Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.

We have studied the axonal projection patterns of commissural interneurons (CINs) in the neonatal rat spinal cord. Some CINs are integral components of the neuronal networks in the vertebrate spinal cord that generate locomotor activity. By using differential retrograde labeling protocols with fluorescent dextran amines, we show that CINs with ascending axons (ascending CINs, or aCINs) and CINs with descending axons (descending CINs, or dCINs) constitute largely different populations. We show that aCINs and dCINs occupy partially overlapping domains in the transverse plane. The aCINs are located at the dorsal margin, within the dorsal horn, centrally within the intermediate zone, and in the medial region of the ventral horn, whereas the dCINs are located predominantly among the ventral and central aCINs and in smaller numbers within the dorsal horn. The labeled aCINs and dCINs project for at least one and a half segment rostrally or caudally and are present in roughly equal numbers. We also demonstrate the presence of a third, smaller population of CINs whose axons bifurcate to project for at least one and a half segment both rostrally and caudally (adCINs). The adCINs are located predominantly among the central and ventral groups of aCINs and dCINs. Finally, we demonstrate the presence of CINs with axons projecting for fewer than one and a half segment in either direction. These "short-range CINs" are intermingled with the aCINs, dCINs, and adCINs. Our results provide an anatomical framework for further electrophysiological studies aimed at identifying the CINs that participate in the mammalian locomotor central pattern generator.

Training seemed not to provoke new pain. Spasticity decreased after a single training session. SCIM III and quality of life increased longitudinally for subsets of participants.

Signaling by receptor tyrosine kinases (RTKs) is mediated by their intrinsic kinase activity. Typically, kinase-activating mutations result in ligand-independent signaling and gain-of-function phenotypes. Like other RTKs, Ephs require kinase activity to signal, but signaling by Ephs in vitro also requires clustering by their membrane bound ephrin ligands. The relative importance of Eph kinase activity and clustering for in vivo functions is unknown. We find that knockin mice expressing a mutant form of EphA4 (EphA4(EE)), whose kinase is constitutively activated in the absence of ephrinB ligands, are deficient in the development of thalamocortical projections and some aspects of central pattern generator rhythmicity. Surprisingly, other functions of EphA4 were regulated normally by EphA4(EE), including midline axon guidance, hindlimb locomotion, in vitro growth cone collapse, and phosphorylation of ephexin1. These results suggest that signaling of Eph RTKs follows a multistep process of induced kinase activity and higher-order clustering different from RTKs responding to soluble ligands.

Interneurons and projection neurons in the lumbar spinal cord of mouse and rat embryos were labeled retrogradely with fluorescent dextran amines from a distance of one segment from the segment of origin [lumbar segment (L) 2]. Six classes with specific axonal projections (ipsilateral ascending, descending, and bifurcating, and commissural ascending, descending, and bifurcating) were identified by differential labeling in both species and followed from embryonic day (E)12 to birth in the mouse. Neurons with shorter projections (intrasegmental interneurons) were not studied. We show that the four nonbifurcating neuron classes occupy characteristic, partially overlapping domains in the transverse plane, indicating a systematic pattern of migration and settlement related to axon trajectories. The number of neurons in each of the nonbifurcating classes increased steadily during development. Bifurcating neurons represented a minor fraction of the total throughout development and had relatively scattered positions within the ipsilateral and commissural neuron domains. Combination of retrograde tracing and immunohistochemistry for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) showed that none of the spinal neurons in the six projection-specific classes was GABA positive, suggesting that all GABA-positive spinal neurons, including previously described GABA-positive commissural neurons, are unlikely to have projections exceeding one or two segments in either direction.

No abstract

Using differential retrograde axonal tracing, we identified motoneurons (MNs) and projection-specific interneuron (IN) classes in lumbar segment D9 of the adult red-eared turtle spinal cord. We characterized the distribution of these neurons in the transverse plane, and estimated their numbers and proportions. Different labeling paradigms allowed us to distinguish ipsilateral INs (IINs) from commissural INs (CINs), and to identify IINs and CINs with either ascending (a) axons, descending (d) axons, or axons that bifurcate to both ascend and descend (ad). Local interneurons with axons shorter than 1 segment in length were not studied. We show that most retrogradely labeled INs are located dorsal to the MNs, in the ventral horn, the intermediate zone and the dorsal horn. IINs predominate in the dorsal horn. CINs are located on average more medially than the IINs in the ventral horn and intermediate zone. Within the IIN and CIN populations, aINs and dINs overlap extensively. The adIINs and adCINs make up only a small fraction of the total number of INs and are scattered throughout much of the respective IIN and CIN domains. The proportions of IINs and CINs are about equal, as are the proportions of aIINs versus dIINs, of aCINs versus dCINs, and of adIINs versus adCINs. The findings are compared to the organization of lumbar spinal INs in other vertebrate species.

Study design: Intra-and inter-rater reliability study. Objectives: To assess intra-and inter-rater reliability of the Modified Ashworth Scale (MAS) and Spasm Frequency Score (SFS) in lower extremities in a population of spinal cord-injured persons, as well as correlations between the two scales. Setting: Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbaek, Denmark. Methods: Thirty-one persons participated in the study and were tested four times in total with MAS and SFS by three experienced raters. Cohen's kappa (κ), simple and quadratic weighted (nominal and ordinal scale level of measurement), was used as a measure of reliability and Spearman's rank correlation coefficient for correlation between MAS and SFS. Results: Neurological level ranged from C2 to L2 and American Spinal Injury Association impairment scale A to D. Time since injury was (mean ± s.d.) 3.4 ± 6.5 years. Age was 48.3 ± 20.2 years. Cause of injury was traumatic in 55% and non-traumatic for 45% of the participants. Antispastic medication was used by 61%. MAS showed intra-rater κ simple = − 0.11 to 0.46 and κ weighted = − 0.11 to 0.83. Inter-rater κ simple = − 0.06 to 0.32 and κ weighted = 0.08 to 0.74. SFS showed intra-rater κ weighted = 0.94 and inter-rater κ weighted = 0.93. Correlation between MAS and SFS showed non-significant correlation coefficients from − 0.11 to 0.90. Conclusion: Reliability of MAS is highly affected by the weighting scheme. With a weighted-κ it was overall reliable and simple-κ overall unreliability. Repeated tests should always be performed by the same rater and in a very standardized manner. SFS was found reliable. MAS and SFS are poorly correlated, and ratings were inversely distributed and suggest that it assesses different aspects of spasticity.