Biomarkers of Spontaneous Recovery from Traumatic Spinal Cord Injury
Abstract
Rationale: Spinal cord injury (SCI) resulting from a trauma, (for example, a car accident, gunshot wound, or fall), affects more than 200,000 Americans, with lifetime costs of care >$1 million/patient. Immediately after SCI, a patient confronts three major questions: (1) How much function have they lost? (2) What treatments promote recovery of function? (3) How much recovery of function can they expect over time? To answer the first question, a detailed clinical exam, known as the International Standards for Neurological Classification of SCI (ISNCSCI), tests motor (movement) and sensory (feeling) function throughout the body. The second question is still largely unanswered: standard rehabilitation focuses on maximizing use of body parts that are intact after the injury and managing medical complications of living with SCI. There is no standardized way to predict how much recovery a person will achieve, which occurs mostly within the first year after SCI. Since the ISNCSCI exam was not designed to predict how much function a person can expect to regain, historical data collected from other SCI patients is often used to estimate recovery for a newly injured SCI patient. Surprisingly little is known about the biological processes that influence how much function a person regains after SCI. This lack of knowledge limits the development and advancement of medicines and other treatments for SCI patients. From laboratory experiments, it is known inflammation worsens the initial area of tissue damage and inhibits physical recovery. We and other researchers have also observed signs of inflammation in people with SCI, including people who are newly injured and people who have been living with SCI for many years. Our hypothesis is that some inflammatory factors in the circulation are higher in SCI patients that have less physical recovery. Our long-term goal is to understand how to predict and promote functional recovery for individual patients with SCI. Objective: In order to test that hypothesis, we will evaluate substances that may be present in the blood after a SCI and see if and how they change over time during the first year after SCI. Specifically, we will evaluate if and how inflammatory proteins or ribonucleic acid (RNA) change in the blood of SCI patients. RNA is the body s genetic material that is the blueprint for making proteins. By comparing samples collected from SCI patients during the first year after SCI, we will try to find out if inflammatory or other types of proteins correlate with the extent of physical recovery. It is hoped that this study will help improve how to predict recovery after SCI or how to treat SCI in the future. Other factors in the blood, including proteins and hormones (substances that can affect protein levels), will also be tested. We will also store a portion of the sample in a tissue bank, so that we or other scientists may study them in the future. Study Design: We expect the study to take 3 years to perform. Each study subject will participate at four study visits during the first year after their SCI. The subjects will be adult patients who have had a SCI within 0-3 days of enrolling in the study. Approximately 2 tablespoons of blood collected at each study visits. Study visit 1 will take place within 0-3 days after SCI. Study visits 2-4 will be at 3, 6, and 12 months after their SCI. At all study visits, study personnel will collect basic demographic and health information from the subjects or their medical record, including evaluating how they are able to perform activities of daily living, such as moving around or dressing themselves. At study visits 2-4, study personnel will also test how they are recovering the ability to do certain tasks after their SCI, including sit, stand, move from sit to stand, and walk in both a regular environment and on a treadmill. Risks: If blood draws are done either through either a central intravenous or arterial l
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510614
Entities
People
- Ona Bloom
Organizations
- The Feinstein Institute for Medical Research
- United States Army