Journal of Spinal Cord Medicine最新文献

{"title":"Spinal epidural electrical stimulation for the recovery of motor function in lower limbs after spinal cord injury: A pilot study.","authors":"H S Chhabra, K K V Kalidindi, N Garg, A Sharma, B Chhibber, H Kumar, G Vishwakarma, M Gupta, M R Bhat","doi":"10.1080/10790268.2025.2517935","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517935","url":null,"abstract":"<p><strong>Study design: </strong>Single-arm prospective pilot study.</p><p><strong>Purpose: </strong>To assess the safety and efficacy of sEES in the recovery of motor function after severe SCI in the Indian population and to evaluate the feasibility of a larger study.</p><p><strong>Overview of literature: </strong>Standing and walking are highly desirable goals for persons with spinal cord injury (SCI). Activity-based locomotor training is the only available practice to enhance recovery at present. However, it does not yield significant outcomes in individuals with severe spinal cord injury. In recent years, Spinal epidural electrical stimulation (sEES) has been reported to produce rhythmic motor activity in limbs in a few case reports and also in clinical trials in animals and more recently, in a few human case reports.</p><p><strong>Methods: </strong>We conducted a single-arm prospective pilot study at a tertiary care spine surgery center in five subjects with chronic spinal cord injury with an absence of useful power in lower limbs and satisfying the eligibility criteria. The Institute Ethics Committee and the Research Review Committee approved the study and it was registered with the Clinical Trials Registry of India.</p><p><strong>Results: </strong>No intraoperative or early postoperative complications were noted in any of the subjects. Two subjects had wound complications at 1 and 3 months, respectively and were managed successfully. All of these participants were unable to stand, step, or walk without assistance before the recruitment. With epidural stimulation, four subjects gained better control of standing full weight bearing (without assistance). Four (<u>80%</u>) subjects were able to coordinate stepping on a treadmill and three (60%) were able to walk without knee braces with epidural stimulation. Objective functional outcome measures such as the Walking Index of spinal cord injury and Spinal Cord Independence Measure showed significant improvement (P = 0.004 and 0.002, respectively) with sEES. The trial could be implemented successfully, <i>i.e.</i> the desired recruitment could be achieved within a defined period, with procedural adherence and participant compliance.</p><p><strong>Conclusions: </strong>sEES is a safe intervention. Locomotor training with sEES improves the motor abilities and functional recovery of persons with chronic SCI. A larger prospective study with more subjects needs to be done to draw a definite conclusion and seems to be feasible using the protocol, outcome measures, and recruitment strategy of the pilot study.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530771","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}

{"title":"Cortical intermittent theta burst stimulation and neurogenic bladder management after traumatic incomplete spinal cord injury: A case report.","authors":"Rohit Banerjee, Deeksha Patel, Kamran Farooque, Siddharth Jain, Amlesh Seth, Suman Das, Kanwal Preet Kocchar, Nand Kumar, Suman Jain","doi":"10.1080/10790268.2025.2514320","DOIUrl":"https://doi.org/10.1080/10790268.2025.2514320","url":null,"abstract":"<p><strong>Context: </strong>Neurogenic bladder is one of the major complications of spinal cord injury (SCI). Due to inadequate, ill-timed intervention, it can be lethal and lead to chronic case of renal calculus, renal failure or recurrent urinary tract infections. Intermittent theta burst stimulation (iTBS) is a patterned, non-invasive transcranial magnetic stimulation procedure that can improve the functional status of patients with SCI by manipulating cortico-spinal plasticity. Trans spinal magnetic stimulation has shown transient improvement in establishing voluntary urination and specific bladder parameters in patients with incomplete SCI (iSCI). The present case report evaluates the effect of motor cortical iTBS combined with a customized exercise regime on neurogenic lower urinary tract symptoms in a patient with incomplete dorsal spinal cord injury.</p><p><strong>Findings: </strong>This is a case of a patient with iSCI who sustaining a stabbing injury. Initial neurological assessment indicated a D5/6 hemi transection. Surgical intervention was followed by cortical iTBS administration for 2 weeks, adjunct to comprehensive rehabilitation for 6 weeks. Urodynamics studies were evaluated for bladder function and neurogenic bladder symptom score (NBSS). We found an improvement in bladder parameters (capacity, compliance, postvoid residual volume, detrusor pressure and bladder indices) linear to the NBSS score, indicating a reduction in neurogenic symptoms.</p><p><strong>Conclusion/clinical relevance: </strong>iTBS combined with bladder rehabilitation, can be a promising, effective treatment strategy in improving bladder dyssynergia and lower urinary tract dysfunction in patients with incomplete SCI.Trial registration: Clinical Trials Registry India identifier: CTRI/2023/08/056.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327546","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}

{"title":"The time-dependent efficacy of early surgical decompression in patients with traumatic spinal cord injury: A systematic review and meta-analysis.","authors":"Xiaolong Li, Yuan Yuan, Yilin Chen, JinYe Lv, Yihao Lian, Heng Yin","doi":"10.1080/10790268.2025.2517925","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517925","url":null,"abstract":"<p><strong>Objective: </strong>Numerous studies have demonstrated that early surgical intervention in patients with traumatic spinal cord injury leads to superior recovery of various indicators, including neurological function, compared to late surgical intervention. However, some relevant clinical randomized controlled trials have indicated that the motor function recovery of patients undergoing early surgical decompression does not show a significant advantage during initial follow-up periods. The benefits of early surgical decompression become more apparent as the follow-up duration extends. Therefore, this study aims to evaluate the prognosis of early versus late surgical intervention on traumatic spinal cord injury and to analyze whether the prognostic benefits of early surgical decompression in traumatic spinal cord injury patients are time-dependent.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis by searching the PubMed, Embase, and Cochrane Library databases for randomized controlled trials and quasi-randomized controlled trials that addressed the timing of surgical intervention for traumatic spinal cord injury. The data extracted from all included studies were processed and analyzed utilizing the RevMan 5.4 software.</p><p><strong>Results: </strong>Eight studies involving 702 patients were included in this analysis, with 345 patients in the early surgery group and 357 patients in the late surgery group. The results showed that the early surgery group had a significantly higher rate of improvement in AIS grade (OR = 1.50; 95% CI: 1.05-2.15; <i>p</i> = 0.03) and a shorter hospital stay (MD = -4.76; 95% CI: -9.19 - -0.32; <i>p</i> = 0.04) compared to the late surgery group. Although there was no significant difference in total motor scores between the two groups in the early postoperative period, the pooled data still favored the early surgery group (MD = 4.43; 95% CI: 1.23-7.63; <i>p</i> = 0.007). There was no significant difference in postoperative complications between the two groups (RR = 0.61; 95% CI: 0.30-1.22; <i>p</i> = 0.16).</p><p><strong>Conclusion: </strong>Early surgical decompression leads to better prognosis in patients with traumatic spinal cord injury and shows a trend of more obvious advantages in motor function recovery with longer follow-up time than late surgical intervention.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327547","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}

{"title":"Successful leadless intracardiac pacemaker for delayed onset bradyarrhythmia after spinal cord injury.","authors":"John Paul S Khouzam, Timothy C Frommeyer, Ajay Agarwal","doi":"10.1080/10790268.2025.2517933","DOIUrl":"10.1080/10790268.2025.2517933","url":null,"abstract":"<p><strong>Context: </strong>Bradyarrhythmias are typically an early consequence of spinal cord injury (SCI).</p><p><strong>Findings: </strong>A 30-year-old woman with high cervical SCI developed symptomatic delayed-bradyarrhythmia six years post-injury.</p><p><strong>Conclusion/clinical relevance: </strong>This case provides evidence of delayed-bradyarrhythmia status due to autonomic dysfunction after SCI. Leadless permanent pacemakers are an effective and safe treatment alternative to traditional pacemakers.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318539","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}

{"title":"Assessment of quality of life and psychologic status in chronic-phase patients with cervical spinal cord injury: Correlation with clinical symptoms and evaluation tools.","authors":"Isamu Sasaki, Gentaro Kumagai, Kanichiro Wada, Toru Asari, Yohshiro Nitobe, Kotaro Aburakawa, Yasuyuki Ishibashi","doi":"10.1080/10790268.2025.2510720","DOIUrl":"https://doi.org/10.1080/10790268.2025.2510720","url":null,"abstract":"<p><strong>Context: </strong>This cross-sectional study examined the correlation and adequacy of the Japanese Orthopaedics Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) for assessing patients with cervical spinal cord injury (SCI).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Single hospital.</p><p><strong>Participants: </strong>38 patients in the chronic phase after cervical SCI (32 men, mean age 67.0 years).</p><p><strong>Outcome measures: </strong>Outcome measures included the association between JOACMEQ scores and bodily symptoms such as neck pain, neuropathic pain in the upper or lower extremities, and chest discomfort; visual analogue scale (VAS) scores for cervical, chest, upper, and lower extremity pain; and the Cronbach's alpha internal consistency of responses between the Medical Outcomes Study 36-item Short Form Health Survey, EuroQOL 5 Dimension, Hospital Anxiety and Depression Scale, and the JOACMEQ.</p><p><strong>Results: </strong>Pain or numbness was reported by 94.7% of patients. Among the 38 patients, 7 (18.4%) had a confirmed diagnosis of depression and 3 (7.9%) had a confirmed diagnosis of anxiety. JOACMEQ domain scores correlated with bodily symptoms, and SF-36 and HADS scores. Cronbach's alpha of the JOACMEQ in patients with SCI was ∼0.8 across all domains except bladder function.</p><p><strong>Conclusion: </strong>JOACMEQ scores significantly correlated with bodily symptoms and established QOL and mental health measures. Furthermore, the JOACMEQ showed good internal consistency in this study. Compared with conventional assessment methods, the JOACMEQ is a simpler instrument for assessing quality of life, including psychologic status, in patients with cervical SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318538","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}

{"title":"Tailored transcutaneous electrical nerve stimulation improves dysesthesia in individuals with spinal cord injury: A randomized N-of-1 trial.","authors":"Yuki Nishi, Koki Ikuno, Yuji Minamikawa, Michihiro Osumi, Shu Morioka","doi":"10.1080/10790268.2025.2517929","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517929","url":null,"abstract":"<p><strong>Context: </strong>Current therapeutic interventions are often ineffective for dysesthesia, including tingling and allodynia, caused by spinal cord injury (SCI). Dysesthesia-matched TENS (DM-TENS) is an innovative approach for dysesthesias that customizes stimulation parameters to align with an individual's specific dysesthesia characteristics.</p><p><strong>Objective: </strong>We aimed to evaluate the efficacy of DM-TENS for dysesthesia in individuals with SCI.</p><p><strong>Design: </strong>A randomized, placebo-controlled, aggregated N-of-1 trial was conducted in six individuals with SCI.</p><p><strong>Methods: </strong>Participants received either DM-TENS as an intervention or sham TENS as a control. Each treatment was administered for 60 min/day over a 7-day period. The outcome measures included the Numeric Rating Scale (NRS) for dysesthesia and Short-Form McGill Pain Questionnaire-2 (SF-MPQ2).</p><p><strong>Results: </strong>Using a hierarchical Bayesian model, we found that dysesthesia-matched TENS provided clinically meaningful improvements in dysesthesia among individuals with SCI, with a high posterior probability (96-100%) exceeding the minimal clinically meaningful difference (NRS of 2.70) at both the individual and population levels. The mean NRS was 5.79 (95% credible interval [95% CI]: 4.58-7.01) during the placebo period, and 1.12 (95% CI: 0.59-1.66) during the DM-TENS period. In the SF-MPQ-2, the dysesthesia-matched TENS effects showed decisive evidence (BF₁₀ > 1000) for items on tender, pain caused by light touch, tingling or pins and needles, and numbness.</p><p><strong>Conclusions: </strong>This series of N-of-1 trials comparing dysesthesia-matched TENS with placebo indicated a reduction in dysesthesia in individuals with SCI. Thus, dysesthesia-matched TENS is a promising therapeutic option for managing dysesthesia in this population.<b>Trial registration:</b> UMIN Japan identifier: UMIN000050250..</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318540","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}

{"title":"The effects of spinal dysraphism on the quality of life of pediatric patients and their families.","authors":"Remi M Rufus-Toye, Sabba Hussain, Yael Gelfer, Donato Giuseppe Leo, Anna Bridgens","doi":"10.1080/10790268.2025.2510721","DOIUrl":"https://doi.org/10.1080/10790268.2025.2510721","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal dysraphism describes a spectrum of conditions resulting from aberrant neural tube closure during the first trimester of fetal development. Consequent neurological deficits may lead to a range of musculoskeletal abnormalities requiring orthopedic intervention. This study sought to evaluate the impact of spinal dysraphism on patients and their families.</p><p><strong>Methods: </strong>Free text questionnaires/interviews were collected from parents. Quantitative questionnaires were collected from children using an emoji response system. These assessed contentment in activities of daily living. Qualitative data were analyzed via thematic analysis. Descriptive statistics were applied to quantitative data.</p><p><strong>Results: </strong>In total 32 responses (13 patients and 19 carers) were collected and analyzed. The median age of patients was 10 years (IQR = 3), with a sex distribution of 7 boys and 6 girls. Overall, 3 key themes were identified: (i) Independence, (ii) Mental Health, (iii) Family Impact, each with corresponding subthemes. Quantitative data corroborated these themes well, highlighting impacts on activities of daily living in the majority of domains assessed.</p><p><strong>Conclusion: </strong>Spinal dysraphism has a multifactorial impact on patient and family quality of life spanning the societal, mental, and physical domains. These findings will be included in ongoing work to create a set of core outcomes for use in the clinical and research settings.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250583","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}

{"title":"Robotic-assisted gait training for spinal cord injury neuropathic pain: A systematic review.","authors":"Conor White, Samantha Klus, Wing Hai Ho, Lily Barrett, Orlaith Doherty, Olive Lennon","doi":"10.1080/10790268.2025.2503049","DOIUrl":"https://doi.org/10.1080/10790268.2025.2503049","url":null,"abstract":"<p><strong>Context: </strong>Neuropathic pain (NP), can be a debilitating consequence of spinal cord injury. Robotic-assisted gait training (RAGT) is an effective rehabilitation tool, but emerging evidence suggests it may prove an effective treatment for NP post-SCI.</p><p><strong>Objective: </strong>This systematic review aims to synthesize the available evidence examining RAGT for pain reduction post-SCI, focusing on NP.</p><p><strong>Methods: </strong>Six databases were searched from inception to February 18th 2025, using search strings addressing: SCI and RAGT. No date or study type restrictions applied. Studies with SCI populations, delivering RAGT and measuring pain outcomes were included. Meta-analyses were conducted for pain intensity, pain interference (PI) and HRQoL outcomes. Certainty of evidence (COE) was assessed using GRADE criteria.</p><p><strong>Results: </strong>Thirty two studies (n = 567) (6 RCTs) met eligibility criteria. No RCT mandated pain as an inclusion criterion. Meta-analysis of 6 RCTs (n = 174) identified no effect for RAGT over other interventions for outcomes of overall pain intensity (SMD = 0.03 [-0.40, 0.46]; P = 0.90), non-specified pain-type intensity (SMD = 0.08 [-0.39, 0.55]; P = 0.74) and in one RCT reporting NP intensity (SMD = -0.46 [-1.61, 0.70]; P = 0.44). Meta-analysis identified no difference between RAGT and comparators for outcomes of HRQoL (3 RCTs (n = 69): SMD = 0.15 [-0.33,0.62]; P = 0.54) and PI (2 RCTs (n = 53): SMD = -0.1 [-0.64,0.44]; P = 0.71). Very-low COE for pain intensity & PI and low COE for HRQoL were assigned.</p><p><strong>Conclusions: </strong>Very limited studies and inconclusive evidence supports RAGT for the reduction of NP post-SCI. Future RCTs of RAGT that recruit patients with moderate-to-severe NP at baseline are required.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-27"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235789","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}

{"title":"Strategies to mitigate muscle mass loss in individuals with spinal cord injury.","authors":"Astrid M H Horstman, Janneke M Stolwijk-Swüste, Luc J C van Loon, Sonja de Groot","doi":"10.1080/10790268.2025.2503048","DOIUrl":"https://doi.org/10.1080/10790268.2025.2503048","url":null,"abstract":"<p><strong>Context: </strong>Muscle atrophy following spinal cord injury (SCI) is severe, often exceeding rates observed in disuse or critical illness. Neurogenic factors, such as the loss of neural input and disruption of neuromuscular signaling worsen the effects of physical inactivity. The severe muscle loss lowers muscle quality and impairs function, increasing the risk of chronic metabolic diseases. Understanding the mechanisms underlying SCI-induced muscle atrophy is crucial for developing targeted interventions.</p><p><strong>Objective: </strong>This review examines SCI-induced muscle atrophy mechanisms, addresses limitations of current interventions, and proposes therapeutic strategies integrating exercise mimetics, nutrition, and pharmacological agents to overcome anabolic resistance and improve muscle preservation.</p><p><strong>Methods: </strong>A PubMed search was conducted using terms including \"spinal cord injury\", \"disuse\", \"muscle atrophy\", \"anabolic resistance\", \"muscle protein metabolism\" and \"interventions\". (Pre)clinical studies and reviews relevant to skeletal muscle physiology after SCI were included.</p><p><strong>Results: </strong>Anabolic resistance seems to be a key contributor to rapid SCI-induced muscle loss. Motor-complete SCI prevents voluntary contractions, limiting traditional exercise-based interventions. Neuromuscular electrical stimulation (NMES) can mitigate muscle atrophy during immobilization and critical illness especially when combined with protein supplementation. Additional nutritional interventions, including vitamin D, creatine, ursolic acid, polyunsaturated fatty acids (PUFAs), and pharmacological agents such as androgens, myostatin inhibitors, and β2-adrenoceptor agonists, may further attenuate muscle atrophy.</p><p><strong>Conclusion: </strong>A multidimensional approach integrating NMES, targeted nutrition, and pharmacological strategies may enhance muscle mass retention, metabolic health, and rehabilitation outcomes in individuals with SCI. Further research is needed to refine these interventions and establish clinical guidelines for muscle preservation in this population.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235790","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}

{"title":"Cerebrolysin-loaded platelet-rich plasma exosomes: Restoring immune homeostasis via TNF-α/IL-10 modulation and apoptosis targeting for spinal cord injury repair.","authors":"Naeimeh Akbari-Gharalari, Zeinab Aliyari-Serej, Maryam Ghahremani-Nasab, Hamid Soltani Zangbar, Yahya Yahyavi, Farshad Nezhadshahmohammad, Abbas Ebrahimi-Kalan","doi":"10.1080/10790268.2025.2503053","DOIUrl":"https://doi.org/10.1080/10790268.2025.2503053","url":null,"abstract":"<p><strong>Context/objective: </strong>Spinal cord injury (SCI) is a severe condition characterized by neuronal apoptosis and inflammation, with limited therapeutic options. This study aimed to assess the effects of platelet-rich plasma (PRP)-derived exosomes (Exo), Cerebrolysin (CBL), and Cerebrolysin-loaded exosomes (CLE) on inflammation, apoptosis, tissue organization, and motor function recovery in a mouse model of compression SCI.</p><p><strong>Design: </strong>An experimental study using a mouse model of SCI, investigating the effects of Exo, CBL, and CLE treatments.</p><p><strong>Setting: </strong>Laboratory-based research in a controlled environment.</p><p><strong>Participants: </strong>Sixty healthy adult female BALB/c mice, aged 8-10 weeks, weighing 24 ± 2 g were used. SCI was induced via compression to model SCI.</p><p><strong>Interventions: </strong>Mice with induced SCI were treated with Exo, CBL, or CLE. Apoptosis was assessed by Bax and Bcl2 expression. Inflammatory markers TNF-α and IL-10 were measured. Histological analysis examined tissue organization, and motor function recovery was evaluated using the Basso-Beattie-Bresnahan (BBB) locomotor scale.</p><p><strong>Outcome measures: </strong>The study measured Bax and Bcl2 expression, TNF-α and IL-10 levels, tissue organization, and motor function recovery.</p><p><strong>Results: </strong>CLE treatment significantly modulated Bax and Bcl2 expression, reducing apoptosis and enhancing neuronal survival. TNF-α levels decreased, indicating reduced inflammation, while IL-10 levels increased, showing anti-inflammatory effects. Histological assessment revealed improved tissue organization, and motor function recovery was significantly enhanced as measured by BBB scores.</p><p><strong>Conclusion: </strong>CLE showed neuroprotective and anti-inflammatory effects, reducing apoptosis and inflammation while promoting tissue repair and motor function recovery in SCI, making it a promising therapeutic candidate.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227419","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}