Pub Date : 2024-06-24DOI: 10.1038/s41393-024-01003-7
Benjamin D. Holmes, Ruta Brazauskas, Harvinder S. Chhabra
Cross-sectional study. To evaluate etiologic factors associated with spinal cord injury (SCI) severity and to identify predictive factors of reduction in SCI severity in six countries. SCI centers in Bangladesh, India, Malaysia, Nepal, Sri Lanka, and Thailand. Data from centers collected between October 2015 and February 2021 were analyzed using descriptive statistics and logistic regression. Among 2634 individuals, the leading cause of SCIs was falls (n = 1410, 54%); most occurred from ≥1 meter (n = 1078). Most single-level neurological injuries occurred in the thoracic region (n = 977, 39%). Greater than half of SCIs (n = 1423, 54%) were graded American Spinal Injury Association Impairment Scale (AIS) A. Thoracic SCIs accounted for 53% (n = 757) of all one-level AIS A SCIs. The percentage of thoracic SCIs graded AIS A (78%) was significantly higher than high cervical (52%), low cervical (48%), lumbar (24%), and sacral (31%) SCIs (p < 0.001). Regression analyses isolated predictive factors both of SCI severity and inpatient improvement. Four factors predicted severity: age, neurological level, etiology, and country of residence. Four factors predicted improvement: age, neurological level, AIS grade on intake, and country of residence. Findings can be used by healthcare providers and public health agencies in these countries to inform the public of the risk of SCI due to falls. Future studies should examine the social and occupational milieux of falls. Country-to-country comparisons of prehospital and inpatient care are also justified. Fall prevention policies can encourage the use of safety equipment when performing tasks at heights ≥1 meter.
{"title":"Spinal cord injury etiology, severity, and care in East Asia: a cross-sectional analysis of the International Spinal Cord Society Database Project","authors":"Benjamin D. Holmes, Ruta Brazauskas, Harvinder S. Chhabra","doi":"10.1038/s41393-024-01003-7","DOIUrl":"10.1038/s41393-024-01003-7","url":null,"abstract":"Cross-sectional study. To evaluate etiologic factors associated with spinal cord injury (SCI) severity and to identify predictive factors of reduction in SCI severity in six countries. SCI centers in Bangladesh, India, Malaysia, Nepal, Sri Lanka, and Thailand. Data from centers collected between October 2015 and February 2021 were analyzed using descriptive statistics and logistic regression. Among 2634 individuals, the leading cause of SCIs was falls (n = 1410, 54%); most occurred from ≥1 meter (n = 1078). Most single-level neurological injuries occurred in the thoracic region (n = 977, 39%). Greater than half of SCIs (n = 1423, 54%) were graded American Spinal Injury Association Impairment Scale (AIS) A. Thoracic SCIs accounted for 53% (n = 757) of all one-level AIS A SCIs. The percentage of thoracic SCIs graded AIS A (78%) was significantly higher than high cervical (52%), low cervical (48%), lumbar (24%), and sacral (31%) SCIs (p < 0.001). Regression analyses isolated predictive factors both of SCI severity and inpatient improvement. Four factors predicted severity: age, neurological level, etiology, and country of residence. Four factors predicted improvement: age, neurological level, AIS grade on intake, and country of residence. Findings can be used by healthcare providers and public health agencies in these countries to inform the public of the risk of SCI due to falls. Future studies should examine the social and occupational milieux of falls. Country-to-country comparisons of prehospital and inpatient care are also justified. Fall prevention policies can encourage the use of safety equipment when performing tasks at heights ≥1 meter.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 7","pages":"421-427"},"PeriodicalIF":2.1,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447135","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 : 2024-06-21DOI: 10.1038/s41393-024-01011-7
Giovana S. Sprizon, Natália D. Pereira, Lorena O. Almeida, Sarah M. Dos Anjos, David M. Morris, Jocemar Ilha
Mixed-method approach. To develop and assess the content validity of a semi-structured interview that captures the lived experience of using a manual wheelchair among individuals with SCI in the real world, the Wheelchair Mobility Activity Log (WC-MAL). SCIR-Group (UDESC)/Brazil. Developing the WC-MAL comprised five steps: (1) defining the construct—based on the International Classification of Functioning, Disability and Health (ICF); (2) identifying relevant activities from other assessment instruments and interviews with the end-users (14 Individuals with SCI and 13 rehabilitation professionals); (3) Selecting the items – activities were linked to ICF codes and grouped into sets; (4) developing the scoring scales based on interviews with the end-users; and, (5) evaluating content validity in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The content validity ratio (CVR) for each item and scale and the overall instrument content validity index (CVI) were calculated. From an initial draft of 295 activities identified, a set of 222 activities was linked to the ICF domain of “Mobility (d4)” and further refined to generate the 23 items in the WC-MAL. Three scales were developed to assess Frequency (how often), Performance (how well), and Assistance (assistance needed) levels. The items and scales showed a CVR superior to the critical value established (≥0.64). The general CVI value was 0.96. The WC-MAL is a promising clinical instrument with adequate content validity to assess the spontaneous use of the manual wheelchair in the real world among individuals with SCI.
{"title":"A semi-structured interview to capture manual wheelchair use for mobility activities among individuals with spinal cord injury in real-life situations: development and content validity of the Wheelchair Mobility Activity Log (WC-MAL)","authors":"Giovana S. Sprizon, Natália D. Pereira, Lorena O. Almeida, Sarah M. Dos Anjos, David M. Morris, Jocemar Ilha","doi":"10.1038/s41393-024-01011-7","DOIUrl":"10.1038/s41393-024-01011-7","url":null,"abstract":"Mixed-method approach. To develop and assess the content validity of a semi-structured interview that captures the lived experience of using a manual wheelchair among individuals with SCI in the real world, the Wheelchair Mobility Activity Log (WC-MAL). SCIR-Group (UDESC)/Brazil. Developing the WC-MAL comprised five steps: (1) defining the construct—based on the International Classification of Functioning, Disability and Health (ICF); (2) identifying relevant activities from other assessment instruments and interviews with the end-users (14 Individuals with SCI and 13 rehabilitation professionals); (3) Selecting the items – activities were linked to ICF codes and grouped into sets; (4) developing the scoring scales based on interviews with the end-users; and, (5) evaluating content validity in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The content validity ratio (CVR) for each item and scale and the overall instrument content validity index (CVI) were calculated. From an initial draft of 295 activities identified, a set of 222 activities was linked to the ICF domain of “Mobility (d4)” and further refined to generate the 23 items in the WC-MAL. Three scales were developed to assess Frequency (how often), Performance (how well), and Assistance (assistance needed) levels. The items and scales showed a CVR superior to the critical value established (≥0.64). The general CVI value was 0.96. The WC-MAL is a promising clinical instrument with adequate content validity to assess the spontaneous use of the manual wheelchair in the real world among individuals with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 8","pages":"468-478"},"PeriodicalIF":2.1,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437567","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 : 2024-06-20DOI: 10.1038/s41393-024-01010-8
Reed Handlery, Kaci Handlery, Dana Kahl, Lyndsie Koon, Elizabeth W. Regan
{"title":"Correction: High intensity functional training for people with spinal cord injury & their care partners","authors":"Reed Handlery, Kaci Handlery, Dana Kahl, Lyndsie Koon, Elizabeth W. Regan","doi":"10.1038/s41393-024-01010-8","DOIUrl":"10.1038/s41393-024-01010-8","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 7","pages":"428-428"},"PeriodicalIF":2.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01010-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432854","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 : 2024-06-19DOI: 10.1038/s41393-024-01006-4
Pablo V. Escribá, Ángel M. Gil-Agudo, Joan Vidal Samsó, Judith Sánchez-Raya, Sebastián Salvador-de la Barrera, Vanesa Soto-León, Natacha León-Álvarez, Bosco Méndez Ferrer, Miguel David Membrilla-Mesa, Carolina Redondo Galán, Jesús Benito-Penalva, Antonio Montoto-Marqués, Javier Medel Rebollo, Ramiro Palazón García, Francisco Gutiérrez Henares, Marc Miralles, Manuel Torres, Ana B. Nieto-Librero, David García Marco, Carmela Gómez, David Jimeno, Antonio Oliviero
Double-blind, randomized, placebo-controlled, parallel-group multicentric phase IIA clinical trial. To assess the safety and tolerability of oral administration of NFX-88 in subjects with chronic spinal cord injury (SCI) and explore its efficacy in pain control. A total of 7 spinal cord injury rehabilitation units in Spain. A total of 61 adult with traumatic complete or incomplete spinal cord injury (C4-T12 level), were randomised 1:1:1:1 to a placebo, NFX88 1.05 g, 2.1 g, 4.2 g/day for up to 12 weeks. The placebo or NFX-88 was administered as add-on therapy to pre-existing pregabalin (150–300 mg per day). Safety and tolerability were evaluated, and the Visual Analogue Scale (VAS) was the primary measure to explore the efficacy of NFX-88 in pain control. No severe treatment-related adverse effects were reported for any of the four study groups. 44 SCI individuals completed the study and were analysed. The data obtained from the VAS analysis and the PainDETECT Questionnaire (PD-Q) suggested that the combination of NFX88 with pregabalin is more effective than pregabalin with placebo at reducing neuropathic pain (NP) in individuals with SCI and that the dose 2.10 g/day causes the most dramatic pain relief. NFX88 treatment was found to be highly safe and well tolerated, with the dose of 2.10 g/day being the most effective at causing pain relief. Thus, the promising efficacy of this first-in-class lipid mediator deserves further consideration in future clinical trials.
{"title":"Randomised, double-blind, placebo-controlled, parallel-group, multicentric, phase IIA clinical trial for evaluating the safety, tolerability, and therapeutic efficacy of daily oral administration of NFX88 to treat neuropathic pain in individuals with spinal cord injury","authors":"Pablo V. Escribá, Ángel M. Gil-Agudo, Joan Vidal Samsó, Judith Sánchez-Raya, Sebastián Salvador-de la Barrera, Vanesa Soto-León, Natacha León-Álvarez, Bosco Méndez Ferrer, Miguel David Membrilla-Mesa, Carolina Redondo Galán, Jesús Benito-Penalva, Antonio Montoto-Marqués, Javier Medel Rebollo, Ramiro Palazón García, Francisco Gutiérrez Henares, Marc Miralles, Manuel Torres, Ana B. Nieto-Librero, David García Marco, Carmela Gómez, David Jimeno, Antonio Oliviero","doi":"10.1038/s41393-024-01006-4","DOIUrl":"10.1038/s41393-024-01006-4","url":null,"abstract":"Double-blind, randomized, placebo-controlled, parallel-group multicentric phase IIA clinical trial. To assess the safety and tolerability of oral administration of NFX-88 in subjects with chronic spinal cord injury (SCI) and explore its efficacy in pain control. A total of 7 spinal cord injury rehabilitation units in Spain. A total of 61 adult with traumatic complete or incomplete spinal cord injury (C4-T12 level), were randomised 1:1:1:1 to a placebo, NFX88 1.05 g, 2.1 g, 4.2 g/day for up to 12 weeks. The placebo or NFX-88 was administered as add-on therapy to pre-existing pregabalin (150–300 mg per day). Safety and tolerability were evaluated, and the Visual Analogue Scale (VAS) was the primary measure to explore the efficacy of NFX-88 in pain control. No severe treatment-related adverse effects were reported for any of the four study groups. 44 SCI individuals completed the study and were analysed. The data obtained from the VAS analysis and the PainDETECT Questionnaire (PD-Q) suggested that the combination of NFX88 with pregabalin is more effective than pregabalin with placebo at reducing neuropathic pain (NP) in individuals with SCI and that the dose 2.10 g/day causes the most dramatic pain relief. NFX88 treatment was found to be highly safe and well tolerated, with the dose of 2.10 g/day being the most effective at causing pain relief. Thus, the promising efficacy of this first-in-class lipid mediator deserves further consideration in future clinical trials.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 8","pages":"454-467"},"PeriodicalIF":2.1,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427668","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 : 2024-06-18DOI: 10.1038/s41393-024-01008-2
Christina Draganich, Dustin Anderson, Grant J. Dornan, Mitch Sevigny, Jeffrey Berliner, Susan Charlifue, Abigail Welch, Andrew Smith
Retrospective multi-site cohort study. To develop an accurate machine learning predictive model using predictor variables from the acute rehabilitation period to determine ambulatory status in spinal cord injury (SCI) one year post injury. Model SCI System (SCIMS) database between January 2000 and May 2019. Retrospective cohort study using data that were previously collected as part of the SCI Model System (SCIMS) database. A total of 4523 patients were analyzed comparing traditional models (van Middendorp and Hicks) compared to machine learning algorithms including Elastic Net Penalized Logistic Regression (ENPLR), Gradient Boosted Machine (GBM), and Artificial Neural Networks (ANN). Compared with GBM and ANN, ENPLR was determined to be the preferred model based on predictive accuracy metrics, calibration, and variable selection. The primary metric to judge discrimination was the area under the receiver operating characteristic curve (AUC). When compared to the van Middendorp all patients (0.916), ASIA A and D (0.951) and ASIA B and C (0.775) and Hicks all patients (0.89), ASIA A and D (0.934) and ASIA B and C (0.775), ENPLR demonstrated improved AUC for all patients (0.931), ASIA A and D (0.965) ASIA B and C (0.803). Utilizing artificial intelligence and machine learning methods are feasible for accurately classifying outcomes in SCI and may provide improved sensitivity in identifying which individuals are less likely to ambulate and may benefit from augmentative strategies, such as neuromodulation. Future directions should include the use of additional variables to further refine these models.
研究设计目标：利用急性康复期的预测变量，开发一个准确的机器学习预测模型，以确定脊髓损伤（SCI）患者伤后一年的活动状态：利用急性康复期的预测变量开发精确的机器学习预测模型，以确定脊髓损伤（SCI）伤后一年的活动状态：2000年1月至2019年5月期间的SCI模型系统（SCIMS）数据库：回顾性队列研究，使用之前作为 SCI 模型系统（SCIMS）数据库一部分收集的数据。共对 4523 名患者进行了分析，将传统模型（van Middendorp 和 Hicks）与机器学习算法（包括弹性净惩罚逻辑回归（ENPLR）、梯度提升机（GBM）和人工神经网络（ANN））进行了比较：结果：与 GBM 和 ANN 相比，根据预测准确度指标、校准和变量选择，ENPLR 被确定为首选模型。判别的主要指标是接收者工作特征曲线下的面积（AUC）。与 van Middendorp 所有患者（0.916）、ASIA A 和 D（0.951）以及 ASIA B 和 C（0.775）和 Hicks 所有患者（0.89）、ASIA A 和 D（0.934）以及 ASIA B 和 C（0.775）相比，ENPLR 对所有患者（0.931）、ASIA A 和 D（0.965）以及 ASIA B 和 C（0.803）的 AUC 有所提高：利用人工智能和机器学习方法对 SCI 的结果进行准确分类是可行的，而且可以提高灵敏度，识别出哪些患者不太可能行走，并可能从神经调控等增强策略中获益。未来的发展方向应包括使用其他变量来进一步完善这些模型。
{"title":"Predictive modeling of ambulatory outcomes after spinal cord injury using machine learning","authors":"Christina Draganich, Dustin Anderson, Grant J. Dornan, Mitch Sevigny, Jeffrey Berliner, Susan Charlifue, Abigail Welch, Andrew Smith","doi":"10.1038/s41393-024-01008-2","DOIUrl":"10.1038/s41393-024-01008-2","url":null,"abstract":"Retrospective multi-site cohort study. To develop an accurate machine learning predictive model using predictor variables from the acute rehabilitation period to determine ambulatory status in spinal cord injury (SCI) one year post injury. Model SCI System (SCIMS) database between January 2000 and May 2019. Retrospective cohort study using data that were previously collected as part of the SCI Model System (SCIMS) database. A total of 4523 patients were analyzed comparing traditional models (van Middendorp and Hicks) compared to machine learning algorithms including Elastic Net Penalized Logistic Regression (ENPLR), Gradient Boosted Machine (GBM), and Artificial Neural Networks (ANN). Compared with GBM and ANN, ENPLR was determined to be the preferred model based on predictive accuracy metrics, calibration, and variable selection. The primary metric to judge discrimination was the area under the receiver operating characteristic curve (AUC). When compared to the van Middendorp all patients (0.916), ASIA A and D (0.951) and ASIA B and C (0.775) and Hicks all patients (0.89), ASIA A and D (0.934) and ASIA B and C (0.775), ENPLR demonstrated improved AUC for all patients (0.931), ASIA A and D (0.965) ASIA B and C (0.803). Utilizing artificial intelligence and machine learning methods are feasible for accurately classifying outcomes in SCI and may provide improved sensitivity in identifying which individuals are less likely to ambulate and may benefit from augmentative strategies, such as neuromodulation. Future directions should include the use of additional variables to further refine these models.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 8","pages":"446-453"},"PeriodicalIF":2.1,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421031","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}
Prospective observational study. Classification of spinal-cord injury and prediction of independence in activities of daily living (ADL) based on performance evaluations such as upper-limb function have not been reported. Therefore, this study aimed to establish a severity classification and calculate cutoff values for independence in ADL using the Capabilities of Upper Extremity Test (CUE-T) for individuals with cervical spinal-cord injury (CSCI). A spinal-cord injury rehabilitation center in Japan. This study included individuals with subacute CSCI. Collected data included the CUE-T and Spinal Cord Independence Measure III (SCIM III) scores. The severity classification was used for the hierarchical cluster analysis using the CUE-T. The cutoff values of CUE-T scores for independence in ADL were calculated using an adjustment model with logistic regression analysis. The dependent variable was binary (independent/non-independent) for each SCIM III Self-care item, and the independent variable was CUE-T. A total of 71 participants were included in the analysis. The severity of upper-limb dysfunction was classified into four categories using CUE-T. Significant differences in upper-limb function and ADL were observed between clusters. The cutoff values for CUE-T score for independence in ADL ranged from 37 to 91 points. All cutoff values showed good results in the internal validation, sensitivity analysis. This study determined the severity of upper limb function in CSCI and the cutoff values of CUE-T scores for independence in ADL. These results may help set criteria and goals for interventions in the clinical and research fields. None.
{"title":"Classification of upper-limb dysfunction severity and prediction of independence in activities of daily living after cervical spinal-cord injury","authors":"Kazumasa Jimbo, Kazuhiro Miyata, Hiroshi Yuine, Kousuke Takahama, Tomohiro Yoshimura, Honoka Shiba, Taichi Yasumori, Naohisa Kikuchi, Hideki Shiraishi","doi":"10.1038/s41393-024-01005-5","DOIUrl":"10.1038/s41393-024-01005-5","url":null,"abstract":"Prospective observational study. Classification of spinal-cord injury and prediction of independence in activities of daily living (ADL) based on performance evaluations such as upper-limb function have not been reported. Therefore, this study aimed to establish a severity classification and calculate cutoff values for independence in ADL using the Capabilities of Upper Extremity Test (CUE-T) for individuals with cervical spinal-cord injury (CSCI). A spinal-cord injury rehabilitation center in Japan. This study included individuals with subacute CSCI. Collected data included the CUE-T and Spinal Cord Independence Measure III (SCIM III) scores. The severity classification was used for the hierarchical cluster analysis using the CUE-T. The cutoff values of CUE-T scores for independence in ADL were calculated using an adjustment model with logistic regression analysis. The dependent variable was binary (independent/non-independent) for each SCIM III Self-care item, and the independent variable was CUE-T. A total of 71 participants were included in the analysis. The severity of upper-limb dysfunction was classified into four categories using CUE-T. Significant differences in upper-limb function and ADL were observed between clusters. The cutoff values for CUE-T score for independence in ADL ranged from 37 to 91 points. All cutoff values showed good results in the internal validation, sensitivity analysis. This study determined the severity of upper limb function in CSCI and the cutoff values of CUE-T scores for independence in ADL. These results may help set criteria and goals for interventions in the clinical and research fields. None.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 9","pages":"507-513"},"PeriodicalIF":2.1,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01005-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421030","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 : 2024-06-13DOI: 10.1038/s41393-024-01007-3
Joshua W. Peiffer, Angela Philippus, Karen Kanaster, Kimberley R. Monden
This is a secondary analysis of data from a cross-sectional, observational study. The study aimed to determine whether stigma mediates the relationship between preceived injustice and depression symptoms among individuals with spinal cord injuries. Secondary analysis of participants enrolled in the Spinal Cord Injury Model System at a specialty rehabilitation hospital in the Western United States. A sample of 225 participants completed the questionnaires; eight participants were removed due to incomplete data, resulting in a final sample size of 217 participants (79% male; 21% female). Participants were, on average, 53 years old and were predominantly male, white, and 20 years post-injury. A bootstrapping mediation analysis was conducted to evaluate the stigma-mediated relationship between injustice appraisals and depression symptoms. Injustice appraisals were assessed using the Injustice Experience Questionnaire, stigma with the Spinal Cord Injury Quality of Life Stigma–Short Form, and depression symptoms with the Patient Health Questionnaire–9. Stigma was found to mediate the relationship between injustice appraisals and depression, with an estimated proportion mediated of 80.9% (p ≤ 0.0001). This study provides a novel finding that the relationship between injustice appraisals and depression symptoms is mediated by stigma. Consistent with previous research, injustice appraisals were associated with greater severity of depression symptoms. Results provide further evidence for the role of injustice appraisals after spinal cord injury and a potential mechanism (i.e., stigma) by which it may exert its effect on depression symptoms.
{"title":"Understanding the association between perceived injustice, depression symptoms, and stigma in individuals with traumatic spinal cord injury","authors":"Joshua W. Peiffer, Angela Philippus, Karen Kanaster, Kimberley R. Monden","doi":"10.1038/s41393-024-01007-3","DOIUrl":"10.1038/s41393-024-01007-3","url":null,"abstract":"This is a secondary analysis of data from a cross-sectional, observational study. The study aimed to determine whether stigma mediates the relationship between preceived injustice and depression symptoms among individuals with spinal cord injuries. Secondary analysis of participants enrolled in the Spinal Cord Injury Model System at a specialty rehabilitation hospital in the Western United States. A sample of 225 participants completed the questionnaires; eight participants were removed due to incomplete data, resulting in a final sample size of 217 participants (79% male; 21% female). Participants were, on average, 53 years old and were predominantly male, white, and 20 years post-injury. A bootstrapping mediation analysis was conducted to evaluate the stigma-mediated relationship between injustice appraisals and depression symptoms. Injustice appraisals were assessed using the Injustice Experience Questionnaire, stigma with the Spinal Cord Injury Quality of Life Stigma–Short Form, and depression symptoms with the Patient Health Questionnaire–9. Stigma was found to mediate the relationship between injustice appraisals and depression, with an estimated proportion mediated of 80.9% (p ≤ 0.0001). This study provides a novel finding that the relationship between injustice appraisals and depression symptoms is mediated by stigma. Consistent with previous research, injustice appraisals were associated with greater severity of depression symptoms. Results provide further evidence for the role of injustice appraisals after spinal cord injury and a potential mechanism (i.e., stigma) by which it may exert its effect on depression symptoms.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 8","pages":"440-445"},"PeriodicalIF":2.1,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318308","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 : 2024-06-10DOI: 10.1038/s41393-024-01001-9
Michael G. Fehlings
{"title":"From the desk of Spinal Cord’s New Editor","authors":"Michael G. Fehlings","doi":"10.1038/s41393-024-01001-9","DOIUrl":"10.1038/s41393-024-01001-9","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 5","pages":"199-199"},"PeriodicalIF":2.2,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01001-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301680","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 : 2024-06-07DOI: 10.1038/s41393-024-01004-6
Xin Wang, Chun-Gu Hong, Ran Duan, Zhi-Lin Pang, Min-Na Zhang, Hui Xie, Zheng-Zhao Liu
Animal studies To evaluate the therapeutic effect of olfactory mucosa mesenchymal stem cell (OM-MSCs) transplantation in mice with spinal cord injury (SCI) and to explore the mechanism by which OM-MSCs inhibit neuroinflammation and improve SCI. Xiangya Hospital, Central South University; Affiliated Hospital of Guangdong Medical University. Mice (C57BL/6, female, 6-week-old) were randomly divided into sham, SCI, and SCI + OM-MSC groups. The SCI mouse model was generated using Allen’s method. OM-MSCs were immediately delivered to the lateral ventricle after SCI using stereotaxic brain injections. One day prior to injury and on days 1, 5, 7, 14, 21, and 28 post-injury, the Basso Mouse Scale and Rivlin inclined plate tests were performed. Inflammation and microglial polarization were evaluated using histological staining, immunofluorescence, and qRT-PCR. OM-MSCs originating from the neuroectoderm have great potential in the management of SCI owing to their immunomodulatory effects. OM-MSCs administration improved motor function, alleviated inflammation, promoted the transformation of the M1 phenotype of microglia into the M2 phenotype, facilitated axonal regeneration, and relieved spinal cord injury in SCI mice. OM-MSCs reduced the level of inflammation in the spinal cord tissue, protected neurons, and repaired spinal cord injury by regulating the M1/M2 polarization of microglia.
{"title":"Transplantation of olfactory mucosa mesenchymal stromal cells repairs spinal cord injury by inducing microglial polarization","authors":"Xin Wang, Chun-Gu Hong, Ran Duan, Zhi-Lin Pang, Min-Na Zhang, Hui Xie, Zheng-Zhao Liu","doi":"10.1038/s41393-024-01004-6","DOIUrl":"10.1038/s41393-024-01004-6","url":null,"abstract":"Animal studies To evaluate the therapeutic effect of olfactory mucosa mesenchymal stem cell (OM-MSCs) transplantation in mice with spinal cord injury (SCI) and to explore the mechanism by which OM-MSCs inhibit neuroinflammation and improve SCI. Xiangya Hospital, Central South University; Affiliated Hospital of Guangdong Medical University. Mice (C57BL/6, female, 6-week-old) were randomly divided into sham, SCI, and SCI + OM-MSC groups. The SCI mouse model was generated using Allen’s method. OM-MSCs were immediately delivered to the lateral ventricle after SCI using stereotaxic brain injections. One day prior to injury and on days 1, 5, 7, 14, 21, and 28 post-injury, the Basso Mouse Scale and Rivlin inclined plate tests were performed. Inflammation and microglial polarization were evaluated using histological staining, immunofluorescence, and qRT-PCR. OM-MSCs originating from the neuroectoderm have great potential in the management of SCI owing to their immunomodulatory effects. OM-MSCs administration improved motor function, alleviated inflammation, promoted the transformation of the M1 phenotype of microglia into the M2 phenotype, facilitated axonal regeneration, and relieved spinal cord injury in SCI mice. OM-MSCs reduced the level of inflammation in the spinal cord tissue, protected neurons, and repaired spinal cord injury by regulating the M1/M2 polarization of microglia.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 8","pages":"429-439"},"PeriodicalIF":2.1,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288692","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 : 2024-06-01DOI: 10.1038/s41393-024-01000-w
Qunya Qi, Ling Wang, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Weimin Zheng, Xin Chen, Qian Chen, Fang Li, Jubao Du, Jie Lu, Nan Chen
Cross-sectional study. To study the relationship between the structural changes in the cervical spinal cord (C2/3 level) and the sensorimotor function of children with traumatic thoracolumbar spinal cord injury (TLSCI) and to discover objective imaging biomarkers to evaluate its functional status. Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China. 30 children (age range 5–13 years) with TLSCI and 11 typically developing (TD) children (age range 6–12 years) were recruited in this study. Based on whether there is preserved motor function below the neurological level of injury (NLI), the children with TLSCI are divided into the AIS A/B group (motor complete) and the AIS C/D group (motor incomplete). A Siemens Verio 3.0 T MR scanner was used to acquire 3D high-resolution anatomic scans covering the head and upper cervical spinal cord. Morphologic parameters of the spinal cord at the C2/3 level, including cross-sectional area (CSA), anterior-posterior width (APW), and left-right width (LRW) were obtained using the spinal cord toolbox (SCT; https://www.nitrc.org/projects/sct ). Correlation analyses were performed to compare the morphologic spinal cord parameters and clinical scores determined by the International Standard for Neurological Classification of Spinal Cord Injuries (ISNCSCI) examination. CSA and LRW in the AIS A/B group were significantly lower than those in the TD group and the AIS C/D group. LRW was the most sensitive imaging biomarker to differentiate the AIS A/B group from the AIS C/D group. Both CSA and APW were positively correlated with ISNCSCI sensory scores. Quantitative measurement of the morphologic spinal cord parameters of the cervical spinal cord can be used as an objective imaging biomarker to evaluate the neurological function of children with TLSCI. Cervical spinal cord atrophy in children after TLSCI was correlated with clinical grading; CSA and APW can reflect sensory function. Meanwhile, LRW has the potential to be an objective imaging biomarker for evaluating motor function preservation.
{"title":"The relationship between the structural changes in the cervical spinal cord and sensorimotor function of children with thoracolumbar spinal cord injury (TLSCI)","authors":"Qunya Qi, Ling Wang, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Weimin Zheng, Xin Chen, Qian Chen, Fang Li, Jubao Du, Jie Lu, Nan Chen","doi":"10.1038/s41393-024-01000-w","DOIUrl":"10.1038/s41393-024-01000-w","url":null,"abstract":"Cross-sectional study. To study the relationship between the structural changes in the cervical spinal cord (C2/3 level) and the sensorimotor function of children with traumatic thoracolumbar spinal cord injury (TLSCI) and to discover objective imaging biomarkers to evaluate its functional status. Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China. 30 children (age range 5–13 years) with TLSCI and 11 typically developing (TD) children (age range 6–12 years) were recruited in this study. Based on whether there is preserved motor function below the neurological level of injury (NLI), the children with TLSCI are divided into the AIS A/B group (motor complete) and the AIS C/D group (motor incomplete). A Siemens Verio 3.0 T MR scanner was used to acquire 3D high-resolution anatomic scans covering the head and upper cervical spinal cord. Morphologic parameters of the spinal cord at the C2/3 level, including cross-sectional area (CSA), anterior-posterior width (APW), and left-right width (LRW) were obtained using the spinal cord toolbox (SCT; https://www.nitrc.org/projects/sct ). Correlation analyses were performed to compare the morphologic spinal cord parameters and clinical scores determined by the International Standard for Neurological Classification of Spinal Cord Injuries (ISNCSCI) examination. CSA and LRW in the AIS A/B group were significantly lower than those in the TD group and the AIS C/D group. LRW was the most sensitive imaging biomarker to differentiate the AIS A/B group from the AIS C/D group. Both CSA and APW were positively correlated with ISNCSCI sensory scores. Quantitative measurement of the morphologic spinal cord parameters of the cervical spinal cord can be used as an objective imaging biomarker to evaluate the neurological function of children with TLSCI. Cervical spinal cord atrophy in children after TLSCI was correlated with clinical grading; CSA and APW can reflect sensory function. Meanwhile, LRW has the potential to be an objective imaging biomarker for evaluating motor function preservation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 7","pages":"414-420"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01000-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186939","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}
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