SPINAL MOTOR CONDUCTION AND RECOVERY AFTER HUMAN SCI

描述：（申请人的摘要）关于该机制知之甚少 这使得一些脊髓损伤的人， 恢复重要功能，而其他人则没有。 我们建议进行一项 急性脑梗死患者的一系列电生理和行为学指标 脊髓损伤的人被收进了杰克逊纪念医院。 科目 将在受伤后进行多达12次的研究，以便准确地 定义观察到的任何神经系统改善或改变的时间过程。 在5年期间将入组约150例受试者。 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个肌肉记录， 颈椎受伤，或腿部受伤 胸椎或胸腰椎。 除了自主宫缩， 在某些受试者中将使用非侵入性的大脑磁刺激 导致脊髓损伤导致的肌肉收缩。 的 诱发EMG反应的大小，反应发生的时间，以及 引起反应所需的大脑刺激强度将是 为每块肌肉确定，以提供传导的客观测量， 脊髓运动束 将测量反射反应以估计 脊髓兴奋性和磁共振图像的区域 损伤将在损伤后3个月、12个月和24个月在以下亚组中获得： 恢复了一些腿部自主运动的人， 以匹配组织特性（例如水肿、髓鞘形成）的变化， 临床功能 除了提供目前尚未提供的有价值的科学信息外， 可用，该项目将有利于尝试实施临床试验 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，动物研究正在进行中。 具体而言，从成功完成 本文提出的研究将：1）提供给定受试者的一些感觉， 自发恢复自主运动活动的潜力及其 时间过程，以帮助确定是否有一个最佳的时间受伤后 （2）采取任何干预措施;（3）促进 制定客观的预后指标; 3）制定标准， 为特定干预选择最合适的候选人;以及4） 指导决定哪种类型的干预可能是最重要的 对某种类型的伤害有利。

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.