Baroprosthesis to Reduce Secondary Damage of the Traumatic Spinal Cord Injury
Abstract
Each year, tens of thousands of people around the world are paralyzed after suffering a spinal cord injury (SCI). Despite decades of research, doctors caring for patients who have just suffered an SCI have few treatments that might improve their ability to move and feel again. One of the only treatments that can potentially improve recovery during the period immediately after a SCI is to control patients’ blood pressure at optimal targets. However, controlling blood pressure after SCI within a narrow target range has been very hard. Moreover, the drugs that are used to control blood pressure can actually cause harm. This challenge puts doctors in a difficult situation, since trying to help a patient by controlling their blood pressure can actually worsen their injury. We recently developed a new treatment that uses electricity to modulate the cells of the spinal cord that control blood pressure. We call this treatment the neuroprosthetic baroreflex. We showed that the neuroprosthetic baroreflex can control blood pressure precisely in rodents, monkeys, and humans with SCI. Importantly, the neuroprosthetic baroreflex does not seem to carry the same risk for harm as existing treatments to control the blood pressure. The neuroprosthetic baroreflex has now entered clinical trials to manage blood pressure during the months and years that followed an SCI. The neuroprosthetic baroreflex could also help doctors care for patients immediately after they have suffered an SCI. However, before this can happen, we need to answer two important questions about managing blood pressure immediately after SCI. First, the protocols that doctors use to manage blood pressure are based on the imperative need to avoid causing harm with potentially dangerous drugs. Therefore, we need to identify the best protocols for doctors to manage blood pressure without the risks of current treatments. Second, doctors do not currently know why the control of blood pressure allows patients to recover better movement and feeling after SCI. Understanding exactly why the control of blood pressure is so beneficial could allow us to identify the most important time window after injury and optimal settings to control a patient’s blood pressure. This research could help nearly everyone who suffers an SCI. What we learn could help reduce the risk people with SCI face during their initial management in the hospital. This would be of great benefit to patients, since it would give the doctors taking care of them more and better options to treat them. Ultimately, better treatment immediately after injury would likely improve patients’ ability to move and feel in the months and years afterwards. This research is also one of our most immediately achievable ways to make a difference in the treatment of patients with SCI. Controlling blood pressure is already a key treatment that doctors use immediately after an SCI. If we could discover better guidelines and improved treatments to control blood pressure, doctors would be able to use these discoveries to treat patients with SCI much faster than, say, a newly discovered drug. More specifically, we expect that the neuroprosthetic baroreflex could help doctors manage blood pressure in patients who have just suffered an SCI within the next 3-5 years. To identify new protocols for blood pressure management, we will perform experiments in mice treated with the neuroprosthetic baroreflex. Specifically, we will maintain the mice at different levels of blood pressure during the first week after SCI, and will study how a given blood pressure level impacts the evolution of spinal cord damage and functional recovery. We will use cutting-edge molecular methods to study the complex molecular changes that occur within the spinal cord in the days and weeks after SCI. Therefore, there are no risks to patients as part of this research. Overall, this proposal could lead to a new treatment to manage blood press
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310548
Entities
People
- Aaron Phillips
Organizations
- United States Army
- University of Calgary