Forum for Science, Industry and Business

Recovery from Spinal Cord Injuries Can Be Predicted

A trauma to the spinal cord, quickly leads to a progressive loss of nerve tissue. This not only affects the injured area, but over time affects also other parts of the spinal cord and even the brain. These neurodegenerative changes can be explored in detail using magnetic resonance imaging.

How well patients recover from a spinal cord injury can be reliably predicted.

Marc Bolliger

An international team of researchers headed up by Patrick Freund from the Spinal Cord Injury Center of the University of Zurich and the Balgrist University Hospital has now for the first time investigated the extent and progression of microstructural changes over the first two years after a spinal cord injury.

The smaller the initial nerve loss, the better the long-term recovery

In their study, the scientists examined 15 patients who had suffered acute traumatic injuries to the spinal cord as well as 18 healthy study participants after 2, 6, 12, and 24 months. In the brain as well as spinal cord, they determined the anatomical extent of neurodegeneration, the loss of myelin (the insulating layer surrounding nerve cells), as well as the accumulation of iron in the nerve tissue as a result of degeneration and inflammation.

It then emerged that there was a direct link between the recovery levels of patients after two years and the extent of neurodegenerative change within the first six months after injury. “The smaller the overall loss of nerve tissue across the neuroaxis at the beginning, the better the patients’ long-term clinical recovery,” summarizes Patrick Freund.

Predicting long-term recovery by measuring early changes

What the researchers found surprising was the fact that the recovery was steepest within the first six months but neurodegenerative changes greatest within the same time period with no signs of deceleration over two years in the spinal cord and brain. This indicates a fierce competition between compensatory and neurodegenerative changes early after injury. The battle seems to be lost in favor of neurodegeneration over time.

Nevertheless, the magnitude of early microstructural changes is predictive of the long term recovery of patients suffering from a spinal cord injury. Crucially, non-invasive, high-resolution neuroimaging provides a mean to predict recovery trajectories and distinguish between neurodegeneration caused by the spinal cord injury itself and beneficial changes resulting from therapy.

“We have now a tool to reliably predict recovery and determine the effects of treatments and rehabilitation measures as opposed to spontaneous neurodegeneration in humans” adds neuroimaging specialist Freund. “Clinical studies can thus be carried out more efficiently and cost-effectively in the future.”

Clinical studies into the influence of arm and leg exercises planned

The patients who took part in the study will be examined again after five years using the same method. The scientists want to determine whether the neurodegenerative changes will have ceased by then or whether they will still be ongoing. Patrick Freund and his team are also planning training studies that aim to show whether the high-intensity exercising of arm and leg functions helps to slow down or stop the loss of nerve tissue.

Literature:
Gabriel Ziegler, Patrick Grabher, Alan Thompson, Daniel Altmann, Markus Hupp, John Ashburner, Karl Friston, Nikolaus Weiskopf, Armin Curt, and Patrick Freund. Progressive neurodegeneration following spinal cord injury: implications for clinical trials. Neurology. March 7, 2018. DOI: 10.1212/WNL.0000000000005258

Contact:
PD Patrick Freund, MD, PhD
Spinal Cord Injury Center, Research
Balgrist University Hospital
University of Zurich
Phone +41 44 510 72 11
E-mail: patrick.freund@balgrist.ch

Weitere Informationen:

http://www.media.uzh.ch/en/Press-Releases/2018/prediction-spinal-cord-injury.htm...

Kurt Bodenmüller | Universität Zürich

Im Focus: Light from a roll – hybrid OLED creates innovative and functional luminous surfaces

Up to now, OLEDs have been used exclusively as a novel lighting technology for use in luminaires and lamps. However, flexible organic technology can offer much more: as an active lighting surface, it can be combined with a wide variety of materials, not just to modify but to revolutionize the functionality and design of countless existing products. To exemplify this, the Fraunhofer FEP together with the company EMDE development of light GmbH will be presenting hybrid flexible OLEDs integrated into textile designs within the EU-funded project PI-SCALE for the first time at LOPEC (March 19-21, 2019 in Munich, Germany) as examples of some of the many possible applications.

The Fraunhofer FEP, a provider of research and development services in the field of organic electronics, has long been involved in the development of...

Im Focus: Regensburg physicists watch electron transfer in a single molecule

For the first time, an international team of scientists based in Regensburg, Germany, has recorded the orbitals of single molecules in different charge states in a novel type of microscopy. The research findings are published under the title “Mapping orbital changes upon electron transfer with tunneling microscopy on insulators” in the prestigious journal “Nature”.

The building blocks of matter surrounding us are atoms and molecules. The properties of that matter, however, are often not set by these building blocks...

Im Focus: University of Konstanz gains new insights into the recent development of the human immune system

Scientists at the University of Konstanz identify fierce competition between the human immune system and bacterial pathogens

Cell biologists from the University of Konstanz shed light on a recent evolutionary process in the human immune system and publish their findings in the...

Im Focus: Transformation through Light

Laser physicists have taken snapshots of carbon molecules C₆₀ showing how they transform in intense infrared light

When carbon molecules C₆₀ are exposed to an intense infrared light, they change their ball-like structure to a more elongated version. This has now been...

Im Focus: Famous “sandpile model” shown to move like a traveling sand dune

Researchers at IST Austria find new property of important physical model. Results published in PNAS

The so-called Abelian sandpile model has been studied by scientists for more than 30 years to better understand a physical phenomenon called self-organized...