CLINICAL RESEARCH CENTER FOR ACUTE SPINAL CORD INJURIES

这项提案是为了延续临床研究中心的 纽约大学的急性脊髓损伤。的基本主题 本中心建议对实验性脊髓进行深入研究 作为临床脊柱损伤模型的基本病理生理水平损伤 脐带受伤。主要的重点将放在研究 脊髓损伤超过损伤后急性期的脊髓损伤。 钙、钠、钾等离子分布的变化 在脊髓内，上行和下行的神经生理学研究 途径，以及细胞炎症反应作为致病因素的作用 创伤后几周内脊髓的进行性损伤 将被用来检验脊髓损伤是 在最初的12-24小时后逐渐增加。这将提供重要的 关于可能需要利用的治疗方案的信息 延长期限，如果要实现任何复苏的话。除了……之外 确定这些脊髓的病理生理变化，对 将测试不同治疗方式对这些参数的影响。这个 临床研究将检查阿片类拮抗剂和 皮质类固醇在改善脊髓损伤中的作用 多中心随机试验。替代疗法也将在 先导研究。实验性治疗将检验这样一种假设： 阿片受体在脊髓损伤中发挥作用，这种疗法 皮质类固醇即使在服用1小时以上也是有效的。 受伤后。创伤动物康复治疗方法的评价 将包括神经学、生理学和形态学结果参数。 这将为实验中受伤的人提供一个全面的图像 脊髓和治疗的反应将提供一个合理的基础 用于选择临床治疗方法。建立脊髓治疗中心的目标 伤害将通过组件项目的紧密集成来实现 这项提议。

This Proposal is for a continuation of the Clinical Research Center for Acute Spinal Cord Injuries at New York University. The underlying theme of this Center proposal is to study intensively experimental spinal cord injury at a basic pathophysiologic level as a model for clinical spinal cord injury. Major emphasis will be placed on studying the effects of trauma to the spinal cord beyond the acute period following the injury. Changes in the distribution of ions such as calcium, sodium and potassium within the cord, neurophysiologic studies of ascending and descending pathways, and the role of cellular inflammatory response as a cause of progressive damage to the spinal cord in the weeks following the trauma will be used to test the hypothesis that the injury to the spinal cord is progressive beyond the first 12-24 hours. This will provide important information about treatment regimens which may have to be utilized for extended periods if any recovery is to be achieved. In addition to determining these pathophysiologic changes in the spinal cord, the effect of different treatment modalities on these parameters will be tested. The clinical studies will examine the efficacy of opioid antagonists and corticosteroids in the amelioration of spinal cord injury as part of a multi-center randomized trial. Alternate therapies will also be tested in pilot studies. Experimental treatment will test the hypothesis that the opioid receptors play a role in spinal cord injury and that this therapy and corticosteroids are effective even when administered more than 1 hour after injury. The evaluation of therapy on the recovery of injured animals will include neurologic, physiologic and morphologic outcome parameters. This will provide a comprehensive picture of the experimentally injured spinal cord and the response to therapy that will provide a rational basis for selecting clinical therapies. The goal of a Center for Spinal Cord Injury will be realized by the close integration of the component projects of this proposal.