CLINICAL RESEARCH CENTER FOR ACUTE SPINAL CORD INJURIES

本提案旨在延续临床研究中心， 急性脊髓损伤在纽约大学。 的基本主题 该中心的建议是深入研究实验性脊髓 作为临床脊柱损伤模型的基本病理生理水平 脊髓损伤 主要重点将放在研究 脊髓损伤超过损伤后的急性期。 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导致 在创伤后的几周内对脊髓造成了渐进性损伤 将被用来检验脊髓损伤是 在最初的12-24小时内逐渐增加。 这将提供重要的 关于治疗方案的信息，可能必须用于 如果要实现任何恢复，则需要延长时间。 除了 确定脊髓中的这些病理生理变化， 将测试不同治疗方式对这些参数的影响。 的 临床研究将检查阿片类拮抗剂的功效， 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 试点研究。 实验性治疗将检验这一假设， 阿片受体在脊髓损伤中发挥作用， 皮质类固醇即使在给药超过1小时后也有效 伤后 治疗对创伤动物恢复的评价 将包括神经学、生理学和形态学结局参数。 这将提供一个全面的图片实验受伤 脊髓和对治疗的反应，这将提供一个合理的基础 用于选择临床疗法。 脊髓中心的目标是 伤害将通过组件项目的紧密结合来实现 这个提议。

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.