Erratum: Autologous olfactory mucosal transplant in chronic spinal cord injury: an Indian Pilot Study

Chhabra, HS; Lima, Celson; Sachdeva, S. P.; Mittal, Ankit; Nigam, VK; Chaturvedi, Deepa; Arora, Manali; Aggarwal, Archana; Kapur, R. L.; Khan, Talat

doi:10.1038/sc.2009.109

Cited by 30 publications

(51 citation statements)

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“…[4][5][6] However, the auspicious results in animal experiments often cannot be replicated in humans. For example, the application of regeneration-facilitating olfactory ensheathing cells led to a recovery of function after an SCI in rodents, [7][8][9][10] but had no or only a poor effect on the neurological deficit in humans with SCI [11][12][13][14][15] in wellcontrolled 14 but also rather uncontrolled studies. [11][12][13]15 The main problem is the time of the treatment onset.…”

Section: Introductionmentioning

confidence: 99%

Neuronal dysfunction in chronic spinal cord injury

2010

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This review describes the changes of spinal neuronal function that occur after a motor complete spinal cord injury (cSCI) in humans. In healthy subjects, polysynaptic spinal reflex (SR) evoked by non-noxious tibial nerve stimulation consists of an early SR component and rarely a late SR component. Soon after a cSCI, SR and locomotor activity are absent. After spinal shock; however, an early SR component re-appears associated with the recovery of locomotor activity in response to appropriate peripheral afferent input. Clinical signs of spasticity take place in the following months, largely as a result of nonneuronal changes. After around 1 year, the locomotor and SR activity undergo fundamental changes, that is, the electromyographic amplitude in the leg muscles during assisted locomotion exhaust rapidly, accompanied by a shift from early to dominant late SR components. The exhaustion of locomotor activity is also observed in non-ambulatory patients with an incomplete spinal cord injury (SCI). At about 1 year after injury, in most cSCI subjects the neuronal dysfunction is fully established and remains more or less stable in the following years. It is assumed that in chronic SCI, the patient's immobility resulting in a reduced input from supraspinal and peripheral sources leads to a predominance of inhibitory drive within spinal neuronal circuitries underlying locomotor pattern and SR generation. Training of spinal interneuronal circuits including the enhancement of an appropriate afferent input might serve as an intervention to prevent neuronal dysfunction after an SCI.

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Section: Introductionmentioning

confidence: 99%

Neuronal dysfunction in chronic spinal cord injury

2010

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“…Five studies limited the inclusion criteria based on the MRI findings. Two studies proposed limits in the lesion size, 18,19 one study excluded participants depending on the presence of tethering in the spinal cord, 23 and two studies excluded persons who had complete transections. 15,24 Ten…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies [14][15][16][17][18][19][20][21][22] assessed spinal integrity using magnetic resonance imaging (MRI) ( Tables 3 and 4). Five studies limited the inclusion criteria based on the MRI findings.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Experimental Strategies Aimed at Improving Motor Function after Acute and Chronic Spinal Cord Injury

Gomes‐Osman

Cortes

Guest

et al. 2016

Journal of Neurotrauma

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While various approaches have been proposed in clinical trials aimed at improving motor function after spinal cord injury in humans, there is still limited information regarding the scope, methodological quality, and evidence associated with single-intervention and multi-intervention approaches. A systematic review performed using the PubMed search engine and the key words ''spinal cord injury motor recovery'' identified 1973 records, of which 39 were selected (18 from the search records and 21 from reference list inspection). Study phase (clinicaltrials.org criteria) and methodological quality (Cochrane criteria) were assessed. Studies included proposed a broad range of single-intervention (encompassing cell therapies, pharmacology, electrical stimulation, rehabilitation) (encompassing cell therapies, pharmacology, electrical stimulation, rehabilitation) and multi-intervention approaches (that combined more than one strategy). The highest evidence level was for Phase III studies supporting the role of multi-intervention approaches that contained a rehabilitation component. Quality appraisal revealed that the percentage of selected studies classified with high risk of bias by Cochrane criteria was as follows: random sequence generation = 64%; allocation concealment = 77%; blinding of participants and personnel = 69%; blinding of outcome assessment = 64%; attrition = 44%; selective reporting = 44%. The current literature contains a high proportion of studies with a limited ability to measure efficacy in a valid manner because of low methodological strength in all items of the Cochrane risk of bias assessment. Recommendations to decrease bias are discussed and include increased methodological rigor in the study design and recruitment of study participants, and the use of electrophysiological and imaging measures that can assess functional integrity of the spinal cord (and may be sufficiently sensitive to detect changes that occur in response to therapeutic interventions).

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“…On the other hand, intense PT after the various neural recovery/neuroregenerative surgical procedures including the OMA procedure appears to be an essential component for motor recovery. 36,47,83 It should be noted that there was a tendency for the matched control as compared to the OMA participants to improve their UE LT scores over the first 60 days in the intense PT program; however, this group difference was not sustained over the entire course of therapy. It is uncertain if this is a true finding or is another example of the apparent variability of sensory score outcomes when tested repeatedly over time.…”

Section: Is Olfactory Mucosa Autograft a Factor?mentioning

confidence: 97%

Effectiveness of intense, activity-based physical therapy for individuals with spinal cord injury in promoting motor and sensory recovery: Is olfactory mucosa autograft a factor?

Larson

Dension

2013

The Journal of Spinal Cord Medicine

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Background/objectives: Rehabilitation for individuals with spinal cord injury (SCI) is expanding to include intense, activity-based, out-patient physical therapy (PT). The study's primary purposes were to (i) examine the effectiveness of intense PT in promoting motor and sensory recovery in individuals with SCI and (ii) compare recovery for individuals who had an olfactory mucosa autograft (OMA) with individuals who did not have the OMA while both groups participated in the intense PT program. Methods: Prospective, non-randomized, non-blinded, intervention study. Using the American Spinal Injury Association examination, motor and sensory scores for 23 (7 OMA, 6 matched control and 10 other) participants were recorded. Results: Mean therapy dosage was 137.3 total hours. The participants' total, upper and lower extremity motor scores improved significantly while sensory scores did not improve during the first 60 days and from initial to discharge examination. Incomplete SCI or paraplegia was associated with greater motor recovery. Five of 14 participants converted from motor-complete to motor-incomplete SCI. Individuals who had the OMA and participated in intense PT did not have greater sensory or greater magnitude or rate of motor recovery as compared with participants who had intense PT alone. Conclusion: This study provides encouraging evidence as to the effectiveness of intense PT for individuals with SCI. Future research is needed to identify the optimal therapy dosage and specific therapeutic activities required to generate clinically meaningful recovery for individuals with SCI including those who elect to undergo a neural recovery/regenerative surgical procedure and those that elect intense therapy alone.

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Erratum: Autologous olfactory mucosal transplant in chronic spinal cord injury: an Indian Pilot Study

Cited by 30 publications

References 0 publications

Neuronal dysfunction in chronic spinal cord injury

Neuronal dysfunction in chronic spinal cord injury

A Systematic Review of Experimental Strategies Aimed at Improving Motor Function after Acute and Chronic Spinal Cord Injury

Effectiveness of intense, activity-based physical therapy for individuals with spinal cord injury in promoting motor and sensory recovery: Is olfactory mucosa autograft a factor?

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