan Thomas, Katharine D. Currie, Michèle Hubli, Shane J. T. Balthazaar, Andrei V. Krassioukov","doi":"10.1038/s41393-024-01019-z","DOIUrl":"10.1038/s41393-024-01019-z","url":null,"abstract":"Secondary analysis of a clinical trial. To assess the impact of 6 months of arm cycle ergometry training (ACET), or body weight-supported treadmill training (BWSTT), on autonomic cardiovascular responses to a laboratory sit-up test (SUT) in individuals with chronic (≥1-year post-injury) spinal cord injury (SCI). Tertiary Rehabilitation Centre, Vancouver, Canada. Sixteen individuals with motor-complete (American Spinal Injury Association Impairment Scale A-B) SCI between the fourth cervical and sixth thoracic spinal cord segments, aged 39 ± 11 years, were assessed. Participants were randomized to receive 72 sessions of moderate-to-vigorous intensity ACET (n = 8) or passive BWSTT (n = 8). Changes in mean arterial pressure (finger plethysmography), hemodynamics (Modelflow® method), and heart rate/heart rate variability (HR/HRV; electrocardiography) were measured in response to a SUT before and after 6 months of exercise training. Spontaneous cardiovagal baroreflex sensitivity (cvBRS) was assessed using the sequence method. Neither ACET nor BWSTT impacted hemodynamic responses to SUT or the incidence of orthostatic hypotension (all P > 0.36). ACET increased HR (P < 0.01, ηp2 = 0.34) and high frequency (HF) power HRV responses (P < 0.01, ηp2 = 0.42) to SUT following 6 months of training while BWSTT did not. Consistent with this, cvBRS improved (P < 0.05, ηp2 = 0.16) only following ACET. Improvements in cvBRS were correlated with both the HR (r = 0.726, P < 0.0001) and HF power (r = −0.484, P < 0.01) responses to SUT. Six months of ACET, but not BWSTT, improved cardiovagal baroreflex control of HR but had no effect on BP responses to SUT in individuals with chronic, motor-complete SCI. Canadian Institutes of Health Research (CIHR) NCT01718977","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 10","pages":"597-604"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1038/s41393-024-01025-1
Elena Filimonova, Mars Abdaev, Ivan Vasilenko, Yulij Kubetskij, Oleg Prokhorov, Jamil Rzaev
Prospective case-control study. We investigated the use of the magnetization transfer saturation (MTsat) technique to assess the structural integrity of the spinal cord tracts in individuals with clinically significant degenerative cervical myelopathy (DCM) and associated disability. Novosibirsk Neurosurgery Centre, Russia. A total of 53 individuals diagnosed with DCM and 41 patients with cervical radiculopathy underwent high-resolution MRI of the cervical spinal cord via the magnetization transfer technique. The MRI data were processed using the Spinal Cord Toolbox (v5.5), with MTsat values determined for each spinal tract and compared between the two groups. Furthermore, associations between MTsat values and the clinical disability rates of patients were investigated. A significant decrease in the MTsat of the ventral spinocerebellar tract was observed in the DCM group compared to the control group (adjusted p < 0.001). There was a trend towards lower MTsat values in the rubrospinal tract in the DCM group (adjusted p = 0.08). Additionally, a decrease in MTsat values in the lateral funiculi of the spinal cord was found in patients with DCM (adjusted p < 0.01). Furthermore, a trend toward a positive correlation was observed between the JOA score and the MTsat values within the ventral spinocerebellar tract (R = 0.33, adjusted p = 0.051). The findings of our study indicate that demyelination in patients with DCM affects mainly the ventral spinocerebellar and rubrospinal tracts, and the extent of changes in the ventral spinocerebellar tract is related to the severity of the condition.
{"title":"White matter spinal tracts impairment in patients with degenerative cervical myelopathy evaluated with the magnetization transfer saturation MRI technique","authors":"Elena Filimonova, Mars Abdaev, Ivan Vasilenko, Yulij Kubetskij, Oleg Prokhorov, Jamil Rzaev","doi":"10.1038/s41393-024-01025-1","DOIUrl":"10.1038/s41393-024-01025-1","url":null,"abstract":"Prospective case-control study. We investigated the use of the magnetization transfer saturation (MTsat) technique to assess the structural integrity of the spinal cord tracts in individuals with clinically significant degenerative cervical myelopathy (DCM) and associated disability. Novosibirsk Neurosurgery Centre, Russia. A total of 53 individuals diagnosed with DCM and 41 patients with cervical radiculopathy underwent high-resolution MRI of the cervical spinal cord via the magnetization transfer technique. The MRI data were processed using the Spinal Cord Toolbox (v5.5), with MTsat values determined for each spinal tract and compared between the two groups. Furthermore, associations between MTsat values and the clinical disability rates of patients were investigated. A significant decrease in the MTsat of the ventral spinocerebellar tract was observed in the DCM group compared to the control group (adjusted p < 0.001). There was a trend towards lower MTsat values in the rubrospinal tract in the DCM group (adjusted p = 0.08). Additionally, a decrease in MTsat values in the lateral funiculi of the spinal cord was found in patients with DCM (adjusted p < 0.01). Furthermore, a trend toward a positive correlation was observed between the JOA score and the MTsat values within the ventral spinocerebellar tract (R = 0.33, adjusted p = 0.051). The findings of our study indicate that demyelination in patients with DCM affects mainly the ventral spinocerebellar and rubrospinal tracts, and the extent of changes in the ventral spinocerebellar tract is related to the severity of the condition.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 10","pages":"590-596"},"PeriodicalIF":2.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01025-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-27DOI: 10.1038/s41393-024-01024-2
Tijn van Diemen, Eline W. M. Scholten, Nelleke G. Langerak, Ilse J. W. van Nes
Retrospective cohort study. Determine the course of burden and psychological distress of significant others (SOs) during initial spinal cord injury (SCI) rehabilitation and to predict the caregiver’s burden at discharge with characteristics of SOs and persons with SCI (PSCIs) at the start of rehabilitation. Rehabilitation center Sint Maartenskliniek, Nijmegen, The Netherlands. All PSCIs admitted for initial rehabilitation between October 2020 and December 2022 were included. One of their SOs were asked to complete a set of screening questionnaires, collected in our routine context of care. A total of 181 PSCIs (62% male, average age 60 years, 80% incomplete SCI, 60% paraplegia and 32 days after injury) and 158 SOs (40% male, average age 57 years) were screened at admission, and 145 and 93 at discharge, respectively. For SOs, the average caregiver’s burden and feelings of depression and anxiety did not change during admission. The caregiver’s burden score at discharge was best predicted by the burden score at admission, explaining 20% (P < 0.001) of the variance. An additional 13% (P = 0.02) of the variance was explained by other SO and PSCI variables gathered in this study. The caregiver’s burden in this group of SOs during rehabilitation, was higher than that of a representative group in the chronic phase. On both assessments, around 20% scored above the cutoff. Scores of psychological distress are comparable to former studies. Standard screening of SOs during initial SCI rehabilitation is important to help the interdisciplinary team identify SOs at risk, and target their treatment during inpatient rehabilitation.
设计回顾性队列研究：确定重要他人（SOs）在脊髓损伤（SCI）初期康复过程中的负担和心理困扰，并根据SOs和SCI患者（PSCIs）在康复初期的特征预测出院时照顾者的负担：地点：荷兰奈梅亨 Sint Maartenskliniek 康复中心：方法：纳入 2020 年 10 月至 2022 年 12 月期间接受初次康复治疗的所有 SCI 患者。我们要求他们的一名护理人员完成一套筛查问卷，这些问卷是在我们的常规护理范围内收集的：共有181名PSCI患者（62%为男性，平均年龄60岁，80%为不完全性SCI，60%为截瘫，伤后32天）和158名SO（40%为男性，平均年龄57岁）在入院时接受了筛查，出院时分别有145人和93人接受了筛查。入院时，护理人员的平均负担以及抑郁和焦虑情绪没有变化。入院时的照顾者负担得分对出院时的照顾者负担得分的预测效果最好，占 20%（P 结论：入院时的照顾者负担得分对出院时的照顾者负担得分的预测效果最好，占 20%）：这组 SO 患者在康复期间的照顾者负担高于慢性期的代表性群体。在这两项评估中，约有 20% 的人得分高于临界值。心理压力得分与之前的研究结果相当。在最初的 SCI 康复过程中对 SO 进行标准筛查非常重要，这有助于跨学科团队识别有风险的 SO，并在住院康复期间对其进行有针对性的治疗。
{"title":"Psychological screening of significant others during spinal cord injury rehabilitation","authors":"Tijn van Diemen, Eline W. M. Scholten, Nelleke G. Langerak, Ilse J. W. van Nes","doi":"10.1038/s41393-024-01024-2","DOIUrl":"10.1038/s41393-024-01024-2","url":null,"abstract":"Retrospective cohort study. Determine the course of burden and psychological distress of significant others (SOs) during initial spinal cord injury (SCI) rehabilitation and to predict the caregiver’s burden at discharge with characteristics of SOs and persons with SCI (PSCIs) at the start of rehabilitation. Rehabilitation center Sint Maartenskliniek, Nijmegen, The Netherlands. All PSCIs admitted for initial rehabilitation between October 2020 and December 2022 were included. One of their SOs were asked to complete a set of screening questionnaires, collected in our routine context of care. A total of 181 PSCIs (62% male, average age 60 years, 80% incomplete SCI, 60% paraplegia and 32 days after injury) and 158 SOs (40% male, average age 57 years) were screened at admission, and 145 and 93 at discharge, respectively. For SOs, the average caregiver’s burden and feelings of depression and anxiety did not change during admission. The caregiver’s burden score at discharge was best predicted by the burden score at admission, explaining 20% (P < 0.001) of the variance. An additional 13% (P = 0.02) of the variance was explained by other SO and PSCI variables gathered in this study. The caregiver’s burden in this group of SOs during rehabilitation, was higher than that of a representative group in the chronic phase. On both assessments, around 20% scored above the cutoff. Scores of psychological distress are comparable to former studies. Standard screening of SOs during initial SCI rehabilitation is important to help the interdisciplinary team identify SOs at risk, and target their treatment during inpatient rehabilitation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 10","pages":"584-589"},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1038/s41393-024-01023-3
Morgan J. Forston, Savannah L. Jordan, Greta M. Cesarz, Darlene A. Burke, Alice Shum-Siu, Jeffrey C. Petruska, David S. K. Magnuson
Preclinical pilot study. To explore peripheral and central nociceptive mechanisms that contribute to muscle stretch-induced locomotor deficits following spinal cord injury. Kentucky Spinal Cord Injury Research Center, Louisville, KY, USA. Ten female Sprague-Dawley rats received moderate, 25 g/cm T10 contusion injuries and recovered for 4 weeks. Rats were divided into three groups: Morphine/Ibuprofen-treated, Acetaminophen/Baclofen-treated, and saline control. Each group received daily hindlimb muscle stretching during weeks 4, 5, 9, and 10 post-injury and drugs were administered with stretching during weeks 4 and 9 only. Locomotor function was assessed throughout the experiment using the BBB Open Field Locomotor Scale. Hindlimb responses including spasticity, writhing, and clonic-like vibrations during muscle stretching were classified and scored. Consistent with our previous studies, hindlimb muscle stretching caused significant deficits in locomotor recovery following spinal cord injury. Baclofen and Ibuprofen partially mitigated the stretching effect, but none of the drugs significantly prevented the drop in locomotor function during stretching. Interestingly, treatment with Baclofen or Ibuprofen significantly reduced hindlimb responses such as spasticity and writhing during stretching, while Morphine exacerbated clonic-like vibrations in response to stretching maneuvers. These findings suggest that stretching may inhibit locomotor recovery through combined mechanisms of peripheral inflammation and sensitization of nociceptive afferents. When combined with central sprouting and loss of descending controls after SCI, this results in exaggerated nociceptive input during stretching. The inability of the applied clinical drugs to mitigate the detrimental effects of stretching highlights the complexity of the stretching phenomenon and emphasizes the need for further investigation.
{"title":"Combining clinically common drugs with hindlimb stretching in spinal cord injured rodents","authors":"Morgan J. Forston, Savannah L. Jordan, Greta M. Cesarz, Darlene A. Burke, Alice Shum-Siu, Jeffrey C. Petruska, David S. K. Magnuson","doi":"10.1038/s41393-024-01023-3","DOIUrl":"10.1038/s41393-024-01023-3","url":null,"abstract":"Preclinical pilot study. To explore peripheral and central nociceptive mechanisms that contribute to muscle stretch-induced locomotor deficits following spinal cord injury. Kentucky Spinal Cord Injury Research Center, Louisville, KY, USA. Ten female Sprague-Dawley rats received moderate, 25 g/cm T10 contusion injuries and recovered for 4 weeks. Rats were divided into three groups: Morphine/Ibuprofen-treated, Acetaminophen/Baclofen-treated, and saline control. Each group received daily hindlimb muscle stretching during weeks 4, 5, 9, and 10 post-injury and drugs were administered with stretching during weeks 4 and 9 only. Locomotor function was assessed throughout the experiment using the BBB Open Field Locomotor Scale. Hindlimb responses including spasticity, writhing, and clonic-like vibrations during muscle stretching were classified and scored. Consistent with our previous studies, hindlimb muscle stretching caused significant deficits in locomotor recovery following spinal cord injury. Baclofen and Ibuprofen partially mitigated the stretching effect, but none of the drugs significantly prevented the drop in locomotor function during stretching. Interestingly, treatment with Baclofen or Ibuprofen significantly reduced hindlimb responses such as spasticity and writhing during stretching, while Morphine exacerbated clonic-like vibrations in response to stretching maneuvers. These findings suggest that stretching may inhibit locomotor recovery through combined mechanisms of peripheral inflammation and sensitization of nociceptive afferents. When combined with central sprouting and loss of descending controls after SCI, this results in exaggerated nociceptive input during stretching. The inability of the applied clinical drugs to mitigate the detrimental effects of stretching highlights the complexity of the stretching phenomenon and emphasizes the need for further investigation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 10","pages":"574-583"},"PeriodicalIF":2.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1038/s41393-024-01015-3
Yitong Yan, Zihan Li, Shuangyue Zhang, Fan Bai, Yingli Jing, Fubiao Huang, Yan Yu
Experimental animal study. To investigate the protective effect of remote limb ischemia preconditioning (RLPreC) on traumatic spinal cord injury (SCI) and explore the underlying biological mechanisms using RNA sequencing. China Rehabilitation Science Institute; Beijing; China. spinal cord injury was induced in mice using a force of 0.7 N. RLPreC treatment was administered. Motor function, pain behavior, and gene expression were assessed. RLPreC treatment significantly improved motor function and reduced pain-like behavior in SCI mice. RNA-Seq analysis identified 5247 differentially expressed genes (DEGs). GO analysis revealed enrichment of immune response, inflammatory signaling, and synaptic transmission pathways among these DEGs. KEGG analysis indicated suppression of inflammation and promotion of synapse-related pathways. RLPreC is a promising therapeutic strategy for improving motor function and alleviating pain after traumatic SCI. RNA-Seq analysis provides insights into potential therapeutic targets and warrants further investigation.
{"title":"Remote limb ischemic preconditioning alleviated spinal cord injury through inhibiting proinflammatory immune response and promoting the survival of spinal neurons","authors":"Yitong Yan, Zihan Li, Shuangyue Zhang, Fan Bai, Yingli Jing, Fubiao Huang, Yan Yu","doi":"10.1038/s41393-024-01015-3","DOIUrl":"10.1038/s41393-024-01015-3","url":null,"abstract":"Experimental animal study. To investigate the protective effect of remote limb ischemia preconditioning (RLPreC) on traumatic spinal cord injury (SCI) and explore the underlying biological mechanisms using RNA sequencing. China Rehabilitation Science Institute; Beijing; China. spinal cord injury was induced in mice using a force of 0.7 N. RLPreC treatment was administered. Motor function, pain behavior, and gene expression were assessed. RLPreC treatment significantly improved motor function and reduced pain-like behavior in SCI mice. RNA-Seq analysis identified 5247 differentially expressed genes (DEGs). GO analysis revealed enrichment of immune response, inflammatory signaling, and synaptic transmission pathways among these DEGs. KEGG analysis indicated suppression of inflammation and promotion of synapse-related pathways. RLPreC is a promising therapeutic strategy for improving motor function and alleviating pain after traumatic SCI. RNA-Seq analysis provides insights into potential therapeutic targets and warrants further investigation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 10","pages":"562-573"},"PeriodicalIF":2.1,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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