SPINAL MOTOR CONDUCTION AND RECOVERY AFTER HUMAN SCI

人类脊髓损伤后的脊髓运动传导和恢复

• 批准号: 6495549
• 负责人: Blair Calancie
• 金额: $ 26.27万
• 依托单位: UPSTATE MEDICAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-01 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6495549
• 关键词: behavioral /social science research tag; clinical research; electromyography; functional ability; human subject; magnetic resonance imaging; medical rehabilitation related tag; muscle strength; neural conduction; rehabilitation; spinal cord injury; spinal reflex

DESCRIPTION: (Applicant's Abstract) Little is known about the mechanisms within the spinal cord which allow some persons with spinal cord injury to recover significant function, while others do not. We propose to conduct a series of electrophysiological and behavioral measures on persons with acute spinal cord injury who are admitted to Jackson Memorial Hospital. Subjects will be studied as many as 12 times after injury, in order to accurately define the time-course of any neurologic improvement or alteration seen. Approximately 150 subjects will be enrolled over a 5 year period. Clinical strength (through manual muscle test) and muscle electrical activity (EMG) will be recorded from multiple muscles of the arms and legs for persons with injury to the cervical spine, or from the legs in persons with injury to the thoracic or thoracolumbar spine. In addition to voluntary contractions, non-invasive magnetic stimulation of the brain will be used in some subjects to cause contractions of muscles made weak by the spinal cord injury. The size of the evoked EMG response, the time at which the response occurs, and the intensity of brain stimulation needed to cause a response will be determined for each muscle, to provide objective measures of conduction in spinal cord motor tracts. Reflex responses will be measured to estimate spinal cord excitability, and magnetic resonance images of the region of damage will be obtained at 3, 12, and 24 months after injury in a subset of individuals who have recovered some voluntary movement in the legs, in order to match changes in tissue properties (e.g. edema, myelination) with clinical function. In addition to providing valuable scientific information not currently available, this project will benefit attempts to implement clinical trials of treatment interventions for spinal cord injury - trials which are now being seriously considered and for which animal studies are underway. Specifically, the information gained from the successful completion of studies proposed herein will: 1) provide some sense of a given subjects's potential for spontaneous recovery of volitional motor activity and its time-course, to help establish whether there is an optimal time post-injury to apply whatever interventions are developed; 2) contribute towards the development of objective measures for prognosis; 3) develop criteria to select the most appropriate candidates for a particular intervention; and 4) guide decisions regarding which type of intervention might be most advantageous for a certain type of injury.

描述：（申请人的摘要）对机制知之甚少 在脊髓中，一些脊髓损伤的人 恢复重要的功能，而其他功能则没有。 我们建议进行 急性人士的一系列电生理和行为测量 被送往杰克逊纪念医院的脊髓损伤。 主题 受伤后将研究多达12次，以便准确 定义所看到的任何神经系统改善或改变的时间顺序。 在5年期间，将大约150名受试者入学。 临床 强度（通过手动肌肉测试）和肌肉电活动（EMG） 将从多个胳膊和腿的肌肉中记录 颈椎受伤，或因受伤的人而受伤 胸椎或胸骨脊柱。 除了自愿收缩， 大脑的非侵入性磁刺激将用于某些受试者 引起肌肉收缩因脊髓损伤而变得虚弱。 这 诱发的EMG响应的大小，发生响应的时间以及 引起反应所需的大脑刺激强度将是 确定每个肌肉，以提供客观的传导度量 脊髓运动区。 反射响应将测量以估计 脊髓兴奋性和磁共振图像 受伤后的3、12和24个月将在一部分中获得损害 恢复了腿部自愿运动的个人 要匹配组织特性的变化（例如水肿，髓鞘化） 临床功能。 除了提供有价值的科学信息，而不是目前 可用，该项目将有益于实施临床试验的尝试 脊髓损伤的治疗干预措施 - 现在的试验 认真考虑并正在进行动物研究。 具体而言，从成功完成的信息中获得的信息 本文提出的研究将：1）对给定受试者的某种感觉 自发恢复自发性运动活动及其的潜力 时间课，以帮助确定伤害后是否有最佳时间 应用任何开发的干预措施； 2）为 制定预后的客观措施； 3）制定标准 为特定干预措施选择最合适的候选人；和4） 指导有关哪种干预类型的决定最多 有利于某种类型的伤害。