Mechanisms of Traumatic Spinal Cord Injury AIS Grade Conversion.

IF 1.8 Q3 CLINICAL NEUROLOGY
Neurotrauma reports Pub Date : 2025-06-16 eCollection Date: 2025-01-01 DOI:10.1089/neur.2025.0035
Jesse A Stokum, Riccardo Serra, Nicole Gorny, Bradley Wilhelmy, Timothy J Chryssikos, Gary Schwartzbauer, Bizhan Aarabi, Volodymyr Gerzanich, J Marc Simard
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引用次数: 0

Abstract

Spinal cord injury (SCI) remains a major unsolved problem that permanently impairs the lives of innumerable individuals worldwide. Although advances in the basic, pre-clinical and clinical sciences of SCI hold promise for patients, clinicians may lack a full insight into the relevant cellular and molecular events, and laboratory researchers may underappreciate how cellular and molecular phenomena translate into meaningful functional outcomes. To help bridge these perspectives, we first review the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade, which is the principal instrument used to gauge clinical outcomes in SCI, and the clinically important concept of AIS grade "conversion" (improvement), which occurs in some but not all patients. We then review underlying mechanisms that contribute to the AIS grade and its conversion, including mechanisms of transient neurological dysfunction (neuronal and axonal "stunning"), mechanisms of secondary cell loss (apoptosis, pyroptosis, and necroptosis), and mechanisms of axonal loss (primary axotomy and secondary axonal degeneration). Finally, we briefly review approaches to clinical management that may ameliorate identified mechanisms of secondary tissue loss and neurological dysfunction following SCI.

外伤性脊髓损伤AIS级转换机制。
脊髓损伤(SCI)仍然是一个主要的未解决的问题,它永久性地损害了全世界无数人的生命。尽管SCI的基础、临床前和临床科学的进步为患者带来了希望,但临床医生可能缺乏对相关细胞和分子事件的全面了解,实验室研究人员可能低估了细胞和分子现象如何转化为有意义的功能结果。为了帮助弥合这些观点,我们首先回顾了美国脊髓损伤协会(ASIA)损伤量表(AIS)分级,这是衡量脊髓损伤临床结果的主要工具,以及临床上重要的AIS分级“转换”(改善)概念,这发生在一些但不是所有患者身上。然后,我们回顾了导致AIS分级及其转化的潜在机制,包括短暂性神经功能障碍机制(神经元和轴突“昏迷”)、继发性细胞损失机制(凋亡、焦亡和坏死)和轴突损失机制(原发性轴突切断和继发性轴突变性)。最后,我们简要回顾了可能改善脊髓损伤后继发性组织损失和神经功能障碍机制的临床治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.40
自引率
0.00%
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审稿时长
8 weeks
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