Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label spinal cord. Show all posts
Showing posts with label spinal cord. Show all posts

Thursday, June 14, 2018

Gene therapy reverses rat's paralysis

Cool, but absolutely nothing will be followed up for possible stroke applications since we have NO stroke leadership and NO stroke strategy. You, your children and grandchildren will be screwed after the next stroke. This will take decades to prove out, I'll modify that, your great and great-great grandchildren will be screwed. Thanks to Phil Collis for pointing this out.
https://www.bbc.com/news/health-44484901

Scientists say they have taken a significant step towards the goal of giving paralysed people control of their hands again.
The team at King's College London used gene therapy to repair damage in the spinal cord of rats.
The animals could then pick up and eat sugar cubes with their front paws.
It is early stage research, but experts said it was some of the most compelling evidence that people's hand function could one day be restored.
The spinal cord is a dense tube of nerves carrying instructions from the brain to the rest of the body.
The body repairs a wounded spinal cord with scar tissue.
However, the scar acts like a barrier to new connections forming between nerves.


How the gene therapy works

The researchers were trying to dissolve components of the scar tissue in the rats' spinal cord.
They needed to give cells in the cord a new set of genetic instructions - a gene - for breaking down the scar.
The instructions they gave were for an enzyme called chondroitinase. And they used a virus to deliver them.
Finally, a drug was used to activate the instructions.


The animals regained use of their front paws after the gene therapy had been switched on for two months.
Dr Emily Burnside, one of the researchers, said: "The rats were able to accurately reach and grasp sugar pellets.
"We also found a dramatic increase in activity in the spinal cord of the rats, suggesting that new connections had been made in the networks of nerve cells."
The researchers hope their approach will work for people injured in car crashes or falls.
Prof Elizabeth Bradbury told the BBC: "We find this really exciting, recovery of this type of function, because for spinal injured patients their highest priority is to get their hand function back.
"Being able to pick up a coffee cup, hold a toothbrush, these types of things will have a dramatic increase on their quality of life and their independence."
In 2014, a paralysed man was able to walk with a frame after cells from inside his nose were used to regenerate part of his spinal cord.
The patient, Darek Fidyka, was injured in a knife attack that caused a different type of wound to those in car crashes.
The gene therapy approach is not yet ready for human clinical trials.
Dr Mark Bacon, from the charity Spinal Research, told the BBC: "The data is some of the most compelling I've seen demonstrating restoration of skilled forelimb function.
"It's exciting, but getting approval for gene therapies represents a particular, but not insurmountable, challenge to getting it to the clinic.
"Transferred to the clinic, this research could be life-changing for the millions of people worldwide with paralysis caused by a spinal cord injury."

Friday, November 17, 2017

At the Bench-Stroke Recovery: Inducing Spinal Plasticity Amplifies Benefits of Rehabilitative Training and Improves Stroke Recovery

Now we just need human followup. Is your stroke hospital so fucking incompetent that they will do nothing to advance this research to humans?
http://journals.lww.com/neurotodayonline/Fulltext/2017/11160/At_the_Bench_Stroke_Recovery__Inducing_Spinal.7.aspx
Kreimer, Susan
doi: 10.1097/01.NT.0000527322.43736.10
Features
Back to Top | Article Outline

ARTICLE IN BRIEF

In an animal model of stroke, researchers removed plasticity-inhibiting signals in the spinal cord (via intraspinal injections of the enzyme chondroitinase ABC), which augmented rewiring of circuits connecting the brain to the spinal cord, even weeks after stroke. The researchers proposed that this plasticity can be harnessed by rehabilitative training to significantly promote sensorimotor recovery.
A combination of spinal therapy and rehabilitative training resulted in improved recovery in rats, even 28 days after experimental stroke conditions were induced, according to a study published October 12 in The Journal of Neuroscience.
The investigators amplified spinal plasticity during chronic stroke in male rats via intraspinal injections of chondroitinase ABC (ChABC), an enzyme that has been found to remove plasticity-inhibiting signals in the brain. Injections into the contralesional grey matter of the cervical spinal cord administered 28 days after stroke resulted in significant sprouting of corticospinal axons originating in the peri-infarct cortex.
Without rehabilitative training, ChABC injection during chronic stroke led to moderate improvements of sensorimotor deficits, said Ian R. Winship, PhD, a study author and associate professor and director of the neurochemical research unit at the University of Alberta's department of psychiatry in Edmonton, Alberta in Canada. But combined with the spinal therapy, rehabilitative training during chronic stroke was much more effective.
“These data suggest that the permanent disability affecting millions of individuals living with the chronic effects of stroke may be treatable with spinal therapy and rehabilitation initiated even months or years after the stroke,” the study authors wrote. “Our data also emphasize that inducing a state of plasticity is not sufficient to induce recovery, and that combining such therapies with rehabilitative therapy is required for optimal recovery.”
After inducing initial ischemic injury in the rats via photothrombosis, investigators tested their hypothesis that promoting plasticity in the spinal cord during chronic stroke could spur advances in recovery from persistent sensorimotor impairment. Sprouting of spared corticospinal tract axons in the contralesional spinal cord has a major impact on sensorimotor recovery, they noted, but this structural plasticity is limited to the first few weeks after stroke.
“The major drawback of the current approach is that injection of the enzyme only extends a certain distance and acts for a finite period of time,” Dr. Winship said. “In a human, we need the enzyme to be active over a much larger region,” he said, because “the spinal cord is so much bigger in human than in a rat.”
“Our findings strongly suggest that such a treatment could reduce disability due to stroke. The next question is, what would actually be required to undertake this approach in humans?” Dr. Winship told Neurology Today.
He acknowledged that “probably a different delivery system would be required for humans. One solution may be to employ viral vectors, which present a way to genetically express the same enzyme in tissue rather than injecting it directly,” Dr. Winship said. “A viral delivery system would allow for longer expression and greater spread within the spinal cord, and therefore, could be safer and possibly effective in larger animals such as dogs as well as humans.”
“We can do very similar injection procedures without damaging the spinal cord, without inducing any kind of injury, but we would need a system like one of these vectors, if the drug is going to trying to strengthen the wiring between the brain and the spinal cord,” he said.

Thursday, August 11, 2016

The Role of Therapeutic Hypothermia After Traumatic Spinal Cord Injury—A Systematic Review

Where is the similar review for stroke? I've written 33 posts on hypothermia over the last 5 years so there is enough information already out there to review and come up with a protocol. But our fucking failures of stroke associations will do nothing.
https://www.researchgate.net/profile/Andrew_Boileau/publication/282569544_The_Role_of_Therapeutic_Hypothermia_After_Traumatic_Spinal_Cord_Injury-A_Systematic_Review/links/5767d36908aeb4b9980afdda.pdf
Samir Alkabie and Andrew J. Boileau


-
BACKGROUND:
Traumatic spinal cord injury (SCI) is a devastating neurologic entity characterized by a primary insult followed by a secondary pathologic cascade that propagates further injury. Hypothermia has an established clinical role in preventing SCI after cardiac arrest and thoracoabdominal aortic aneurysm repair, yet its emergence as a potential neuroprotectant after spinal cord trauma remains experimental. There are currently no pharmacologic interventions available to prevent secondary mechanisms of injury after spinal cord trauma.
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METHODS:
Systematic review of literature.
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RESULTS:
Experimental studies demonstrated that hypothermia diminishes secondary pathomechanisms, such as ischemia, oxidative stress, apoptosis, inflammation, and edema. Early onset and longer durations of hypothermia as well as concomitant steroids or neural stem cell engraftment combined with hypothermia appear to improve functional and histologic outcomes in animal models of spinal cord trauma. Recent clinical studies provide evidence that localized and systemic hypothermia may be applied safely and efficaciously in patients with severe acute SCI. Randomized clinical trials are needed to better evaluate optimal cooling parameters and the effectiveness of hypothermia after traumatic SCI.
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CONCLUSION:
Although variability exists in the literature, therapeutic hypothermia most likely confers neuroprotection after spinal cord trauma by diminishing the destructive secondary cascade. The available clinical data suggest that regional and systemic hypothermia is a relatively safe and feasible initial treatment modality for patients with acute SCI when combined with surgical decompression/stabilization with or without steroids. However, establishing a clinical role for therapeutic hypothermia after spinal cord trauma will
invariably depend on future well-designed, multicentered, randomized, controlled clinical trial data.


Monday, January 4, 2016

Implant Could Bridge Lost Brain Connections to Reanimate Paralyzed Limbs

While this is very interesting most people are going to read too much into the ability to help stroke survivors.  This is only going to be helpful for those strokes that leave the motor and premotor cortex intact.  Mainly damage to the white matter which your doctor has no clue about how to objectively determine that damage. This wouldn't help me at all unless the initiation connection point would be in my executive control area.
http://www.mdtmag.com/news/2015/12/implant-could-bridge-lost-brain-connections-reanimate-paralyzed-limbs?
In the next decade, people who have suffered a spinal cord injury or stroke could have their mobility improved or even restored through a radically new technology: implantable devices that can send signals between regions of the brain or nervous system that have been disconnected due to injury.
That's the mission driving the Center for Sensorimotor Neural Engineering, a University of Washington-led effort that includes researchers from the Massachusetts Institute of Technology, San Diego State University and other partners.
To support development of this much-needed technology, the National Science Foundation recently renewed the center's funding. It has awarded $16 million over the next four years to support research on implantable devices that promote brain plasticity and reanimate paralyzed limbs.
"There's a huge unmet need, especially with an aging population of baby boomers, for developing the next generation of medical devices for helping people with progressive or traumatic neurological conditions such as stroke and spinal cord injury," said CSNE director and UW professor of computer science and engineering Rajesh Rao.
The goal is to achieve proof-of-concept demonstrations in humans within the next five years, Rao said. This will lay the groundwork for eventual clinical devices approved by the Food and Drug Administration, in collaboration with the center's industry partners.
CSNE was founded in 2011 with an $18.5 million NSF grant. Since then, its interdisciplinary team of neuroscientists, engineers, computer scientists, neurosurgeons, ethicists and industry partners has led the way in developing 'bi-directional' implantable devices that can both pick up brain signals and send information to other parts of the nervous system.
The devices record and decode electrical signals generated by the brain when a person forms an intention, for example, to move a hand to pick up a cup. The devices are also able to wirelessly transmit that information, essentially creating a new artificial pathway around damaged areas of the brain or nervous system.
"When Christopher Reeve sustained a spinal cord injury due to a fall from his horse, his brain circuits were still intact and able to form the intention to move, but unfortunately the injury prevented that intention from being conveyed to the spinal cord," Rao said.

Friday, September 11, 2015

Protein synthesis in regenerating spinal cord axons

If we had any stroke strategist in the stroke associations or anywhere they would be looking at how to repurpose this for stroke. But we have no one and are screwed in our stroke rehab.
http://nro.sagepub.com/content/21/5/448?etoc
A Kalinski, R Sachdeva, C Gomes, SJ Lee, Z Shah, JD Houle , and others. 2015. mRNAs and protein synthetic machinery localize into regenerating spinal cord axons when they are provided a substrate that supports growth. J Neurosci 35(28):10357–70.
RB Perry, M Fainzilber . 2014. Local translation in neuronal processes-in vivo tests of a “heretical hypothesis”. Dev Neurobiol 74(3):210–7.
While it is well established that ribosomes and mRNAs provide a substrate for protein synthesis within the cell bodies of neurons, there has been debate about whether this biosynthetic machinery is present within the axons of mature neurons. An increasing number of studies have suggested that growing axons exhibit the capacity for protein synthesis, and there is evidence that proteins are synthesized locally within regenerating PNS axons where they provide a substrate for retrograde signaling and act locally as axons extend (Perry and Fainzilber 2014). In contrast, less attention has been given to the question of whether mature CNS …

Tuesday, March 17, 2015

Research on injectable oriented hydrogels for spinal cord repair - Maybe stroke?

And with a great stroke association following up on promising research this would be looked at to repurpose it for stroke repair. We need to repair 12 km (7.5 miles) of connections for each minute of infarct. But nothing will occur.

Research on injectable oriented hydrogels for spinal cord repair - Maybe stroke?


The research objective of Dr.-Ing. Laura De Laporte, junior group leader at DWI – Leibniz Institute for Interactive Materials in Aachen, is to develop a minimally invasive therapy for spinal cord injury. Her goal and her scientific approach to develop an injectable material with the ability to provide biochemical and physical guidance for regenerating nerves across the injury site, was selected by the European Research Council (ERC). Laura De Laporte now receives a 1.5 Million Euro ERC Starting Grant for her project ANISOGEL.
Spinal cord injury affects approximately two million people worldwide and is devastating as it leads to a loss of motor and sensory function below the point of injury. Regenerative therapies therefore try to restore nerve tracts and their function. Human neural stem cells or oligodendrocytes, which form the myelin sheet around the nerve cells, have been successfully transplanted into the damaged area and have created a spark of hope. To support these transplanted and other native cells at the injury site, and to guide neuron growth across this area, scientists are also investigating nerve bridges that are made of biomaterials, provide functional domains, and release growths factors. Unfortunately, such implants still face the challenge to stimulate the growing nerves to cross the point of injury and reenter the healthy spinal cord to rebuild functional connections.
In her project ANISOGEL, Laura De Laporte will engineer an injectable biomaterial that can be used as a matrix for a minimally invasive therapy to support oriented regeneration of damaged nerves. The material is based on a soft, water-rich polymeric network (hydrogel), which gels in situ and can be designed to mimic the conditions of the natural cell environment. The physical, chemical, and biological properties of these gels can be tailored bottom-up to resemble the body’s own extracellular matrix that provides mechanical and biological support to the cells.
“A hydrogel-based approach is not new. The innovative aspect about ANISOGEL is that we want to synthesize a material that can be hierarchically structured and form an anisotropic architecture in situ,” explains De Laporte. “This will improve the cells’ spatial orientation, which is crucial for nerve repair. The hydrogel will be further modified with biological signaling molecules to create an environment that stimulates cellular processes necessary for spinal cord regeneration and to regain functionality.”
Laura De Laporte received her Masters in Chemical Engineering at the University of Ghent and obtained her PhD in the laboratory of Prof. Lonnie Shea at Northwestern University in the United States. There, she focused on the development of multiple channel bridges with the ability for DNA and protein delivery for spinal cord repair. As a post-doctoral researcher at EPFL (Switzerland) in the laboratory of Prof. Jeffrey Hubbell, she engineered extracellular matrix-like hydrogels for tissue and nerve repair. She started her junior research group at DWI in October 2013. With the ERC Starting Grant, the European Research Council supports her work for the next five years.

Thursday, March 12, 2015

Regeneration of Damaged Neurons Promoted by Cancer Drug

Sounds quite useful for stroke damage also. When is your doctor going to start a clinical trial to prove what the stroke protocol should be for this?  Or is he/she one of the lazy ones? Waiting around for somebody else to solve the problem?
 http://neurosciencenews.com/neuroregeneration-epothilone-neurology-1852/
Damage to the spinal cord rarely heals because the injured nerve cells fail to regenerate. The regrowth of their long nerve fibers is hindered by scar tissue and molecular processes inside the nerves. An international team of researchers led by DZNE scientists in Bonn now reports in Science that help might be on the way from an unexpected quarter: in animal studies, the cancer drug epothilone reduced the formation of scar tissue in injuries to the spinal cord and stimulated growth in damaged nerve cells. Both promoted neuronal regeneration and improved the animals’ motor skills.
Nerve cells are wire-like conductors that transmit and receive signals in the form of electrical impulses. This function can be impaired by accidents or disease. Whether or not the affected nerves can recover largely depends on their location: for instance nerve cells in the limbs, torso and nose can regenerate to some degree and regain some or all of their function.
In contrast, the neurons in the brain and spinal cord do not have this ability. If they are damaged by accident or disease, the patient is likely to suffer long-term paralysis or other disabilities. But why is regeneration of these neurons and their long nerve fibers impeded? It is already known that inhibiting factors in newly formed scar tissue and other cellular processes block axon regrowth.
Seeking the ideal treatment
“The ideal treatment for promoting axon regeneration after spinal cord injury would inhibit the formation of scar tissue,” says Professor Frank Bradke, who leads a working group at the DZNE’s site in Bonn and who conducted the study. “However, it is also important that the growth-inhibiting factors are neutralized while reactivating the poor axons’ regenerative potential.” A feasible administration of a potential treatment is also essential for clinical application.

More at link.

Tuesday, February 3, 2015

Walking on ice takes more than brains - Salk scientists discover how a "mini-brain" in the spinal cord aids in balance

So if true, then I should be able to walk on ice even with my damage to my pre-motor and motor cortex. Not completely true, the last time I walked on ice I fell twice.
http://www.salk.edu/news/pressrelease_details.php?press_id=2070
Walking across an icy parking lot in winter–and remaining upright–takes intense concentration. But a new discovery suggests that much of the balancing act that our bodies perform when faced with such a task happens unconsciously, thanks to a cluster of neurons in our spinal cord that function as a “mini-brain” to integrate sensory information and make the necessary adjustments to our muscles so that we don’t slip and fall.
In a paper published January 29, 2015 in the journal Cell, Salk Institute scientists map the neural circuitry of the spinal cord that processes the sense of light touch. This circuit allows the body to reflexively make small adjustments to foot position and balance using light touch sensors in the feet. The study, conducted in mice, provides the first detailed blueprint for a spinal circuit that serves as control center for integrating motor commands from the brain with sensory information from the limbs. A better understanding of these circuits should eventually aid in developing therapies for spinal cord injury and diseases that affect motor skills and balance, as well as the means to prevent falls for the elderly.
Salk Institute researchers mapped neural circuits in the spinal cord that process light touch signals from the feet, a critical function for fine motor tasks, such as walking on ice. This image shows this neural circuitry in a mouse spinal cord. The red cells are RORα neurons, which merge signals coming from neural fibers coming from the brain and limbs (both colored blue).
“When we stand and walk, touch sensors on the soles of our feet detect subtle changes in pressure and movement. These sensors send signals to our spinal cord and then to the brain,” says Martyn Goulding, a Salk professor and senior author on the paper. “Our study opens what was essentially a black box, as up until now we didn’t know how these signals are encoded or processed in the spinal cord. Moreover, it was unclear how this touch information was merged with other sensory information to control movement and posture.”
While the brain’s role in cerebral achievements such as philosophy, mathematics and art often take center stage, much of what the nervous system does is to use information gathered from our environment to guide our movements. Walking across that icy parking lot, for instance, engages a number of our senses to prevent us from falling. Our eyes tell us whether we’re on shiny black ice or damp asphalt. Balance sensors in our inner ear keep our heads level with the ground. And sensors in our muscles and joints track the changing positions of our arms and legs.
Every millisecond, multiple streams of information, including signals from the light touch transmission pathway that Goulding’s team has identified, flow into the brain. One way the brain handles this data is by preprocessing it in sensory way stations such as the eye or spinal cord. The eye, for instance, has a layer of neurons and light sensors at its back that performs visual calculations–a process known as “encoding”–before the information goes on to the visual centers in the brain. In the case of touch, scientists have long thought that the neurological choreography of movement relies on data-crunching circuits in the spinal cord. But until now, it has been exceedingly difficult to precisely identify the types of neurons involved and chart how they are wired together.
In their study, the Salk scientists demystified this fine-tuned, sensory-motor control system. Using cutting-edge imaging techniques that rely on a reengineered rabies virus, they traced nerve fibers that carry signals from the touch sensors in the feet to their connections in the spinal cord. They found that these sensory fibers connect in the spinal cord with a group of neurons known as RORα neurons, named for a specific type of molecular receptor found in the nucleus of these cells. The RORα neurons in turn are connected by neurons in the motor region of brain, suggesting they might serve as a critical link between the brain and the feet.

When Goulding’s team disabled the RORα neurons in the spinal cord using genetically modified mice developed at Salk, they found that these mice were substantially less sensitive to movement across the surface of the skin or to a sticky piece of tape placed on their feet. Despite this, the animals were still able to walk and stand normally on flat ground.
However, when the researchers had the animals walk across a narrow, elevated beam, a task that required more effort and skill, the animals struggled, performing more clumsily than animals with intact RORα neurons. The scientists attribute this to the animals’ reduced ability to sense skin deformation when a foot was slipping off the edge and respond accordingly with small adjustments in foot position and balance–motor skills similar to those necessary for balancing on ice or other slippery surfaces.
Another important characteristic of the RORα neurons is that they don’t just receive signals from the brain and the light touch sensors, but also directly connect with neurons in the ventral spinal cord that control movement. Thus, they are at the center of a “mini-brain” in the spinal cord that integrates signals from the brain with sensory signals to make sure the limbs move correctly.
“We think these neurons are responsible for combining all of this information to tell the feet how to move,” says Steeve Bourane, a postdoctoral researcher in Goulding’s lab and first author on the new paper. “If you stand on a slippery surface for a long time, you’ll notice your calf muscles get stiff, but you may not have noticed you were using them. Your body is on autopilot, constantly making subtle corrections while freeing you to attend to other higher-level tasks.”
The team’s study represents the beginning of a new wave of research that promises to provide precise and comprehensive explanations for how the nervous system encodes and integrates sensory information to generate both conscious and unconscious movement.
“How the brain creates a sensory percept and turns it into an action is one of the central questions in neuroscience,” adds Goulding. “Our work is offering a really robust view of neural pathways and processes that underlie the control of movement and how the body senses its environment. We’re at the beginning of a real sea change in the field, which is tremendously exciting.”
Other authors on the paper were Katja S. Grossmann, Olivier Britz, Antoine Dalet, Marta Garcia Del Barrio, Floor J. Stam, Lidia Garcia-Campmany and Stephanie Koch, all of the Salk Institute.
The research was funding by National Institutes of Health (Grants NS080586, NS086372 and NS072031), the Catharina Foundation, the Humboldt Foundation and Joan and Irwin Jacobs, through Salk’s Innovation Grants Program.

Wednesday, December 17, 2014

SPINAL CORD INJURY Sprouting Neurological Function

Would this be useful after our strokes?
http://stm.sciencemag.org/content/6/267/267ec216.full?utm_source=eloqua
  1. Daniel K. Nishijima
+ Author Affiliations
  1. Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, USA. E-mail: daniel.nishijima@ucdmc.ucdavis.edu
Injury to the spinal cord, the main information highway up and down the body, triggers upregulation of highly glycosylated proteins at the site of injury. This acts as a barrier to nerve regeneration and “traps” nerves’ growing tips, preventing neurological recovery. Lang et al. developed an inhibitor that interferes with proteoglycan binding to its receptor [protein tyrosine phosphatase σ (PTPσ)] and is able to reverse the nerve regrowth blockage after spinal cord injury and improve the animals’ functional recovery.
Rats with spinal cord injury were injected with the PTPσ-binding drug subcutaneously daily for several weeks. At the end of treatment, urinary function and walking were improved compared with control animals, with higher doses producing better urinary function. Unexpectedly, the researchers did not observe regeneration of corticospinal tract fibers through the injury in the treated rats. Rather, below the lesion, they saw significant sprouting of dense territories of serotonergic neurons. Treatment with a serotonin antagonist reduced locomotor and urinary function in the treatment group but not the control group. This result indicated that the neurological improvement was a result of increased serotonin production from sprouting and regrowth of nerves that survived the injury rather than of reconnections of injured nerve fibers.
The practical advantage of delivering the drug systemically and the positive results of this study suggest that this approach holds great potential as a treatment for patients with spinal cord injury.
B. T. Lang et al., Modulation of the proteoglycan receptor PTPσ promotes recovery after spinal cord injury. Nature 10.1038/nature13974 (2014). [Abstract]

Saturday, February 15, 2014

Astroglial-Derived Periostin Promotes Axonal Regeneration after Spinal Cord Injury

Axonal regeneration and sprouting are needed for our recovery. Do your doctors have any idea what it is? Or why it's important to your recovery?
http://www.jneurosci.org/content/34/7/2438.short 
  1. Christoph Pröschel1,2
  1. Author contributions: C.-H.S. and C.P. designed research; C.-H.S., M.L., K.L.-B., and C.P. performed research; C.-H.S. and C.P. analyzed data; C.-H.S. and C.P. wrote the paper.
  1. The Journal of Neuroscience, 34(7): 2438-2443; doi: 10.1523/JNEUROSCI.2947-13.2014

Abstract

Traumatic spinal cord injury (SCI) results in a cascade of tissue responses leading to cell death, axonal degeneration, and glial scar formation, exacerbating the already hostile environment and further inhibiting axon regeneration. Overcoming these inhibitory cues and promoting axonal regeneration is one of the primary targets in developing a cure for SCI. Previously, we demonstrated that transplantation of bone morphogenetic protein (BMP)-induced astrocytes derived from embryonic glial-restricted precursors (GDAsBMP) promotes extensive axonal growth and motor function recovery in a rodent spinal cord injury model. Here, we identify periostin (POSTN), a secreted protein, as a key component of GDABMP-induced axonal regeneration. POSTN is highly expressed by GDAsBMP and the perturbation of POSTN expression by shRNA diminished GDABMP-induced neurite extension in vitro. We also found that recombinant POSTN is sufficient to overcome the inhibitory effect of scar-associated molecules and promote neurite extension in vitro by signaling through focal adhesion kinase and Akt. Furthermore, transplantation of POSTN-deficient GDAsBMP into the injured rat spinal cord resulted in compromised axonal regeneration, indicating that POSTN plays an essential role in GDABMP-mediated axonal regeneration. This finding reveals not only one of the major mechanisms underlying GDABMP-dependent recovery from SCI, but also the potential of POSTN as a therapeutic agent for traumatic injury of the CNS.

Wednesday, January 1, 2014

Manipulating the extracellular matrix and its role in brain and spinal cord plasticity and repair

Sounds extremely important. What is your doctor going to do with this knowledge to help you? You need to demand an answer so you can pay it forward to future stroke survivors.
http://onlinelibrary.wiley.com/doi/10.1111/nan.12114/abstract
  1. Emily R. Burnside,
  2. Elizabeth J. Bradbury*
DOI: 10.1111/nan.12114
  1. This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/nan.12114

Abstract

Brain and spinal cord injury can result in permanent cognitive, motor, sensory and autonomic deficits. The CNS has a poor intrinsic capacity for regeneration, although some functional recovery does occur. This is mainly in the form of sprouting, dendritic remodelling and changes in neuronal coding, firing and synaptic properties; elements collectively known as plasticity. An important approach to repair the injured CNS is therefore to harness, promote and refine plasticity. In the adult, this is partly limited by the extracellular matrix (ECM). While the ECM typically provides a supportive framework to CNS neurons, its role is not only structural; the ECM is homeostatic, actively regulatory and of great signalling importance, both directly via receptor or co-receptor-mediated action and via spatially and temporally relevant localisation of other signalling molecules. In an injury or disease state, the ECM represents a key environment to support a healing and/or regenerative response. However, there are aspects of its composition which prove suboptimal for recovery: some molecules present in the ECM restrict plasticity and limit repair. An important therapeutic concept is therefore to render the ECM environment more permissive by manipulating key components, such as inhibitory chondroitin sulphate proteoglycans. In this review we discuss the major components of the ECM and the role they play during development and following brain or spinal cord injury and we consider a number of experimental strategies which involve manipulations of the ECM, with the aim of promoting functional recovery to the injured brain and spinal cord.


Saturday, November 30, 2013

Plasticity beyond peri-infarct cortex: Spinal up regulation of structural plasticity, neurotrophins, and inflammatory cytokines during recovery from cortical stroke

I'm sure your wonderful up-to-date doctor can explain all this and how it is already incorporated into your 100% recovery protocol. You don't have a 100% recovery protocol? Why not? Is your doctor incompetent?

Plasticity beyond peri-infarct cortex: Spinal up regulation of structural plasticity, neurotrophins, and inflammatory cytokines during recovery from cortical stroke

  • a Centre for Neuroscience, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
  • b Faculty of Rehabilitative Medicine, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
  • c Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada T6G 2R3
  • d Neurochemical Research Unit, University of Alberta, Edmonton, Alberta, Canada T6G 2R3

Highlights

•
Cortical stroke induces heightened expression of GAP-43 in the spinal cord
•
Plasticity in the spinal cord after cortical stroke has a finite temporal window
•
TNF-α, IL-6, and NT-3 protein levels in spinal cord correlate with GAP-43 levels
•
BDNF increases transiently in spinal cord prior to heightened GAP-43 expression

Abstract

Stroke induces pathophysiological and adaptive processes in regions proximal and distal to the infarct. Recent studies suggest that plasticity at the level of the spinal cord may contribute to sensorimotor recovery after cortical stroke. Here, we compare the time course of heightened structural plasticity in the spinal cord against the temporal profile of cortical plasticity and spontaneous behavioural recovery. To examine the relation between trophic and inflammatory effectors and spinal structural plasticity, spinal expression of brain derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured. Growth-associated protein 43 (GAP-43), measured at 3, 7, 14, or 28 days after photothrombotic stroke of the forelimb sensorimotor cortex (FL-SMC) to provide an index of periods of heightened structural plasticity, varied as a function of lesion size and time after stroke in the cortical hemispheres and the spinal cord. Notably, GAP-43 levels in the cervical spinal cord were significantly increased after FL-SMC lesion, but the temporal window of elevated structural plasticity was more finite in spinal cord relative to ipsilesional cortical expression (returning to baseline levels by 28 post-stroke). Peak GAP-43 expression in spinal cord occurred during periods of accelerated spontaneous recovery, as measured on the Montoya Staircase reaching task, and returned to baseline as recovery plateaued. Interestingly, spinal GAP-43 levels were significantly correlated with spinal levels of the inflammatory cytokines TNF-α and IL-6 as well as the neurotrophin NT-3, while a transient increase in BDNF levels preceded elevated GAP-43 expression. These data identify a significant but time-limited window of heightened structural plasticity in the spinal cord following stroke that correlates with spontaneous recovery and the spinal expression of inflammatory cytokines and neurotrophic factors.

Abbreviations

  • IC, ipsilesional cortex;
  • CC, contralesional cortex;
  • CSC, cervical spinal cord;
  • LSC, lumbar spinal cord;
  • FL-SMC, forelimb sensorimotor cortex;
  • GAP-43, growth associated protein-43;
  • TNF-α, tumor necrosis factor - alpha;
  • IL-6, interleukin 6;
  • BDNF, brain derived neurotrophic factor;
  • NT-3, neurotrophin-3

Keywords

  • Ischemia;
  • Sensorimotor cortex;
  • Plasticity;
  • Spinal cord;
  • Inflammation;
  • Neurotrophins;
  • GAP-43;
  • TNF-alpha;
  • IL-6;
  • BDNF;
  • NT-3

Monday, August 26, 2013

Neuromuscular electrical stimulation for stroke rehabilitation: Is spinal plasticity a possible mechanism associated with diminished spasticity?

DEMAND your doctor figure out how to stop spasticity. Tell them that Dr. William M. Landau is not worth listening to.
http://www.sciencedirect.com/science/article/pii/S0306987713004027
  • a Universidade Estadual Paulista, School of Science and Technology, Physical Therapy Department, Biomechanics and Motor Control Laboratory, Rua Roberto Simonsen, 305, Presidente Prudente, SP, Brazil
  • b School of Arts, Sciences and Humanities, Universidade de São Paulo, EACH, Avenida Arlindo Bettio, 1000, SP, Brazil
  • c Neuroscience Program and Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, PTC, BrazilThe country name has been inserted in the affiliation. Please check, and correct if necessary.

Abstract

Although the specific pathophysiological mechanisms underlying the development of spasticity are not fully understood, a large amount of evidence suggests that abnormalities in spinal pathways regulating the stretch reflex may contribute to the hypertonia and hyperreflexia that characterize spasticity. It is quite interesting that neuromuscular electrical stimulation (NMES) has been reported as an efficient treatment for reducing spasticity after stroke while other reports have shown that it promotes neuroplasticity in healthy subjects. The hypothesis addressed in this paper is that plastic effects within some spinal cord pathways may be a possible mechanism associated with the NMES-induced improvements in spasticity. If the hypothesis is proven corrected, the association between plasticity within specific spinal pathways and NMES-induced improvements in spasticity may be used to guide the choice of stimulation parameters to be used in NMES-based stroke rehabilitation protocols.

Friday, July 5, 2013

Axonal Remodeling of the Corticospinal Tract in the Spinal Cord Contributes to Voluntary Motor Recovery After Stroke in Adult Mice

Read the conclusion paragraph and demand to know that means from your neurologist.
http://stroke.ahajournals.org/content/44/7/1951.abstract

Abstract

Background and Purpose—We sought to demonstrate the contribution of axonal remodeling of the corticospinal tract (CST) in the spinal cord to functional outcome after stroke.
Methods—Bilateral pyramidotomy (BPT) or sham-BPT was performed in mice with transgenic yellow fluorescent protein labeling in the CST subjected to middle cerebral artery occlusion (MCAo). Foot-fault and single pellet reaching tests were performed 3 days after MCAo and weekly thereafter. Mice were euthanized at day 14 or 28 after stroke. Immunofluorescent staining for growth-associated protein-43 and Synaptophysin was performed on cervical sections.
Results—Functional improvements were evident during the initial 14 days in both MCAo-sham-BPT and MCAo-BPT mice (P<0.01, versus day 3). Progressive recovery was present during the subsequent 14 days in MCAo-sham-BPT mice (P<0.001, versus day 14) but not in MCAo-BPT mice. In the stroke-affected cervical gray matter of MCAo-sham-BPT mice, growth-associated protein-43-Cy3 staining on CST axons were significantly increased at day 14 after stroke compared with normal mice (P<0.001), and CST axonal density and Synaptophysin-Cy3 staining of CST-yellow fluorescent protein axonal terminals were significantly increased at day 28 compared with day 14 after MCAo (P<0.001).
Conclusions—Our data demonstrate that voluntary motor recovery is associated with CST axonal outgrowth and synaptic formation in the denervated side of the spinal gray matter during the later phase after stroke, suggesting that the CST axonal plasticity in the spinal cord contributes to neurological recovery.

Thursday, May 23, 2013

Regenerating spinal cord fibers may be treatment for stroke-related disabilities

Don't expect any followup from any stroke association, that would involve real work.
http://medicalxpress.com/news/2013-05-regenerating-spinal-cord-fibers-treatment.html
A study by researchers at Henry Ford Hospital found "substantial evidence" that a regenerative process involving damaged nerve fibers in the spinal cord could hold the key to better functional recovery by most stroke victims.
The findings may offer new hope to those who suffer stroke, the leading cause of long-term disability in adults. Although most stroke victims recover some ability to voluntarily use their hands and other body parts, about half are left with weakness on one side of their bodies, while a substantial number are permanently disabled. The study is published in the current issue of Stroke and is available online. Discovering a treatment to improve or restore this lost motor function in stroke patients is a holy grail for neurologists, because none exists, primarily due to unsolved mysteries about how the brain and nerves repair themselves. The new Henry Ford research was intended to solve some of those mysteries. It focused on changes in axons – the fibers, the nerve signal "transmission" lines within the spinal cord that affect voluntary movement after stroke.

Read more at: http://medicalxpress.com/news/2013-05-regenerating-spinal-cord-fibers-treatment.html#jCp
 The findings may offer new hope to those who suffer stroke, the leading cause of long-term disability in adults. Although most stroke victims recover some ability to voluntarily use their hands and other body parts, about half are left with weakness on one side of their bodies, while a substantial number are permanently disabled. The study is published in the current issue of Stroke and is available online. Discovering a treatment to improve or restore this lost motor function in stroke patients is a holy grail for neurologists, because none exists, primarily due to unsolved mysteries about how the brain and nerves repair themselves. The new Henry Ford research was intended to solve some of those mysteries. It focused on changes in axons – the fibers, the nerve signal "transmission" lines within the spinal cord that affect voluntary movement after stroke.
More at link or look up the study in Stroke magazine.
A study by researchers at Henry Ford Hospital found "substantial evidence" that a regenerative process involving damaged nerve fibers in the spinal cord could hold the key to better functional recovery by most stroke victims.

Read more at: http://medicalxpress.com/news/2013-05-regenerating-spinal-cord-fibers-treatment.html#jCp
A study by researchers at Henry Ford Hospital found "substantial evidence" that a regenerative process involving damaged nerve fibers in the spinal cord could hold the key to better functional recovery by most stroke victims.

Read more at: http://medicalxpress.com/news/2013-05-regenerating-spinal-cord-fibers-treatment.html#jCp

Tuesday, March 5, 2013

Mn (III) tetrakis (4-Benzoic Acid) porphyrin scavenges reactive species, reduces oxidative stres s, and improves functional recovery after experimental spinal cord injury in rats: comparison with methylprednisolone

Ask your doctor why this wouldn't help in stroke recovery. And then ask when s/he is going to start clinical trials on this.
http://www.biomedcentral.com/content/pdf/1471-2202-14-23.pdf
Abstract
Background
Substantial experimental evidence supports that reactive species mediate secondary damage
after traumatic spinal cord injury (SCI) by inducing oxidative stress. Removal of reactive
species may reduce secondary damage following SCI. This study explored the effectiveness
of a catalytic antioxidant - Mn (III) tetrakis (4-benzoic acid) porphyrin (MnTBAP) - in
removing reactive oxygen species (ROS), reducing oxidative stress, and improving functional
recovery in vivo in a rat impact SCI model. The efficiency of MnTBAP was also compared
with that of methylprednisolone – the only drug used clinically in treating acute S
CI.
Results
In vivo measurements of time courses of ROS production by microdialysi
s and microcannula sampling in MnTBAP, methylprednisolone, and saline (as vehicle contr
ol)-treated SCI rats showed that both agents significantly reduced the production of hydrogen
peroxide, but only MnTBAP significantly reduced superoxide elevation after SCI.
In vitro experiments further demonstrated that MnTBAP scavenged both of the preceding ROS, whereas methylprednisolone had no effect on either. By counting the immuno-positive
neurons in the spinal cord sections immunohistochemically stained with anti-nitrotyrosine and anti-4-hydroxy-nonenal antibodies as the markers of protein nitration and membrane lipid peroxidation, we demonstrated that MnTBAP significantly reduced the numbers of 4-hydroxy-nonenal-positive and nitrotyrosine-positive neurons in the sections at 1.55 to 2.55 mm and 1.1 to 3.1 mm, respectively, rostral to the injury epicenter compared to the vehicle-treated animals. By behavioral tests (open field and inclined plane tests), we demonstrated that at 4 hours post-SCI treatment with MnTBAP and the standard met hylprednisolone regimen both significantly increased test scores compared to thos
e produced by vehicle treatment. However, the outcomes for MnTBAP-treated rats were significantly better than those for methylprednisolone-treated animals.
Conclusions
This study demonstrated for the first time in vivo and in vitro that MnTBAP significantly reduced the levels of SCI-elevated ROS and that MnTBAP is superior to methylprednisolone in removing ROS. Removal of ROS by MnTBAP significantly reduced protein nitration and membrane lipid peroxidation in neurons. MnTBAP more effectively reduced neurological deficits than did by methylprednisolone after SCI - the first most important criterion for assessing SCI treatments. These results support the therapeutic potential of MnTBAP in treating SCI.