Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"SCI Model Systems Complicated Urinary Tract Infection (cUTI) Guidelines: International Consensus on cUTI Likelihood Based on Symptoms.","authors":"Rochelle E Tractenberg, Ana Valeria Aguirre Guemez, Marla Petriello, Suzanne L Groah","doi":"10.46292/sci25-00019","DOIUrl":"10.46292/sci25-00019","url":null,"abstract":"<p><strong>Background: </strong>Complicated urinary tract infection (cUTI) is prevalent among people with spinal cord injury and disease (SCI/D). Diagnostic guidelines are neither consistent nor evidence based.</p><p><strong>Objectives: </strong>To establish consensus around symptoms-based diagnostic and decision-making criteria for cUTI for SCI/D.</p><p><strong>Methods: </strong>A representative sample of clinicians from PM&R, infectious disease, urology, and primary care within the United States (phase 1) and internationally (phase 2) participated in this study. Phase 1 involved focus groups and interviews to refine a decision-making paradigm for cUTI based on reliable and validated Urinary Symptom Questionnaires for Neurogenic Bladder (USQNBs: intermittent catheterization, indwelling catheterization, and voider versions). The phase 2 international Delphi survey on cUTI diagnostic criteria reflected phase 1 results. These criteria feature 6 \"profiles\": combinations of symptom number and types with associated likelihood of cUTI for each USQNB (18 total decisions).</p><p><strong>Results: </strong>Analyses of the phase 1 transcripts (<i>n</i> = 32) led to the Delphi design. Across the United States and internationally, 24 responses were obtained on the complete Delphi, with 48 responses on the USQNB for intermittent catheterization only. We achieved the a priori target 80% consensus on 13 of 18 decisions. The remaining 5 decisions reached 62.2% to 77.8% agreement. Changes were made based on respondent suggestions to clarify decisions and slightly modify risk descriptors. One hundred percent consensus among subject matter experts from 9 collaborating SCI model systems centers was achieved for the revisions.</p><p><strong>Conclusion: </strong>This is the first international and empirical initiative to establish cUTI symptoms-based guidelines for cUTI in SCI/D. These guidelines provide a coherent and evidence-based approach to decision making based on symptoms for clinicians and patients.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"101-120"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Standards for Neurological Classification of Spinal Cord Injury: Classification Questions and Cases.","authors":"Brittany Snider, Steven Kirshblum, Ruediger Rupp, Christian Schuld, Fin Biering-Sorensen, Stephen Burns, James Guest, Linda Jones, Andrei Krassioukov, Gianna Rodriguez, Mary Schmidt Read, Keith Tansey, Kristen Walden","doi":"10.46292/sci25-00013","DOIUrl":"10.46292/sci25-00013","url":null,"abstract":"<p><strong>Background: </strong>The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) have been refined through the years and continue to evolve with advances in the field. The International Standards Committee of the American Spinal Injury Association (ASIA) is responsible for maintaining, continually reviewing, and updating the ISNCSCI. Questions from spinal cord injury (SCI) professionals are frequently submitted to ASIA for review by the International Standards Committee.</p><p><strong>Methods: </strong>Of the questions submitted to the International Standards Committee, 5 were selected for this article, as they relate to common areas of confusion, address challenging classification concepts, and have not previously been described. Representative cases were also created to reinforce classification rules and the committee's recommendations.</p><p><strong>Cases: </strong>The 5 questions/cases address ISNCSCI classification in the setting of (1) AIS E grade, (2) tendon transfer, (3) spinal cord stimulation, (4) nontraumatic SCI (ntSCI) etiology, and (5) AIS D grade (vs. AIS B) based on the presence of non-key muscle function. Each case includes a detailed review of the correct classification components and thorough discussion of the impact the corresponding question has on the classification.</p><p><strong>Conclusion: </strong>The International Standards Committee provides answers to questions about ISNCSCI classification. The scenarios presented in this article address important classification rules and challenging concepts that have not previously been described. This article can serve as a useful reference when similar cases are encountered in clinical and research settings.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"77-88"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Low-Glycemic Index Diet on Postprandial Hypotension in Individuals With Chronic Spinal Cord Injury: Results From a Pilot Study.","authors":"Matthew Farrow, Jia Li, Sana Chahande, Raquel Minarsch, Tonya Orchard, Jan Schwab, Ceren Yarar-Fisher","doi":"10.46292/sci24-00044","DOIUrl":"10.46292/sci24-00044","url":null,"abstract":"<p><strong>Background: </strong>One in two individuals with spinal cord injury (SCI) experiences postprandial hypotension (PPH), a decline (>20 mm Hg) in systolic blood pressure (SBP) within 2 hours after eating. Consuming meals with a low glycemic index (GI) could prevent or lessen PPH.</p><p><strong>Objectives: </strong>To determine the effect of a low-GI diet on PPH and postprandial glucose and insulin in individuals with chronic SCI (>1 year postinjury).</p><p><strong>Methods: </strong>Eleven participants (6 males, 5 females; age 43 ± 11 years) with chronic SCI (C4-C7, 7; T4-T12, 4) took part in a randomized crossover study (low GI vs. high GI). On each occasion, BP, glucose, and insulin were measured in the fasted state and for 2 hours after consuming a breakfast meal (60% carbohydrate, 28% fat, 12% protein) in laboratory-controlled conditions. Participants wore an ambulatory BP monitor and continuous glucose monitor for 3 days at home, and consumed study meals that were macronutrient-matched across conditions.</p><p><strong>Results: </strong>The maximum decrease in systolic blood pressure (SBP) following the laboratory-controlled breakfast meals tended to be lower in the low-GI (14 ± 12 mm Hg) compared to the high-GI (24 ± 25 mm Hg) diet (<i>d</i> = 0.52, <i>P</i> = .056). Serum glucose (<i>P</i> < .01) and insulin (<i>P</i> = .026) concentrations were lower at 30 minutes in the low-GI diet. In the home setting, peak glucose concentrations were lower after lunch (<i>P</i> = .011) and dinner (<i>P</i> < .01) in the low-GI diet.</p><p><strong>Conclusion: </strong>A low-GI meal may be an effective solution to reduce the magnitude of PPH and peak glucose concentrations in individuals with chronic SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"30-41"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of SCIseg Automated Measurement of Midsagittal Tissue Bridges in Spinal Cord Injuries Using an External Dataset.","authors":"J R Connor, W A Thornton, K A Weber, D Pfyffer, P Freund, C Tefertiller, A C Smith","doi":"10.46292/sci25-00015","DOIUrl":"10.46292/sci25-00015","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the interrater reliability between an automated and manual measure of lesion damage following spinal cord injury (SCI) using T2-weighted magnetic resonance images (MRI).</p><p><strong>Methods: </strong>Twenty-one MRIs were collected from patients who had completed rehabilitation at Craig Hospital. Manual measurements of midsagittal tissue bridges were conducted by an experienced rater using OsiriX (Pixmeo Sarl, Geneva, Switzerland), and automated measures were taken using the SCIsegV2 automated function through the Spinal Cord Toolbox (SCT). Manual and automated measurements were compared using intraclass correlation coefficients (ICC). Percentage agreement and Cohen's kappa statistic were calculated to compare detection of midsagittal tissue bridges.</p><p><strong>Results: </strong>ICCs between the manual and automated measures were excellent (ICC 0.94, 95% CI 0.84-0.97, <i>P</i> < .001, for ventral tissue bridges; ICC 0.99, 95% CI 0.97-0.99, <i>P</i> < .001, for dorsal tissue bridges). Percentage agreement between raters was 90.8% for ventral, dorsal, and any midsagittal tissue bridge. Cohen's kappa for the detection of tissue bridges showed substantial agreement between the two raters for ventral, dorsal, and any tissue bridges (0.81, <i>P</i> < .001; 0.79, <i>P</i> < .001; and 0.81, <i>P</i> < .001, respectively).</p><p><strong>Conclusion: </strong>Measurements of midsagittal tissue bridges between manual and automated raters are reliable. Automated measurements may help to expedite research related to midsagittal tissue bridges and functional outcomes for individuals with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"39-49"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Audit Determining Standard of Care for Musculoskeletal Health in Children With Spinal Cord Disorders.","authors":"Jamie Ellis, Mary P Galea, Peter Simm, Sarah Knight, Adam Scheinberg","doi":"10.46292/sci24-00033","DOIUrl":"10.46292/sci24-00033","url":null,"abstract":"<p><strong>Background: </strong>Pediatric spinal cord disorders (SCD) are rare and devastating. However, evidence on the effect on musculoskeletal health management is limited.</p><p><strong>Objectives: </strong>To investigate the relationships between SCD characteristics and musculoskeletal complications in children with SCD.</p><p><strong>Methods: </strong>Medical records of patients admitted between January 2010 and December 2022 with SCD were retrospectively reviewed. Demographic data and the presence of hypercalcemia, fractures, scoliosis, hip dysplasia, spasticity, contractures, calcium, and vitamin D status were obtained (<i>N</i> = 100; male, 61%; median [IQR] age at diagnosis, 9 [9.5] years, range 0-17).</p><p><strong>Results: </strong>Traumatic diagnoses represented 36% of patients. Incidence of scoliosis was 41%, hip dysplasia 12%, pathological fractures 9%, spasticity 32%, contractures 27%, hypercalcemia 20%, and vitamin D insufficiency 28% of total. Hypercalcemia was associated with male patients (odds ratio [OR] 4.07, 95% CI 1.03-16.06) and wheelchair users (OR 6.77, 95% CI 1.99-23.84). Nonambulant subjects were at increased risk of having scoliosis (OR 11.69, 95% CI 3.04-44.96), hip dysplasia (OR 55.64, 95% CI 5.59-553.41), contractures (OR 10.72, 95% CI 2.64-43.53), spasticity (OR 3.19, 95% CI 1.14-8.87), and presence of three or more musculoskeletal-related complications (OR 27.03, 95% CI 5.62-130.10).</p><p><strong>Conclusion: </strong>Children with SCD are susceptible to many complications related to musculoskeletal health. This research provides comprehensive data on both traumatic and nontraumatic SCD disease etiologies in Victoria, Australia.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"101-110"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Vitamin D3 Supplementation in Elevating Circulating 25(OH)D Concentration in Individuals With Chronic Spinal Cord Injury (VitD-SCI): Evidence From a Randomized, Double-Blind, Placebo-Controlled Trial.","authors":"Anneke Hertig-Godeschalk, Martin W G Brinkhof, Claudio Perret, Anke Scheel-Sailer, Joelle L Flueck","doi":"10.46292/sci24-00077","DOIUrl":"10.46292/sci24-00077","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) are at increased risk for insufficient 25(OH)D levels and associated adverse health outcomes, highlighting the need for vitamin D supplementation. However, the optimal dosing strategy for vitamin D supplementation in this population remains unclear.</p><p><strong>Objectives: </strong>To evaluate the efficacy of medium-dose (MD) and high-dose (HD) vitamin D3 supplementation in raising 25(OH)D levels above the sufficiency threshold of 75 nmol/L in individuals with SCI.</p><p><strong>Methods: </strong>A 12-month randomized, double-blind, placebo-controlled, superiority clinical trial was conducted in 42 individuals living with SCI for at least 3 years and who had insufficient 25(OH)D levels at baseline. Participants (7 female, 35 male; age 48 ± 10 years; 32 with paraplegia, 10 with tetraplegia) were randomly assigned to the placebo, MD intervention (24,000 IU D3 once every 4 weeks), or HD intervention (24,000 IU D3 once every 2 weeks) group. Baseline 25(OH)D levels (43 ± 16 nmol/L) did not differ between intervention groups (<i>P</i> = .8).</p><p><strong>Results: </strong>Supplementation was well tolerated, and 25(OH)D levels remained well below the excess threshold. A dose-response effect on 25(OH)D levels was observed [<i>F</i>(2, 40) = 8.21, <i>P</i> < .001]. In the HD group, 46% of the participants reached sufficient levels. Participants having an incomplete lesion, higher baseline 25(OH)D levels, lower body mass index, supplementation during summer, autumn, or winter, or higher sun scores were more likely to reach sufficient 25(OH)D levels.</p><p><strong>Conclusion: </strong>Vitamin D3 supplementation effectively increased 25(OH)D concentration to sufficient levels in participants with specific characteristics. Higher supplementation doses are needed to successfully increase 25(OH)D levels in all individuals with chronic SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"61-73"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding After Spinal Cord Injury: A Systematic Review of Prevalence and Associated Complications.","authors":"Andrei Krassioukov, Amanda H X Lee, Stacy Elliott, Teri Thorson, Nathan Agon-Chen, Gavin Naicker, Matthew Querée, Janice Eng","doi":"10.46292/sci24-00035","DOIUrl":"10.46292/sci24-00035","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding can be a vital component for maternal and infant health, but successful breastfeeding may be especially difficult for mothers with spinal cord injury (SCI). No reliable research on prevalence or complications associated with breastfeeding for mothers with SCI currently exists.</p><p><strong>Methods: </strong>Our systematic review aimed to answer the following: (1) What are the breastfeeding rates in women after SCI? (2) What are the rates and nature of postpartum complications reported by women with SCI in conjunction with breastfeeding?</p><p><strong>Results: </strong>Ten studies were included; the reported rates at which women with SCI were able to breastfeed varied widely, ranging from 11% to 100%. Generally speaking, women with higher-level SCI (above T6) were less likely to breastfeed and would breastfeed less frequently than women with lower-level SCI and less frequently than women without SCI. Complications reported included problems with the let-down reflex, autonomic dysreflexia, and a higher incidence of postpartum depression in women with SCI.</p><p><strong>Conclusion: </strong>More research on mothers with SCI is needed, especially matched-control research comparing mothers with and without SCI on successful breastfeeding and associated complications.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"52-65"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Access to Neuropsychological Services for Individuals with Spina Bifida: Insights from the 2022 Provider Survey.","authors":"Lizabeth L Jordan, Rosalia Costello, Beatriz MacDonald, Amy Heffelfinger, Erin F Jones, T Andrew Zabel, Jennifer T Queally","doi":"10.46292/sci24-00023","DOIUrl":"10.46292/sci24-00023","url":null,"abstract":"<p><strong>Background: </strong>Many people with spina bifida (SB) have congenital brain malformations and receive neurosurgical intervention that can impact cognitive, behavioral, and emotional functioning. The Spina Bifida Association's (SBA) guidelines for care recommend that people with SB have neuropsychology evaluations to assess cognitive, behavioral, and emotional functioning throughout their lifespan; however, people with SB anecdotally report having trouble finding and accessing such care.</p><p><strong>Objectives: </strong>The goal of this study was to gain information about neuropsychology services available to people with SB and identify possible barriers to care.</p><p><strong>Methods: </strong>Neuropsychologists in the United States were invited to complete a practice-focused survey created by members of the Spina Bifida Neuropsychology Collaborative (SBNC). The survey was emailed to professional neuropsychology listservs and directly to providers at the SBA Clinic Care Partner and National Spina Bifida Patient Registry (NSBPR) sites.</p><p><strong>Results: </strong>Responses from 34 neuropsychologists (representing 22 sites, including 40% of SBA Clinic Care Partner sites and 67% of NSBPR sites) indicated that multilingual SB-focused neuropsychology services are available within all regions of the United States. Comprehensive, outpatient evaluations are common; however, integration of neuropsychology services into inpatient settings and multidisciplinary clinics is limited. Respondents report that waitlist time is the most frequent barrier to neuropsychology care, followed by cost/insurance/payor type, travel/transportation difficulties, and limited referrals.</p><p><strong>Conclusion: </strong>There are considerable gaps in the currently available array of US-based neuropsychology services for individuals with SB. Neuropsychologists and SB clinical programs are encouraged to strategically increase availability of neuropsychological services and expand care options.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"104-113"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Virtual Walking on Neuropathic Pain in People With Spinal Cord Injury: A Systematic Review.","authors":"Sara Molla-Casanova, Elena Muñoz-Gomez, Marta Ingles de la Torre, Noemi Moreno-Segura, Pilar Serra-Año","doi":"10.46292/sci24-00078","DOIUrl":"10.46292/sci24-00078","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain after a spinal cord injury (SCI) is a common disorder whose management is highly complex. New therapies based on mirror neuron activation have been studied to address this problem.</p><p><strong>Objectives: </strong>This systematic review aims to update the information about the effect of virtual walking (VW) systems on pain in people with complete or incomplete SCI.</p><p><strong>Methods: </strong>Five databases (MEDLINE, Cochrane, Scopus, Embase, and PEDro) were consulted to find clinical trials on the topic. An Excel table was designed to collect all selected study data, including information about the design, objectives, samples, interventions, outcomes, and main results. PEDro scale was used to assess study quality.</p><p><strong>Results: </strong>Ten studies were included in this systematic review. Six of them were clinical trials, and the methodological quality of the studies was moderate to high. The results of these trials support that VW reduces neuropathic pain in complete and incomplete SCI patients. This effect can be enhanced and maintained if combined with other therapies such as transcranial direct current stimulation.</p><p><strong>Conclusion: </strong>Isolated VW is effective in reducing neuropathic pain in complete and incomplete SCI patients, and these effects are enhanced when combined with other therapies.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"32-51"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Likely Incidents of Traumatic Spinal Cord Injury and Elevated Risk of Alzheimer's Disease and Related Dementia: Health Care Cost Institute Data.","authors":"Adit Doza, Paul Lin, Gianna M Rodriguez, Christine Cigolle, Elham Mahmoudi","doi":"10.46292/sci24-00050","DOIUrl":"10.46292/sci24-00050","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the association between incident traumatic spinal cord injury (TSCI) and the risk of Alzheimer's disease and related dementia (ADRD).</p><p><strong>Methods: </strong>This is a longitudinal case-control study. We used 2012-2019 commercial insurance claims data from the Health Care Cost Institute (HCCI) and applied semi-parametric Cox survival models to compute hazard ratio (HR) for ADRD diagnosis comparing cases with incident TSCI with their controls without TSCI, adjusting for age, sex, a set of comorbid conditions, and any use of 6 classes of prescription medications. To reduce potential selection bias, we conducted a probability matching between cases (<i>n</i> = 251) and controls (<i>n</i> = 2480) using a 1:10 ratio without replacement based on age, sex, diagnosed chronic conditions, and index year of the TSCI diagnosis.</p><p><strong>Results: </strong>Cases with incident TSCI had a higher HR of 2.39 (95% CI 1.19-4.80) for ADRD compared to their matched controls. Our sensitivity analysis of removing cases with traumatic brain injury at the index TSCI date or afterward did not change the results (HR 2.21, 95% CI 1.06-4.62).</p><p><strong>Conclusion: </strong>Incident TSCI is associated with an increased risk of ADRD. Clinical guidelines for people with TSCI should consider the early and regular use of cognitive screening.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"188-198"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}