Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Urinary Tract Infection Diagnosis Among People With Neurogenic Lower Urinary Tract Infection Due to Spinal Cord Injury and Disease: Time for a Change.","authors":"Suzanne L Groah, Alan Wolfe","doi":"10.46292/sci24-00064","DOIUrl":"10.46292/sci24-00064","url":null,"abstract":"<p><p>Urinary tract infection (UTI) is the most common infection for people with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury/disease (SCI/D). While the current diagnostic pillars include symptoms, inflammation, and bacterial load, each is uniquely problematic when applied to NLUTD-related UTI. Authoritative guidelines have not taken into account the impact of bladder management on symptoms; baseline inflammation in the absence of symptoms limits usefulness of white blood count; and bacteriuria in the absence of symptoms and limitations of standard urine culture (SUC) limits utility of SUC-based determination of bacterial load. Newer approaches are being developed to better guide diagnosis and antibiotic use. These include the Urinary Symptom Questionnaires for Neurogenic Bladder for symptom measurement and decision-making around symptoms, novel inflammatory markers (urine NGAL, IL-1, and IL-8), and culture-independent microbial detection methods. Rapid antimicrobial susceptibility testing (AST) methods have been developed utilizing a number of different approaches, increasing the likelihood of point-of-care application in the future. Advancements in UTI diagnosis will include reconceptualization of \"urine is sterile\" to \"eubiosis and dysbiosis,\" symptom complexes to aid decision-making, use of novel inflammatory markers, and less reliance on SUC with increased emphasis on culture-independent methods for bacterial identification, AST, and decision-making.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"141-146"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565655","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":"Multiomic Analysis of the Gut Microbiome and Serum Metabolome in Response to a Low-Carbohydrate, High-Protein Diet in Individuals With Spinal Cord Injury.","authors":"Jia Li, Phillip G Popovich, Kristina A Kigerl, Dana M McTigue, Jan Schwab, Stephen Barnes, Ceren Yarar-Fisher","doi":"10.46292/sci24-00061","DOIUrl":"10.46292/sci24-00061","url":null,"abstract":"<p><strong>Background: </strong>Dietary interventions play a significant role in preventing and managing cardiometabolic diseases partly through their impact on the gut microbiome and circulating metabolites.</p><p><strong>Objectives: </strong>To assess the impact of an 8-week low-carbohydrate, high-protein (LC/HP) diet on gut microbiome composition, function, and serum metabolome in individuals with spinal cord injury (SCI).</p><p><strong>Methods: </strong>Twenty-four adults with chronic SCI were randomized into an LC/HP diet or a control group for 8 weeks. Stool and fasting serum samples were collected at baseline and week 8. The gut microbiome composition and metabolic potential were determined using metagenomic sequencing, while serum metabolome was assessed through untargeted liquid chromatography-tandem mass spectrometry. Statistical analyses focused on diet and time interaction effects, using R (version 4.1.0).</p><p><strong>Results: </strong>A trend for increased alpha diversity (Gini-Simpson, <i>P</i> = .09) in the diet group indicated a more evenly distributed microbial community. Compared to the control group, several microbiome species (e.g., <i>Fusicatenibacter saccharivorans, Eubacterium siraeum)</i> that are implicated with better intestinal health and reduced inflammation increased, while other species (e.g., <i>Hungatella hathewayi, Clostridium symbiosum</i>) that are associated with colorectal cancer risk decreased in the diet group. Microbial metabolic pathways related to amino acid and purine nucleotides were altered. Increased tryptophan betaine and decreased 8-hydroxy-deoxyguanosine were observed in the serum in the diet group (<i>P</i> _interaction < .05), indicating compliance and reduced oxidative stress, respectively.</p><p><strong>Conclusion: </strong>Adopting an LC/HP diet resulted in favorable gut microbiome and metabolome adaptations that may reduce the risk for cardiometabolic disease and colorectal cancer in individuals with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"111-129"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565579","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":"Development and Validation of an Algorithm for Item Reduction of the International Standards for Neurological Classification of Spinal Cord Injury Examination to Determine Level and Severity of SCI.","authors":"Stephen P Burns, Kristen Walden, Steven Kirshblum, Mary Schmidt-Read, Keith Tansey, Christian Schuld, Ruediger Rupp","doi":"10.46292/sci25-00008","DOIUrl":"10.46292/sci25-00008","url":null,"abstract":"<p><strong>Background: </strong>In 2020, a first, expedited version of the International Standards for Neurological Classification of Spinal Cord Injury (E-ISNCSCI-V1) was proposed for determination of neurological level of injury (NLI) and American Spinal Injury Association Impairment Scale (AIS) classifications.</p><p><strong>Objectives: </strong>This work describes assessment of E-ISNCSCI-V1 classification accuracy and the development and data-based validation of an ISNCSCI Item Reduction Algorithm (IIRA).</p><p><strong>Methods: </strong>Classification accuracy for E-ISNCSCI-V1 examination shortcut options was assessed with automated analysis of 7026 full ISNCSCI examinations. Rules for the IIRA were iteratively adjusted to optimize the balance between omitting exam items and minimizing misclassification errors, and then it was validated through classification of 100 full ISNCSCI exams.</p><p><strong>Results: </strong>If S1 findings are substituted for anorectal exam findings as proposed for E-ISNCSCI-V1, the error rate for AIS is 10%, with a high error rate (45%) for classifying true AIS B. The IIRA, which begins with full motor testing, followed by limited sensory testing required an average of 31% (42/134) of the full ISNCSCI exam items, with a 2% error rate for NLI and no AIS errors.</p><p><strong>Conclusion: </strong>The previously proposed E-ISNCSCI-V1, which included an option to substitute S1 findings for anorectal exam findings, is not recommended due to AIS error rate. The IIRA provides a standardized option for a shortened examination classifying NLI and AIS with high accuracy. It will serve as a basis for version 2 of the E-ISNCSCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"61-67"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973833","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 Exercise Interventions on Cardiac Structure, Function, and Mechanics in Individuals with Chronic Motor-Complete Spinal Cord Injury: An Exploratory Randomized Clinical Trial.","authors":"Shane J T Balthazaar, Tom E Nightingale, Abdullah A Alrashidi, Katharine D Currie, Andrei V Krassioukov","doi":"10.46292/sci24-00002","DOIUrl":"10.46292/sci24-00002","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) at or above T6 face increased cardiovascular disease (CVD) risks due to altered autonomic control and physical inactivity. Arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) may improve cardiovascular health, but the impact on cardiac structure and function remains unclear.</p><p><strong>Objectives: </strong>The study aimed to compare the impact of two exercise interventions on cardiac measures in individuals with chronic SCI.</p><p><strong>Methods: </strong>Participants with motor-complete SCI (C4-T6, American Spinal Injury Association Impairment Scale [AIS] grade A or B) were randomly assigned to perform 72 ACET or BWSTT sessions. Left ventricular (LV) echocardiography assessments were performed pre and post training. Data were analyzed using a two-way repeated measures analysis of variance and effect sizes (Cohen's <i>d</i>).</p><p><strong>Results: </strong>Twelve participants underwent analysis (6 per group), revealing significant Group (ACET, BWSTT) x Time (pre, post) interactions for global circumferential systolic and diastolic strain rate (SR) and early diastolic filling velocity (<i>P</i> ≤ .018; Cohen's <i>d</i> > .8/ -.8). Within-group post hoc testing demonstrated a significant decrease in global circumferential systolic SR (<i>P</i> < .001, <i>d</i> = -4.00) and a significant increase in global circumferential diastolic SR (<i>P</i> = .025, <i>d</i> = 2.48) following ACET, with no significant differences following BWSTT. Although there were no statistically significant within-group post hoc changes (<i>P</i> > .58) for diastolic filling, there was a large effect size favoring ACET (<i>d</i> = 1.11).</p><p><strong>Conclusion: </strong>This exploratory study suggests that ACET alters LV mechanics and potentially diastolic function in a cohort of individuals with chronic, cervical or upper thoracic, motor-complete SCI. Conversely, no significant changes were observed following BWSTT. These findings indicate that ACET can improve cardiac function relative to BWSTT in individuals with SCI, though further studies are warranted.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"62-75"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530244","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 Spinal Cord Injury Fracture History Extended Data Set.","authors":"Leslie R Morse, William A Bauman, B Catharine Craven, William D Leslie, Thomas J Schnitzer, Karen Troy, Fin Biering-Sorensen","doi":"10.46292/sci25-00025","DOIUrl":"10.46292/sci25-00025","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the study is to develop the International Spinal Cord Injury (SCI) Fracture History Extended Data Set within the framework of the International SCI Data Sets to permit consistent collection and reporting of fracture history in the SCI population.</p><p><strong>Methods: </strong>The International SCI Fracture History Extended Data Set has been developed by a working group. The initial data set was open for 2 months for discussion and was revised based on suggestions from members of the International SCI Data Sets Committee, the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, American Spinal Injury Association (ASIA) Board, other interested organizations, societies, and individual reviewers. The data set was also posted for 2 months for comments on ISCoS's and ASIA's websites.</p><p><strong>Results: </strong>The final data set contains questions on fractures after SCI. Because the information may be collected at any time, the date of data collection is important to capture relative to the time lapsed after SCI. The data set includes information on fracture history (location, etiology, treatment, complications for each fracture event), osteoporosis treatment (current and past use), bone measures by quantitative computed tomography (6 variables), and body composition (7 variables). The complete instructions for data collection and the data sheet itself are freely available on the ISCoS website (https://cdn.ymaws.com/www.iscos.org.uk/resource/resmgr/fracture/iscieds_fracture_1.pdf).</p><p><strong>Conclusion: </strong>The data set proposes to collect information on bone loss, other factors potentially predictive of fracture risk, and fracture in persons with SCI to guide clinical management and future research activities.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"121-128"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973798","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":"Systematic Search and Modified e-Delphi Consensus for Serum Bone Biomarkers in Humans and Animal Models with SCI: Methodology.","authors":"Philemon Tsang, Matthew Cleland, Matheus Wiest, Kristine C Cowley, Emily Newton, Eleni Patsakos, Matteo Ponzano, Lora Giangregorio, Saina Aliabadi, Katrina Armstrong, Karim Fouad, David Magnuson, B Catharine Craven","doi":"10.46292/sci24-00042","DOIUrl":"10.46292/sci24-00042","url":null,"abstract":"<p><strong>Introduction: </strong>Alterations to bone metabolism deteriorations in bone density and architecture after spinal cord injury (SCI) are complex and multifactorial: mechanical unloading, impaired osteoblast activity, altered hormone levels, and regional blood flow combine to increase lower extremity fracture incidence and mortality. Bone biomarkers are vital to detect disease, identify candidate therapies, monitor therapy effectiveness, and quantify fracture risk.</p><p><strong>Objectives: </strong>This study aimed to synthesize available literature on serum and plasma bone biomarkers in both animal and human SCI models and to generate consensus regarding their appropriateness for use across the translational continuum.</p><p><strong>Methods: </strong>A systematic search was conducted; 4731 studies were excluded, yielding 125 studies for data extraction. Data were reviewed by an interdisciplinary panel of experts. Through a modified e-Delphi process, consensus statements were iteratively developed regarding the appropriateness of 14 serum bone biomarkers in human and animal models and across the translational continuum.</p><p><strong>Results: </strong>The consensus process highlighted challenges in interpreting animal and human models, emphasizing the need for methodological rigor and standardized biomarker reporting. Consideration of diurnal variations in biomarkers and model selection (transection vs. clip) underscored the complexity of SCI research. Limitations included defining \"adult\" rodents and lack of data on sex-related differences in biomarkers and their interpretation, given most human data were obtained from males and animal data from females.</p><p><strong>Conclusion: </strong>The consensus statements provide guidance, address gaps in reporting and interpretation of biomarkers, promote use of standardized protocols and assay kits, and emphasize interdisciplinary approaches to advancing scientific discovery and facilitating knowledge translation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"13-28"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530250","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":"ISNCSCI Exam Changes Following Spinal Cord Stimulation.","authors":"Ryan J Solinsky, Daniel D Veith, Megan L Gill, Lisa A Beck, Candee J Mills, Anders J Asp, K A Fernandez, Omid Jahanian, Kristin D Zhao, Peter J Grahn","doi":"10.46292/sci25-00017","DOIUrl":"10.46292/sci25-00017","url":null,"abstract":"<p><strong>Objectives: </strong>To describe changes in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam in sublesional motor and sensory domains following short-term epidural electrical stimulation of lumbosacral spinal segments in individuals with spinal cord injury (SCI).</p><p><strong>Methods: </strong>Twenty individuals with SCI underwent implantation of percutaneous epidural spinal cord stimulation followed by stimulation parameter optimization and 10-12 sessions of stimulation-enabled motor training. Pre-/postintervention ISNCSCI exams were compared to determine changes in motor/sensory scores for regions within 3 levels of the neurological level of injury (NLI) and caudal to this, with subanalyses per motor/sensory complete versus incomplete baseline status.</p><p><strong>Results: </strong>Individuals with motor complete SCI gained 6% ± 3% of available motor points within 3 levels of NLI and 1% ± 0% of motor points caudal to this (<i>P</i> = .08). Motor incomplete individuals gained 9% ± 22% of available motor points within 3 levels of NLI and lost 4% ± 7% of motor points caudal to this (<i>P</i> = .63). Following stimulation, changes in motor scores with potential high functional impact occurred in 3 individuals (5 total muscle groups with conversion from baseline <3/5 strength to ≥3/5 at completion). Individuals with sensory complete SCI had fewer sensory gains within 3 levels of NLI (6%) compared to those with sensory incomplete SCI (30%, <i>P</i> = .02).</p><p><strong>Discussion: </strong>Spinal cord stimulation after SCI rapidly induces changes in both motor and sensory domains that are retained after stimulation is removed. These changes primarily occur within 3 levels of the NLI and occur to a greater degree in those with incomplete SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"68-76"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973838","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":"German Transcreation of the International Standards to Document Remaining Autonomic Function After Spinal Cord Injury (Second Edition): A Feasibility Study in Individuals With Subacute Phase Spinal Cord Injury/Disease (SCI/D).","authors":"Carole Niederberger, Elena Henes, Andrei V Krassioukov, Michael Baumberger, Jörg Krebs, Jürgen Pannek, Matthias Walter, Anke Scheel-Sailer","doi":"10.46292/sci25-00010","DOIUrl":"10.46292/sci25-00010","url":null,"abstract":"<p><strong>Background: </strong>In May 2021, the second edition of International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) was published.</p><p><strong>Objectives: </strong>To transcreate the 2021 ISAFSCI (2nd ed.) to German and to assess its feasibility in the subacute phase following spinal cord injury/disease (SCI/D).</p><p><strong>Methods: </strong>Transcreation to German was performed by an interdisciplinary team of native English and German speakers. We screened individuals with SCI/D for eligibility (i.e., age ≥18 years; >3 months following SCI/D) between August 2021 and January 2022. To minimize the time for the assessment, we first interviewed participants in a supine position before conducting the clinical examination. We assessed participants thrice within 14 days using a randomized sequence of assessors, and we assessed SCI/D according to the International Standards for Classification of Spinal Cord Injury (ISNCSCI) grading of the SCI/D, including the American Spinal Injury Association Impairment Scale (AIS). Time of ISAFSCI assessments (median and quartiles) and its completeness (%) were calculated.</p><p><strong>Results: </strong>Twelve participants (3 females; median age 42 years [Q1: 31, Q3: 54]) were enrolled and assessed thrice. Severity and level of injury were either sensorimotor complete (AIS A, 9) or incomplete (AIS C, 3) SCI/D and tetraplegia (<i>n</i> = 5) or paraplegia <i>(n</i> = 7), respectively. Median time to complete an assessment was 39 minutes (Q1: 32, Q3: 46).</p><p><strong>Conclusion: </strong>The German version of the ISAFSCI second edition is feasible to perform in a subacute cohort. However, given the subacute stage following SCI, certain limitations must be acknowledged. Many participants have not yet engaged in sexual activity, which limits the evaluation of sexual function.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"89-100"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973796","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":"Percutaneous Spinal Cord Stimulator Enables Novel Clonus Biomarker and Management in Persons With Spinal Cord Injury and Multiple Sclerosis: An Exploratory Study.","authors":"Anders J Asp, Megan L Gill, Daniel D Veith, Omid Jahanian, K A Fernandez, Candee J Mills, Andrew R Thoreson, Jonathan M Hagedorn, Markus A Bendel, Ryan J Solinsky, W Oliver Tobin, Kristin D Zhao, Peter J Grahn","doi":"10.46292/sci24-00070","DOIUrl":"10.46292/sci24-00070","url":null,"abstract":"<p><strong>Background: </strong>Spasticity is common in spinal cord injury (SCI) and multiple sclerosis (MS), and it can manifest as repeated, rhythmic muscle contractions called clonus. The spontaneous nature of clonus can disrupt independent performance of activities of daily living and negatively impact overall health and quality of life.</p><p><strong>Objectives: </strong>To quantify biomarkers of clonus and explore management of clonus in individuals with SCI or progressive MS using epidural spinal cord stimulation (ES) or dorsal root stimulation (DRS).</p><p><strong>Methods: </strong>Four male participants were included in this case series study: 3 with SCI and 1 with MS. All participants underwent temporary percutaneous ES lead placement over the dorsolateral thoracolumbar region of the spinal cord. Participants with SCI were also implanted with DRS leads at the L4 dorsal root. Clonus was elicited mechanically at the ankle while recording electromyography of the soleus muscle synchronized to direct spinal cord field potential recordings from ES and DRS percutaneous leads.</p><p><strong>Results: </strong>Clonus was evident as a prominent band (5-8 Hz) in recordings from ES leads, DRS leads, soleus muscle, and accelerometry. In 4 participants, percutaneous spinal stimulation reduced median clonus duration and cycle count. Clonus was immediately suppressed upon activation of spinal cord stimulation, and the suppression persisted even when clonus was reinitiated after turning off the stimulation.</p><p><strong>Conclusion: </strong>The use of objective biomarkers, including spinal cord potentials, to quantify clonus in real time combined with the immediate and reversible effects of stimulation highlight the potential of neuromodulation as a therapeutic tool for managing clonus. These data demonstrate preliminary efficacy of ES and DRS for clonus monitoring and treatment in 4 participants.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"114-124"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186981","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":"Different Circulating Endothelial Microvesicle Subtype Signature in Subacute and Chronic Spinal Cord Injury.","authors":"Andrew J Park, Hannah K Fandl, Vinicius P Garcia, Auburn R Berry, Kendra N Wegerson, Emily I Ostrander, Hannah L Cardenas, Noah M DeSouza, Jared J Greiner, Brian Stauffer, Christopher A DeSouza","doi":"10.46292/sci24-00068","DOIUrl":"10.46292/sci24-00068","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to determine whether circulating concentrations of activation- and apoptosis-derived endothelial cell-derived microvesicles (EMVs) differ between adults after subacute (time since injury ≤6 months) and chronic (time since injury >12 months) spinal cord injury (SCI).</p><p><strong>Methods: </strong>Peripheral blood was collected from 43 adults (age range 18-71 years): 12 non-injured adults (9 male/3 female), 16 adults with subacute cervical and high thoracic (C2-T3) motor complete injuries (13 male/3 female; time since injury 1-3 months), and 15 adults with chronic cervical and high thoracic (C1-T2) motor complete injuries (14 male/1 female; time since injury 12-52 months). EMVs were defined by markers of endothelial origin either by activation (CD62e⁺) or apoptosis (CD31⁺/CD42b^-) by flow cytometry. Activation-derived but not apoptosis-derived EMVs were significantly higher (<i>P</i> < .05) in adults with chronic SCI (median [IQR], 139 [83-181] EMVs/μL) compared with adults with subacute SCI (median [IQR], 99 [83-104] EMVs/μL) and non-injured adults (median [IQR], 74 [51-104] EMVs/μL). In contrast, apoptosis-derived but not activation-derived EMVs were significantly higher (<i>P</i> < .05) in adults with subacute SCI (mean ± <i>SD</i>, 77 ± 17 EMVs/μL) compared with adults with chronic SCI (mean ± <i>SD</i>, 55 ± 19 EMVs/μL) and non-injured adults (mean ± <i>SD</i>, 52 ± 25 EMVs/μL). Differential expression of circulating EMVs in adults with SCI during the subacute and chronic phase of injury may represent a biomarker of the vascular environment associated with each condition. Our findings suggest that the vascular phenotype is markedly different in subacute compared with the chronic SCI and provide insight into endothelial function after SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"29-38"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530243","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}