SCI with Brain Injury: Bedside to Bench Modeling for Developing Treatment and Rehabilitation Strategies

Abstract

Spinal cord injury (SCI) is frequently accompanied by traumatic brain injury (TBI), but evidence-based approaches for treatment of this dual-diagnosis are lacking. This project proposed using current clinical-practice evidence to guide development of an animal model to provide a new tool for studying the biological mechanisms involved, and to open new directions for therapeutics for combined injury. We initially established an animal model of dual injury that reflected an unexpected complexity of interactions between these injuries. The group then focused on building a clinical TBI+SCI patient database from San Francisco General Hospital, the Santa Clara Valley Medical Center and from the VA Palo Alto Health Care System, that detailed the acute and chronic stages of recovery after dual-injury. This required development of common data elements and methods for querying different types of patient records. We now have an overview of recovery and the medications given to the SCI+TBI patients. Interestingly, more medications are used in the dual-diagnosis patients than for each injury alone, resulting in altered recovery. These clinical data were used to guide hypothesis development for testing agents in the newly established model of SCI+TBI. The first agent tested, topiramate, confirmed our suspicion that drug effects differ with injury type, improving one and retarding the other. The project has resulted in a continuing community of practice and research and the animal model should continue to inform and be informed by the clinical enterprise.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2013
Accession Number
ADA599471

Entities

People

  • Geoffrey Manley

Organizations

  • University of California, San Francisco

Tags

DTIC Thesaurus Topics

  • Anticonvulsants
  • Brain Injuries
  • Central Nervous System
  • Cognitive Impairment
  • Community Of Practice
  • Disability Administration
  • Diseases And Disorders
  • Drug Therapy
  • Health Care
  • Health Services
  • Medical Personnel
  • Rehabilitation
  • Spinal Cord
  • Spinal Injuries
  • Therapy
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

  • Medical or Health Care Field.
  • Systems Analysis and Design
  • Traumatic Brain Injury (TBI) and Cognitive Aging in the Guam and Border Populations Affected by Alzheimer's Disease and Tau-Associated Dementias.