A Speculative Pharmaceutical Cocktail to Treat Spinal Cord Injury

Sledge, John B.; Mahadevappa, Karthik; Stacey, Paul; Graham, Andrew; Nesathurai, Shanker

doi:10.1097/phm.0000000000000486

Cited by 6 publications

(9 citation statements)

References 14 publications

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“…Although related corticosteroid clinical trials attract extreme criticisms over wound infection, gastrointestinal hemorrhages, sepsis, pulmonary embolism, severe pneumonia, and even death, MPSS until now is still an expedient strategy in the treatment of SCI [5][6][7]. With the understanding of SCI based on increasing clinical and basic researches, a plenty of key neuroprotective trials about pharmacological therapy (riluzole, magnesium, minocycline, GM-1, fibroblast growth factor, granulocyte colony-stimulating factor, hepatocyte growth factor) [8][9][10] and non-pharmacologic therapy (therapeutic hypothermia, CSF drainage) are underway. Furthermore, in terms of neuroregeneration, the specific clinical result of both drug therapeutics (Rho-ROCK inhibitor, anti-NOGO antibody) and nondrug therapeutics (spinal cord stimulation) are still in pending.…”

Section: Introductionmentioning

confidence: 99%

Is cell transplantation a reliable therapeutic strategy for spinal cord injury in clinical practice? A systematic review and meta-analysis from 22 clinical controlled trials

et al. 2019

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Purpose It is an open question whether cell transplantation can provide safety and effective outcome to spinal cord injury (SCI) patient which has remained controversial for almost 40 years. This study aimed to evaluate the safety and efficacy of cell transplantation in SCI patients. Method Studies of the cell transplantation for SCI were retrieved from PubMed, Embase, Medline, Cochrane Library and analyzed quantitative data by Review Manager 5.3.Results Twenty-one clinical controlled studies with 973 patients were included. The pooled results suggested that cell transplantation significantly improved ASIA score, ASIA motor score, ASIA sensory score, Barthel Index score, residual urine volume, rehabilitative time of automatic micturition. Furthermore, subgroup analysis indicated that the stem cells exhibited more potent than the non-stem cells in spinal cord repair. Cell transplantation at more than 14 days after injury showed more significant improvements than that within 14 days from injury. The dosage of cell transplantation between 1-5 × 10 7 and 10-20 × 10 7 was the potent quantity for the patient with SCI. Intrathecal injection and intravenous + intrathecal injection showed more superior to the other method. The top 5 adverse events were febrile reaction (11.5%), neurologic pain (11.3%), headache (2.6%), neurologic deterioration (2.4%), and rigidity or spasticity (1.6%). Conclusion Cell transplantation appears to be a safe therapeutic strategy possessing substantial beneficial effects in the patients with SCI in clinic. Moreover, treating SCI with stem cell, the dosage of cells between 1-5 × 10 7 and 10-20 × 10 7 , in intermediate or chronic phase, minimally invasive techniques, may bring more advantage to SCI patient.

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Section: Introductionmentioning

confidence: 99%

Is cell transplantation a reliable therapeutic strategy for spinal cord injury in clinical practice? A systematic review and meta-analysis from 22 clinical controlled trials

et al. 2019

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“…However, in the context of a limited number of subjects, this should be considered as a preliminary inference. The rationale for this combination treatment in TSCI and the implications thereof are published elsewhere [40].…”

Section: Discussionmentioning

confidence: 99%

“…TRH is a tripeptide produced by the hypothalamus; selenium and Vitamin E are antioxidants. The combination of these agents may modulate the physiological sequelae of TSCI [40]. This protocol was approved by the Institutional Animal Care and Use Committee (IACUC) at Harvard University and the University of Wisconsin at Madison.…”

Section: Methodsmentioning

confidence: 99%

Neurophysiological Characterization of a Non-Human Primate Model of Traumatic Spinal Cord Injury Utilizing Fine-Wire EMG Electrodes

Masood

Abdullah

Seth

et al. 2019

Sensors

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This study aims to characterize traumatic spinal cord injury (TSCI) neurophysiologically using an intramuscular fine-wire electromyography (EMG) electrode pair. EMG data were collected from an agonist-antagonist pair of tail muscles of Macaca fasicularis, pre- and post-lesion, and for a treatment and control group. The EMG signals were decomposed into multi-resolution subsets using wavelet transforms (WT), then the relative power (RP) was calculated for each individual reconstructed EMG sub-band. Linear mixed models were developed to test three hypotheses: (i) asymmetrical volitional activity of left and right side tail muscles (ii) the effect of the experimental TSCI on the frequency content of the EMG signal, (iii) and the effect of an experimental treatment. The results from the electrode pair data suggested that there is asymmetry in the EMG response of the left and right side muscles (p-value < 0.001). This is consistent with the construct of limb dominance. The results also suggest that the lesion resulted in clear changes in the EMG frequency distribution in the post-lesion period with a significant increment in the low-frequency sub-bands (D4, D6, and A6) of the left and right side, also a significant reduction in the high-frequency sub-bands (D1 and D2) of the right side (p-value < 0.001). The preliminary results suggest that using the RP of the EMG data, the fine-wire intramuscular EMG electrode pair are a suitable method of monitoring and measuring treatment effects of experimental treatments for spinal cord injury (SCI).

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“…The experimental methods were as described in detail elsewhere [ 3 , 4 , 10 , 11 , 24 ]. Briefly, the subjects were adult Macaca fasicularis monkeys.…”

Section: Methodsmentioning

confidence: 99%

A Novel Application of Deep Learning (Convolutional Neural Network) for Traumatic Spinal Cord Injury Classification Using Automatically Learned Features of EMG Signal

Masood

Sharma

Mand

et al. 2022

Sensors

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In this study, a traumatic spinal cord injury (TSCI) classification system is proposed using a convolutional neural network (CNN) technique with automatically learned features from electromyography (EMG) signals for a non-human primate (NHP) model. A comparison between the proposed classification system and a classical classification method (k-nearest neighbors, kNN) is also presented. Developing such an NHP model with a suitable assessment tool (i.e., classifier) is a crucial step in detecting the effect of TSCI using EMG, which is expected to be essential in the evaluation of the efficacy of new TSCI treatments. Intramuscular EMG data were collected from an agonist/antagonist tail muscle pair for the pre- and post-spinal cord lesion from five Macaca fasicularis monkeys. The proposed classifier is based on a CNN using filtered segmented EMG signals from the pre- and post-lesion periods as inputs, while the kNN is designed using four hand-crafted EMG features. The results suggest that the CNN provides a promising classification technique for TSCI, compared to conventional machine learning classification. The kNN with hand-crafted EMG features classified the pre- and post-lesion EMG data with an F-measure of 89.7% and 92.7% for the left- and right-side muscles, respectively, while the CNN with the EMG segments classified the data with an F-measure of 89.8% and 96.9% for the left- and right-side muscles, respectively. Finally, the proposed deep learning classification model (CNN), with its learning ability of high-level features using EMG segments as inputs, shows high potential and promising results for use as a TSCI classification system. Future studies can confirm this finding by considering more subjects.

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A Speculative Pharmaceutical Cocktail to Treat Spinal Cord Injury

Cited by 6 publications

References 14 publications

Is cell transplantation a reliable therapeutic strategy for spinal cord injury in clinical practice? A systematic review and meta-analysis from 22 clinical controlled trials

Is cell transplantation a reliable therapeutic strategy for spinal cord injury in clinical practice? A systematic review and meta-analysis from 22 clinical controlled trials

Neurophysiological Characterization of a Non-Human Primate Model of Traumatic Spinal Cord Injury Utilizing Fine-Wire EMG Electrodes

A Novel Application of Deep Learning (Convolutional Neural Network) for Traumatic Spinal Cord Injury Classification Using Automatically Learned Features of EMG Signal

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