Journal of neurotrauma
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Journal of neurotrauma · Dec 2009
Administration of chondroitinase ABC rostral or caudal to a spinal cord injury site promotes anatomical but not functional plasticity.
Growth-inhibitory chondroitin sulfate proteoglycans (CSPG) are a primary target for therapeutic strategies after spinal cord injury because of their contribution to the inhibitory nature of glial scar tissue, a major barrier to successful axonal regeneration. Chondroitinase ABC (ChABC) digestion of CSPGs promotes axonal regeneration beyond a lesion site with subsequent functional improvement. ChABC also has been shown to promote sprouting of spared fibers but it is not clear if functional recovery results from such plasticity. ⋯ When injected caudal to a hemicontusion injury, ChABC promoted sprouting of 5HT+ fibers into the ventral horn but not the dorsal horn. None of this sprouting resulted in a change in the synaptic component synapsin, nor did it impact performance in behavioral tests assessing motor function. These data suggest that ChABC-mediated sprouting of spared fibers does not necessarily translate into functional recovery.
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Journal of neurotrauma · Dec 2009
Temporospatial expression and cellular localization of oligodendrocyte myelin glycoprotein (OMgp) after traumatic spinal cord injury in adult rats.
Traumatic spinal cord injury (SCI) leads to permanent neurological deficits, which, in part, is due to the inability of mature axons to regenerate in the mammalian central nervous system (CNS). The oligodendrocyte myelin glycoprotein (OMgp) is one of the myelin-associated inhibitors of neurite outgrowth in the CNS. To date, limited information is available concerning its expression following SCI, possibly due to the lack of a reliable antibody against it. ⋯ OMgp was exclusively localized in neurons and oligodendrocytes in the normal and sham-operated controls with an increased expression found in these cells following SCI. OMgp was not expressed in astrocytes or microglia in all groups. Thus, our study has provided evidence for temporospatial expression and cellular localization of OMgp following SCI and suggested that this molecule may contribute to the overall inhibition of axonal regeneration.
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Journal of neurotrauma · Dec 2009
Randomized Controlled Trial Multicenter StudyThe citicoline brain injury treatment (COBRIT) trial: design and methods.
Traumatic brain injury (TBI) is a major cause of death and disability. In the United States alone approximately 1.4 million sustain a TBI each year, of which 50,000 people die, and over 200,000 are hospitalized. Despite numerous prior clinical trials no standard pharmacotherapy for the treatment of TBI has been established. ⋯ The primary outcome consists of a set of measures that will be analyzed as a composite measure using a global test procedure at 90 days. The measures comprise the following core battery: the California Verbal Learning Test II; the Controlled Oral Word Association Test; Digit Span; Extended Glasgow Outcome Scale; the Processing Speed Index; Stroop Test part 1 and Stroop Test part 2; and Trail Making Test parts A and B. Secondary outcomes include survival, toxicity, and rate of recovery.
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Journal of neurotrauma · Dec 2009
The Relationship between age, injury severity, and MRI findings after traumatic brain injury.
Age and injury severity are among the most significant predictors of outcome after traumatic brain injury (TBI). However, only a few studies have investigated the association between, age, injury severity, and the extent of brain damage in TBI. The purpose of this study was to investigate the association between age, measures of injury severity, and brain lesion volumes, as well as viable brain volumes, following TBI. ⋯ Older age was also associated with smaller viable grey matter volumes in most neo-cortical brain regions, while longer PTA was associated with smaller viable white matter volumes in most brain regions. The results suggest that older age worsens the impact of TBI on the brain. They also indicate the validity of duration of PTA as a measure of injury severity that is not just related to one particular injury location.
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Journal of neurotrauma · Dec 2009
The retrospective application of a prediction model to patients who have had a decompressive craniectomy for trauma.
There is currently a resurgence of interest in the use of decompressive craniectomy. As the procedure is used more frequently, there may be an increasing number of patients surviving a severe traumatic brain injury with severe neurological impairment. The aim of this study was to determine if we could predict those cases that fall into this category. ⋯ Our analysis indicated that a significant cut-off point appeared at which the model predicted a 75% risk of an unfavorable outcome at 6 months; 19 of 27 patients with CRASH scores <75% returned to work, whereas none of the 14 patients with higher scores achieved this degree of rehabilitation at 18 months. Statistical analysis of the outcomes in our cohort confirmed that the CRASH model reliably predicted unfavorable outcome. This study demonstrated that our ability to predict poor outcome has improved.