SPINAL MOTOR CONDUCTION AND RECOVERY AFTER HUMAN SCI

描述：(申请者摘要)人们对这种机制知之甚少 在脊髓内，这允许一些脊髓损伤的人 恢复显著的功能，而其他人则没有。我们建议进行一项 急性精神分裂症患者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患者。科目 受伤后会进行多达12次的研究，以便准确 定义所见的任何神经改善或改变的时间进程。 大约150个科目将在5年内招收。临床 力量(通过手动肌肉测试)和肌肉电活动(EMG) 将从手臂和腿部的多块肌肉中记录下来 颈椎的损伤，或来自腿部的损伤 胸椎或胸腰椎。除了自愿宫缩之外， 脑的非侵入性磁刺激将在一些受试者中使用 导致因脊髓损伤而变得虚弱的肌肉收缩。这个 诱发的肌电响应的大小、响应发生的时间，以及 引起反应所需的脑刺激强度将是 为每一块肌肉确定，以提供客观的传导测量 脊髓运动束。将测量反射反应以估计 脊髓兴奋性和延髓区域的磁共振成像 伤害将在受伤后3个月、12个月和24个月获得 已经恢复了腿部一些自愿运动的个人，以便 将组织特性的变化(例如，水肿、髓鞘形成)与 临床功能。 除了提供有价值的科学信息外，目前 如果可行，该项目将有利于实施临床试验的尝试 脊髓损伤的治疗干预措施--目前正在进行的试验 正在认真考虑，并正在进行动物研究。 具体而言，从成功完成 这里提出的研究将：1)提供对特定受试者的一些感觉 自主运动活动自发性恢复的潜力及其 时间-进程，以帮助确定是否存在受伤后的最佳时间 应用任何已开发的干预措施；2)为 制定客观的预后措施；3)制定标准 为特定干预选择最合适的候选人；以及4) 指导关于哪种类型的干预可能是最多的决策 对某种类型的伤害有利的。

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.