Little is known about the mechanisms within the spinal cord which allow some persons with spinal cord injury to recover significant function, while others do not. We propose to conduct a series of electrophysiological and behavioral measures on persons with acute spinal cord injury who are admitted to Jackson Memorial Hospital. Subjects will be studied as many as 12 times after injury, in order to accurately define the time-course of any neurologic improvement or alteration seen. Approximately 150 subjects will be enrolled over a 5 year period. Clinical strength (through manual muscle test) and muscle electrical activity (EMG) will be recorded from multiple muscles of the arms and legs for persons with injury to the cervical spine, or from the legs in persons with injury to the thoracic or thoracolumbar spine. In addition to voluntary contractions, non-invasive magnetic stimulation of the brain will be used in some subjects to cause contractions of muscles made weak by the spinal cord injury. The size of the evoked EMG response, the time at which the response occurs, and the intensity of brain stimulation needed to cause a response will be determined for each muscle, to provide objective measures of conduction in spinal cord motor tracts. Reflex responses will be measured to estimate spinal cord excitability, and magnetic resonance images of the region of damage will be obtained at 3, 12, and 24 months after injury in a subset of individuals who have recovered some voluntary movement in the legs, in order to match changes in tissue properties (e.g. edema, myelination) with clinical function. In addition to providing valuable scientific information not currently available, this project will benefit attempts to implement clinical trials of treatment interventions for spinal cord injury - trials which are now being seriously considered and for which animal studies are underway. Specifically, the information gained from the successful completion of studies proposed herein will: 1) provide some sense of a given subjects's potential for spontaneous recovery of volitional motor activity and its time-course, to help establish whether there is an optimal time post-injury to apply whatever interventions are developed; 2) contribute towards the development of objective measures for prognosis; 3) develop criteria to select the most appropriate candidates for a particular intervention; and 4) guide decisions regarding which type of intervention might be most advantageous for a certain type of injury.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS036542-03
Application #
2892266
Study Section
Neurology A Study Section (NEUA)
Program Officer
Heetderks, William J
Project Start
1997-08-01
Project End
2002-04-30
Budget Start
1999-05-01
Budget End
2000-04-30
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Miami School of Medicine
Department
Neurosurgery
Type
Schools of Medicine
DUNS #
City
Miami
State
FL
Country
United States
Zip Code
33146
Alexeeva, Natalia; Calancie, Blair (2016) Efficacy of QuadroPulse rTMS for improving motor function after spinal cord injury: Three case studies. J Spinal Cord Med 39:50-7
Calancie, Blair; Molano, Maria R; Broton, James G (2005) Epidemiology and demography of acute spinal cord injury in a large urban setting. J Spinal Cord Med 28:92-6
Calancie, Blair; Alexeeva, Natalia; Broton, James G et al. (2005) Interlimb reflex activity after spinal cord injury in man: strengthening response patterns are consistent with ongoing synaptic plasticity. Clin Neurophysiol 116:75-86
Calancie, B; Molano, M R; Broton, J G (2004) Abductor hallucis for monitoring lower-limb recovery after spinal cord injury in man. Spinal Cord 42:573-80
Calancie, Blair; Molano, Maria R; Broton, James G (2004) EMG for assessing the recovery of voluntary movement after acute spinal cord injury in man. Clin Neurophysiol 115:1748-59
Calancie, Blair; Molano, Maria R; Broton, James G (2004) Tendon reflexes for predicting movement recovery after acute spinal cord injury in humans. Clin Neurophysiol 115:2350-63
Calancie, Blair; Molano, Maria R; Broton, James G (2002) Interlimb reflexes and synaptic plasticity become evident months after human spinal cord injury. Brain 125:1150-61
Molano, Maria del Rosario; Broton, James G; Bean, Judy A et al. (2002) Complications associated with the prophylactic use of methylprednisolone during surgical stabilization after spinal cord injury. J Neurosurg 96:267-72
Calancie, B; Molano, M R; Broton, J G et al. (2001) Relationship between EMG and muscle force after spinal cord injury. J Spinal Cord Med 24:19-25
Calancie, B; Molano, M R; Broton, J G (2000) Neural plasticity as revealed by the natural progression of movement expression--both voluntary and involuntary--in humans after spinal cord injury. Prog Brain Res 128:71-88

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