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Published Research

Some recent papers published by ICORD researchers are listed below. Links to each of our researchers’ most recent publications are included at the bottom of their respective researcher profile.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report

Authors: Glennie RA, Bailey CS, Tsai EC, Noonan VK, Rivers CS, Fourney DR, Ahn H, Kwon BK, Paquet J, Drew B, Fehlings MG, Attabib N, Christie SD, Finkelstein J, Hurlbert RJ, Parent S, Dvorak M.
Published in: Spinal Cord. 2017 Apr 18. doi: 10.1038/sc.2016.177. [Epub ahead of print]
About: The objective of this study is to identify surgeon opinion on ideal practice regarding the timing of decompression/stabilization for spinal cord injury and actual practice. Discrepancies in surgical timing and barriers to ideal timing of surgery were explored.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report

Authors: Chisholm AE, Alamro RA, Williams AM, Lam T.
Published in: J Neuroeng Rehabil. 2017 Apr 11;14(1):27. doi: 10.1186/s12984-017-0236-z.
About: Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI).

Luminal Water Imaging: A New MR Imaging T2 Mapping Technique for Prostate Cancer Diagnosis

Authors: Sabouri S, Chang SD, Savdie R, Zhang J, Jones EC, Goldenberg SL, Black PC, Kozlowski P.
Published in: Radiology. 2017 Apr 10:161687. doi: 10.1148/radiol.2017161687. [Epub ahead of print]
About: The objective of this study is to assess the feasibility of luminal water imaging, a quantitative T2-based magnetic resonance (MR) imaging technique, for the detection and grading of prostate cancer (PCa).

The role of the autonomic nervous system in arrhythmias and sudden cardiac death

Authors: Franciosi S, Perry FK, Roston TM, Armstrong KR, Claydon VE, Sanatani S.
Published in: Auton Neurosci. 2017 Mar 31. pii: S1566-0702(16)30139-4. doi: 10.1016/j.autneu.2017.03.005. [Epub ahead of print]
About: The autonomic nervous system (ANS) is complex and plays an important role in cardiac arrhythmia pathogenesis. A deeper understanding of the anatomy and development of the ANS has shed light on its involvement in cardiac arrhythmias. Alterations in levels of Sema-3a and NGF, both growth factors involved in innervation patterning during development of the ANS, leads to cardiac arrhythmias. Dysregulation of the ANS, including polymorphisms in genes involved in ANS development, have been implicated in sudden infant death syndrome. Disruptions in the sympathetic and/or parasympathetic systems of the ANS can lead to cardiac arrhythmias and can vary depending on the type of arrhythmia. Simultaneous stimulation of both the sympathetic and parasympathetic systems is thought to lead to atrial fibrillation whereas increased sympathetic stimulation is thought to lead to ventricular fibrillation or ventricular tachycardia. In inherited arrhythmia syndromes, such as Long QT and Catecholaminergic Polymorphic Ventricular Tachycardia, sympathetic system stimulation is thought to lead to ventricular tachycardia, subsequent arrhythmias, and in severe cases, cardiac death. On the other hand, arrhythmic events in Brugada Syndrome have been associated with periods of high parasympathetic tone. Increasing evidence suggests that modulation of the ANS as a therapeutic strategy in the treatment of cardiac arrhythmias is safe and effective. Further studies investigating the involvement of the ANS in arrhythmia pathogenesis and its modulation for the treatment of cardiac arrhythmias is warranted.

The development of an outcome measures toolkit for spinal cord injury rehabilitation

Authors: Chan CW, Miller WC, Querée M, Noonan VK, Wolfe DL; SCIRE Research Team.
Published in: Can J Occup Ther. 2017 Jan 1:8417417690170. doi: 10.1177/0008417417690170. [Epub ahead of print]
About: This study aimed to establish a common set of validated outcome measures specifically for SCI clinical practice.

Validating myelin water imaging with transmission electron microscopy in a rat spinal cord injury model

Authors: Chen HS, Holmes N, Liu J, Tetzlaff WKozlowski P.
Published inNeuroimage. 2017 Apr 2;153:122-130. doi: 10.1016/j.neuroimage.2017.03.065. [Epub ahead of print]
About: Myelin content is an important marker for neuropathology and MRI generated myelin water fraction (MWF) has been shown to correlate well with myelin content. However, because MWF is based on the amount of signal from myelin water, that is, the water trapped between the myelin lipid bilayers, the reading may depend heavily on myelin morphology. This is of special concern when there is a mix of intact myelin and myelin debris, as in the case of injury. To investigate what MWF measures in the presence of debris, we compared MWF to transmission electron microscopy (TEM) derived myelin fraction that measures the amount of compact appearing myelin. A rat spinal cord injury model was used with time points at normal (normal myelin), 3 weeks post-injury (myelin debris), and 8 weeks post-injury (myelin debris, partially cleared). The myelin period between normal and 3 or 8 weeks post-injury cords did not differ significantly, suggesting that as long as the bilayer structure is intact, myelin debris has the same water content as intact myelin. The MWF also correlated strongly with the TEM-derived myelin fraction, suggesting that MWF measures the amount of compact appearing myelin in both intact myelin and myelin debris. From the TEM images, it appears that as myelin degenerates, it tends to form large watery spaces within the myelin sheaths that are not classified as myelin water. The results presented in this study improve our understanding and allows for better interpretation of MWF in the presence of myelin debris.

Frontal TBI increases impulsive decision making in rats: A potential role for the inflammatory cytokine interleukin-12

Authors: Vonder Haar C, Martens KM, Riparip LK, Rosi S, Wellington CL, Winstanley CA.
Published in: J Neurotrauma. 2017 Apr 4. doi: 10.1089/neu.2016.4813. [Epub ahead of print]
About: Traumatic brain injury is associated with the development of numerous psychiatric diseases. Of particular concern for TBI patients is the impact of chronic impulsivity on daily functioning. Despite the scope of the human problem, little has been done to address impulsivity in animal models of brain injury. In the current study, we examined the effects of either a severe or a milder bilateral frontal controlled cortical impact injury on impulsivity using the delay discounting task (DDT), in which preference for smaller-sooner over larger-later rewards is indicative of greater impulsive choice. Both milder and severe TBI caused a significant, chronic increase in impulsive decision-making. Despite these pronounced changes in performance of the DDT, memory function, as assessed by the Morris Water Maze, was not impaired in more mildly injured rats, and only transiently impacted in the severe TBI group. While a significant lesion was only evident in severely injured rats, analysis of cytokine levels within the frontal cortex revealed a selective increase in interleukin-12 that was associated with the magnitude of the change in impulsive choice caused by both milder and severe TBI. These findings suggest that tissue loss alone cannot explain the increased impulsivity observed, and that inflammatory pathways mediated by interleukin-12 may be a contributing factor. The findings from this study highlight the sensitivity of sophisticated behavioral measures designed to assess neuropsychiatric dysfunction in the detection of TBI-induced cognitive impairments, and their utility in identifying potential mechanistic pathways and therapeutic targets.

Emerging Biofabrication Strategies for Engineering Complex Tissue Constructs

Authors: Pedde RD, Mirani B, Navaei A, Styan T, Wong S, Mehrali M, Thakur A, Mohtaram NK, Bayati A, Dolatshahi-Pirouz A, Nikkhah M, Willerth SM, Akbari M.
Published in: Adv Mater. 2017 Apr 3. doi: 10.1002/adma.201606061. [Epub ahead of print]
About: The demand for organ transplantation and repair, coupled with a shortage of available donors, poses an urgent clinical need for the development of innovative treatment strategies for long-term repair and regeneration of injured or diseased tissues and organs. Bioengineering organs, by growing patient-derived cells in biomaterial scaffolds in the presence of pertinent physicochemical signals, provides a promising solution to meet this demand. However, recapitulating the structural and cytoarchitectural complexities of native tissues in vitro remains a significant challenge to be addressed. Through tremendous efforts over the past decade, several innovative biofabrication strategies have been developed to overcome these challenges. This review highlights recent work on emerging three-dimensional bioprinting and textile techniques, compares the advantages and shortcomings of these approaches, outlines the use of common biomaterials and advanced hybrid scaffolds, and describes several design considerations including the structural, physical, biological, and economical parameters that are crucial for the fabrication of functional, complex, engineered tissues. Finally, the applications of these biofabrication strategies in neural, skin, connective, and muscle tissue engineering are explored.

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome

Authors: Qannam H, Mahmoud H, Mortenson WB.
Published in: Brain Inj. 2017 Mar 31:1-7. doi: 10.1080/02699052.2017.1286386. [Epub ahead of print]
About: The objectives of this study are to (1) describe trends in time to rehabilitation admission and rehabilitation length of stay (LOS), (2) compare functional independence at discharge from rehabilitation between patients who arrived directly from acute care versus those from elsewhere and (3) identify independent predictors of functional outcomes following rehabilitation.

Economic evaluation of aerobic exercise training in older adults with vascular cognitive impairment: PROMoTE trial

Authors: Davis JC, Hsiung GR, Bryan S, Best JR, Eng JJ, Munkacsy M, Cheung W, Chiu B, Jacova C, Lee P, Liu-Ambrose T.
Published in: BMJ Open. 2017 Mar 29;7(3):e014387. doi: 10.1136/bmjopen-2016-014387.
About: Evidence suggests that aerobic exercise may slow the progression of subcortical ischaemic vascular cognitive impairment (SIVCI) by modifying cardiovascular risk factors. Yet the economic consequences relating to aerobic training (AT) remain unknown. Therefore, our primary objective was to estimate the incremental cost per quality-adjusted life years (QALYs) gained of a thrice weekly AT intervention compared with usual care.

Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Authors: Forman DE, Arena R, Boxer R, Dolansky MA, Eng JJ, Fleg JL, Haykowsky M, Jahangir A, Kaminsky LA, Kitzman DW, Lewis EF, Myers J, Reeves GR, Shen WK; American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council.
Published in: Circulation. 2017 Apr 18;135(16):e894-e918. doi: 10.1161/CIR.0000000000000483. Epub 2017 Mar 23.
About: Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.

Geomapping of Traumatic Spinal Cord Injury in Canada and Factors Related to Triage Pattern

Authors: Cheng CL, Noonan VK, Shurgold J, Chen J, Rivers CS, Hamedani HK, Humphreys S, Bailey C, Attabib N, Mac-Thiong JM, Goytan M, Paquet J, Fox R, Ahn H, Kwon BK, Fourney DR.
Published in: J Neurotrauma. 2017 Mar 22. doi: 10.1089/neu.2016.4929. [Epub ahead of print]
About: Current research indicates that more than half of patients with traumatic spinal cord injury (tSCI) experience delays in transfer and receive surgery more than 24 hours post-injury. The objectives of this study were to determine the geographic distribution of tSCI in Canada relative to specialized treatment facilities, to assess clinical and logistical factors at play for indirect admissions to those facilities, and to explore differences in current time to admission and simulated scenarios in an attempt to assess the potential impact of changes to triage protocols. This study included data from 876 patients with tSCI enrolled in the prospectively collected acute Rick Hansen Spinal Cord Injury Registry (RHSCIR) between January 1, 2010 and December 31, 2013 who had data on the location of their injury. Patients transported directly to a RHSCIR acute facility were more likely to reach the facility within 1 h of injury while those transported indirectly were more likely to arrive 7 h later. Considering the injuries occurring within 40 km of a RHSCIR acute facility (n=323), 249 patients (77%) were directly and 74 (23%) were indirectly admitted. In the multivariate regression analysis, only older age and longer road distance remained significantly associated with being indirectly admitted to a RHSCIR facility. Compared to the current status, the median time to admission decreased by 20% (3.5 h) in the 100% direct admission scenario; and increased by 102% (8.9 h) in the 100% indirect admission scenario.

Experiences with and perceptions of an adaptive hiking program

Authors: James L, Shing J, Mortenson WB, Mattie J, Borisoff J.
Published in: Disabil Rehabil. 2017 Mar 21:1-7. doi: 10.1080/09638288.2017.1302006. [Epub ahead of print]
About: Outdoor activities in natural settings have been found to be beneficial for overall health and well-being. However, people with disabilities may have different experiences accessing outdoor activities in natural settings. This research explored the experiences of users, volunteers, and staff, and perspectives of non-users about an adapted hiking program that uses a specialized mobility device called a TrailRider. The research had three objectives: 1. Describe the experiences of users, volunteers, and staff; 2. Identify perceived barriers to or limitations of participating for users, volunteers, staff, and non-users; and 3. Explore the impact of participation for users, volunteers, and staff.

Leisure time physical activity among older adults with long-term spinal cord injury

Authors: Jörgensen S, Martin Ginis KA, Lexell J.
Published in: Spinal Cord. 2017 Mar 21. doi: 10.1038/sc.2017.26. [Epub ahead of print]
About: The objective of this study is to describe participation in leisure time physical activity (LTPA) (amount, intensity and type) among older adults with long-term spinal cord injury (SCI), and to investigate the associations with sociodemographics, injury characteristics and secondary health conditions (SHCs).

Development of the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST): a universal disease-specific outcome instrument for individuals with traumatic spinal column injury

Authors: Sadiqi S, Lehr AM, Post MW, Dvorak MF, Kandziora F, Rajasekaran S, Schnake KJ, Vaccaro AR, Oner FC.
Published inEur Spine J. 2017 Mar 17. doi: 10.1007/s00586-017-5032-8. [Epub ahead of print]
About: Ex vivo compression experiments on isolated cadaveric vertebrae. OBJECTIVE: To qualitatively compare the fracture locations identified in video analysis with the locations of high compressive strain measured with DIC on vertebral bodies and to evaluate the timing of local damage to the cortical shell relative to the global yield force. SUMMARY OF BACKGROUND DATA: In previous ex vivo experiments, cortical bone fracture has been identified using various methods including acoustic emission sensors, strain gages, video analysis, or force signals. However, these methods are limited in their ability to detect the location and timing of fracture. We propose use of digital image correlation (DIC), a non-contact optical technique that measures surface displacement, to quantify variables related to damage.

Damage Identification on Vertebral Bodies During Compressive Loading Using Digital Image Correlation

Authors: Santos A, Fallah N, Lewis R, Dvorak MF, Fehlings MG, Burns AS, Noonan VK, Cheng CL, Chan E, Singh A, Belanger LM, Atkins D.
Published in: Spine (Phila Pa 1976). 2017 Mar 16. doi: 10.1097/BRS.0000000000002156. [Epub ahead of print]
About: Ex vivo compression experiments on isolated cadaveric vertebrae OBJECTIVE.: To qualitatively compare the fracture locations identified in video analysis with the locations of high compressive strain measured with DIC on vertebral bodies and to evaluate the timing of local damage to the cortical shell relative to the global yield force SUMMARY OF BACKGROUND DATA.: In previous ex vivo experiments, cortical bone fracture has been identified using various methods including acoustic emission sensors, strain gages, video analysis, or force signals. However, these methods are limited in their ability to detect the location and timing of fracture. We propose use of digital image correlation (DIC), a non-contact optical technique that measures surface displacement, to quantify variables related to damage.

Methodology of the Access to Care and Timing Simulation Model for Traumatic Spinal Cord Injury Care

Authors: Santos A, Fallah N, Lewis R, Dvorak MF, Fehlings MG, Burns AS, Noonan VK, Cheng CL, Chan E, Singh A, Belanger LM, Atkins D.
Published in: J Neurotrauma. 2017 Mar 12. doi: 10.1089/neu.2016.4927. [Epub ahead of print]
About: Despite the relatively low incidence, the management and care of persons with traumatic spinal cord injury (tSCI) can be resource intensive and complex, spanning multiple phases of care and disciplines. Using a simulation model built with a system level view of the healthcare system allows for prediction of the impact of interventions on patient and system outcomes from injury through to community reintegration after tSCI. The Access to Care and Timing (ACT) project developed a simulation model for tSCI care using techniques from operations research and its development has been described previously. The objective of this article is to briefly describe the methodology and the application of the ACT Model as it was used in several of the articles in this focus issue. The approaches employed in this model provide a framework to look into the complexity of interactions both within and among the different SCI programs, sites and phases of care.

Kynurenic acid downregulates IL-17/1L-23 axis in vitro

Authors: Salimi Elizei S, Poormasjedi-Meibod MS, Wang X, Kheirandish M, Ghahary A.
Published in: Mol Cell Biochem. 2017 Mar 11. doi: 10.1007/s11010-017-2975-3. [Epub ahead of print]
About: Exploring the function of interleukin (IL) 17 and related cytokine interactions have been proven useful toward understanding the role of inflammation in autoimmune diseases. Production of the inflammatory cytokine IL-23 by dendritic cells (DC’s) has been shown to promote IL-17 expression by Th17 cells. It is well established that Th17 cells play an important role in several autoimmune diseases including psoriasis and alopecia. Our recent investigations have suggested that Kynurenine-rich environment can shift a pro-inflammatory response to an anti-inflammatory response, as is the case in the presence of the enzyme Indoleamine 2,3 dioxygenase (IDO), the rate-limiting enzyme in tryptophan degradation and Kynurenine (Kyn) production. In this study, we sought to explore the potential role of kynurenic acid (KynA), in modulating the expression of IL-23 and IL-17 by DCs and CD4+ cells, respectively. The result of flow cytometry demonstrated that the frequency of IL-23-producing DCs is reduced with 100 µg/ml of KynA as compared with that of LPS-stimulated DCs. KynA (100 μg/ml) addition to activated T cells significantly decreased the level of IL-17 mRNA and frequency of IL-17+ T cells as compared to that of concanavalin (Con) A-activated T cells. To examine the mechanism of the suppressive role of KynA on IL-23/IL-17 in these cells, cells were treated with 3 μM G-protein-coupled receptor35 (GPCR35) inhibitor (CID), for 60 min. The result showed that the reduction of both adenylate cyclase (AC) and cyclic adenosine monophosphate (cAMP) by KynA is involved in suppression of LPS-induced IL-23p19 expression. Since GPCR35 is also detected on T cells; therefore, it is concluded that KynA plays an important role in modulating the expression of IL-23 and IL-17 in DCs and Th17 cells through inhibiting GPCR35 and downregulation of both AC and cAMP.

Characterizing the community use of an ultralight wheelchair with “on the fly” adjustable seating functions: A pilot study

Authors: Mattie J, Borisoff J, Miller WC, Noureddin B.
Published in: PLoS One. 2017 Mar 9;12(3):e0173662. doi: 10.1371/journal.pone.0173662. eCollection 2017.
About: An ultralight manual wheelchair that allows users to independently adjust rear seat height and backrest angle during normal everyday usage was recently commercialized. Prior research has been performed on wheelchair tilt, recline, and seat elevation use in the community, however no such research has been done on this new class of manual ultralight wheelchair with “on the fly” adjustments. The objective of this pilot study was to investigate and characterize the use of the two adjustable seating functions available on the Elevation™ ultralight dynamic wheelchair during its use in the community. Eight participants had data loggers installed onto their own wheelchair for seven days to measure rear seat height, backrest angle position, occupied sitting time, and distance traveled. Analysis of rear seat height and backrest adjustment data revealed considerable variability in the frequency of use and positions used by participants. There was a wide spread of mean daily rear seat heights among participants, from 34.1 cm to 46.7 cm. Two sub-groups of users were further identified: those who sat habitually at a single typical rear seat height, and those who varied their rear seat height more continuously. Findings also showed that participants used the rear seat height adjustment feature significantly more often than the backrest adjustment feature. This obvious contrast in feature use may indicate that new users of this class of wheelchair may benefit from specific training. While the small sample size and exploratory nature of this study limit the generalizability of our results, our findings offer a first look at how active wheelchairs users are using a new class of ultralight wheelchair with “on the fly” seating adjustments in their communities. Further studies are recommended to better understand the impact of dynamic seating and positioning on activity, participation and quality of life.

Participant experiences and perceptions of physical activity-enhancing interventions for people with physical impairments and mobility limitations: a meta-synthesis of qualitative research evidence

Authors: Williams TL, Ma JK, Martin Ginis KA.
Published in: Health Psychol Rev. 2017 Mar 13:1-18. doi: 10.1080/17437199.2017.1299027. [Epub ahead of print]
About: Disabled people face multiple personal, environmental and social barriers that interfere with leading a physically active lifestyle. Thus, there is an urgent need for behaviour change interventions to increase physical activity (PA) by specifically addressing the situations of disabled people, and barriers to participation. This original meta-synthesis of qualitative research was undertaken to explore participants’ experiences and perceptions of PA-enhancing interventions for adults with physical impairments resulting in mobility limitations. Published articles were identified through a rigorous systematic search. Based on the inclusion/exclusion criteria, 10 articles were included for review. Following a critical appraisal of the articles, methods of thematic synthesis were drawn upon to generate overarching concepts through interpretation and conceptual synthesis. Seven interrelated concepts were constructed representing both components and outcomes of the interventions. These were (i) Diversity of interventions; (ii) Importance of communication; (iii) Need for social support; (iv) Behavioural strategies; (v) Gaining knowledge; (vi) Re-framing thoughts about exercise and the self and (vii) Health and well-being. The results revealed that a combination of informational, social and behavioural interventions is perceived as crucial for PA initiation and maintenance. Furthermore, key elements of effective intervention design and implications for policies and practices to increase PA participation are proposed.

A Targeted Proteomics Analysis of Cerebrospinal Fluid after Acute Human Spinal Cord Injury

Authors: Streijger F, Skinnider M, Rogalski JC, Balshaw R, Shannon CP, Prudova A, Belanger LM, Ritchie L, Tsang A, Christie S, Parent S, Mac-Thiong JM, Bailey C, Urquhart J, Ailon T, Paquette SJ, Boyd MC, Street J, Fisher CG, Dvorak MF, Borchers CH, Foster LJ, Kwon BK.
Published in: J Neurotrauma. 2017 Mar 9. doi: 10.1089/neu.2016.4879. [Epub ahead of print]
About: Efforts to validate novel therapies in acute clinical trials for spinal cord injury (SCI) are impeded by the lack of objective quantitative measures that reflect injury severity and accurately predict neurologic recovery. Therefore, a strong rationale exists to establish neurochemical biomarkers that objectively quantify injury severity and predict outcome. Here, we conducted a targeted proteomics analysis of cerebrospinal fluid (CSF) samples derived from 29 acute SCI patients (AIS A, B, or C) acquired at 24, 48, and 72 hours post-injury. From a total of 165 proteins, we identified 27 potential biomarkers of injury severity (baseline AIS A, B, or C), with triosephosphate isomerase having the strongest relationship to AIS grade. The majority of affected proteins (24 of 27) were more abundant in samples from AIS A patients compared to the AIS C patients, suggesting that for the most part, these proteins are released into the CSF more readily with more severe trauma to the spinal cord. We then analyzed the relationship between CSF protein abundance and neurologic recovery. For AIS grade improvement over 6 months, we identified 34 proteins that were associated with AIS grade conversion (p<0.05), but these associations were not statistically significant after adjusting for multiple comparisons. For (TMS) recovery over 6 months, after adjusting for baseline neurologic injury level, we identified 46 proteins with a statistically significant association with TMS recovery. Twenty-two of these proteins were amongst the 27 proteins that were related to baseline AIS grade, consistent with the notion that protein markers that reflect a more severe injury also appropriately predict a poorer recovery of motor function. In summary, this study provides a description of the CSF proteome changes that occur after acute human SCI, and reveals a number of protein candidates for further validation as potential biomarkers of injury severity.

Defining the biomechanical and biological threshold of murine mild traumatic brain injury using CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration)

Authors: Namjoshi DR, Cheng WH, Bashir A, Wilkinson A, Stukas S, Martens KM, Whyte T, Abebe ZA, McInnes KA, Cripton PA, Wellington CL.
Published in: Exp Neurol. 2017 Mar 6;292:80-91. doi: 10.1016/j.expneurol.2017.03.003. [Epub ahead of print]
About: CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration) is a recently described animal model of traumatic brain injury (TBI) that primarily produces diffuse axonal injury (DAI) characterized by white matter inflammation and axonal damage. CHIMERA was specifically designed to reliably generate a variety of TBI severities using precise and quantifiable biomechanical inputs in a nonsurgical user-friendly platform. The objective of this study was to define the lower limit of single impact mild TBI (mTBI) using CHIMERA by characterizing the dose-response relationship between biomechanical input and neurological, behavioral, neuropathological and biochemical outcomes. Wild-type male mice were subjected to a single CHIMERA TBI using six impact energies ranging from 0.1 to 0.7J, and post-TBI outcomes were assessed over an acute period of 14days. Here we report that single TBI using CHIMERA induces injury dose- and time-dependent changes in behavioral and neurological deficits, axonal damage, white matter tract microgliosis and astrogliosis. Impact energies of 0.4J or below produced no significant phenotype (subthreshold), 0.5J led to significant changes for one or more phenotypes (threshold), and 0.6 and 0.7J resulted in significant changes in all outcomes assessed (mTBI). We further show that linear head kinematics are the most robust predictors of duration of unconsciousness, severity of neurological deficits, white matter injury, and microgliosis following single TBI. Our data extend the validation of CHIMERA as a biofidelic animal model of DAI and establish working parameters to guide future investigations of the mechanisms underlying axonal pathology and inflammation induced by mechanical trauma.

Understanding Length of Stay following Spinal Cord Injury: Insights and Limitations from the Access to Care and Timing (ACT) Project

Authors: Burns AS, Santos A, Cheng CL, Chan E, Fallah N, Atkins D, Dvorak MF, Ho C, Ahn H, Paquet J, Kwon BK, Noonan V.
Published in: J Neurotrauma. 2017 Feb 28. doi: 10.1089/neu.2016.4935. [Epub ahead of print]
About: Costs associated with initial hospitalization following spinal cord injury (SCI) are substantial, and a major driver of costs is the length of stay (LOS) the injured individual remains hospitalized prior to community reintegration. Our aim was to study the factors and variables that contribute to LOS following traumatic SCI. Modeling (process mapping of the SCI healthcare delivery system in Canada and discrete event simulation) and regression analysis using a national registry of individuals with acute traumatic SCI in Canada, existing databases and peer-reviewed literature were used to examine the driver of LOS following traumatic SCI. In different jurisdictions, there is considerable variation in the definitions and methods used to determine LOS following SCI. System LOS can be subdivided into subcomponents and progression through these is not unidirectional. Modeling reveals that healthcare organization and processes are important contributors to differences in LOS independent of patient demographics and injury characteristics. Future research is required to identify and improve our understanding of contributors to LOS following traumatic SCI. This will help enhance system performance. Work in this area will be facilitated by the adoption of common terminology and definitions, as well as the use of simulations and modeling.

In vivo imaging reveals that pregabalin inhibits cortical spreading depression and propagation to subcortical brain structures

Authors: Cain SM, Bohnet B, LeDue J, Yung AC, Garcia E, Tyson JR, Alles SR, Han H, van den Maagdenberg AM, Kozlowski P, MacVicar BA, Snutch TP.
Published in: Proc Natl Acad Sci U S A. 2017 Feb 28;114(9):2401-2406. doi: 10.1073/pnas.1614447114. Epub 2017 Feb 21.
About: Migraine is characterized by severe headaches that can be preceded by an aura likely caused by cortical spreading depression (SD). The antiepileptic pregabalin (Lyrica) shows clinical promise for migraine therapy, although its efficacy and mechanism of action are unclear. As detected by diffusion-weighted MRI (DW-MRI) in wild-type (WT) mice, the acute systemic administration of pregabalin increased the threshold for SD initiation in vivo. In familial hemiplegic migraine type 1 mutant mice expressing human mutations (R192Q and S218L) in the CaV2.1 (P/Q-type) calcium channel subunit, pregabalin slowed the speed of SD propagation in vivo. Acute systemic administration of pregabalin in vivo also selectively prevented the migration of SD into subcortical striatal and hippocampal regions in the R192Q strain that exhibits a milder phenotype and gain of CaV2.1 channel function. At the cellular level, pregabalin inhibited glutamatergic synaptic transmission differentially in WT, R192Q, and S218L mice. The study describes a DW-MRI analysis method for tracking the progression of SD and provides support and a mechanism of action for pregabalin as a possible effective therapy in the treatment of migraine.

Development of a chronic disease management program for stroke survivors using intervention mapping: The Stroke Coach

Authors: Sakakibara BM, Lear SA, Barr SI, Benavente O, Goldsmith CH, Silverberg ND, Yao J, Eng JJ.
Published in: Arch Phys Med Rehabil. 2017 Feb 17. pii: S0003-9993(17)30084-9. doi: 10.1016/j.apmr.2017.01.019. [Epub ahead of print]
About: The objective of this study is to describe the systematic development of the Stroke Coach, a theory- and evidence-based intervention to improve control of lifestyle behaviour risk factors in stroke patients.

Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Authors: Fortin M, Dobrescu O, Courtemanche M, Sparrey CJ, Santaguida C, Fehlings MG, Weber MH.
Published in: Spine (Phila Pa 1976). 2017 Feb 15;42(4):232-239. doi: 10.1097/BRS.0000000000001704.
About: The aim of this study was to assess fatty infiltration and asymmetry of the multifidus (MF), semispinalis cervicis (SCer), semispinalis capitis (SCap), and splenius capitis (SPL) muscles in patients with degenerative cervical myelopathy (DCM), and evaluate their correlations with clinical symptoms and functional scores.

Clinicians’ and researchers’ perspectives on manual wheelchair data loggers

Authors: Routhier F, Lettre J, Miller WCBorisoff JF, Keetch K, Mitchell IM, CanWheel Research Team.
Published inArch Phys Med Rehabil. 2017 Feb 12. pii: S0003-9993(17)30078-3. doi: 10.1016/j.apmr.2017.01.013. [Epub ahead of print]
About: Recent studies have employed data loggers to record a wide range of, sometimes differing, objective outcomes associated with the use of manual wheelchairs. To identify which outcomes are broadly perceived to be the most important to measure when objectively documenting manual wheelchair use, a cross-sectional survey was conducted with groups of researchers and clinicians in the field of wheeled mobility. We also surveyed the challenges these groups experienced when using data loggers. The survey was informed by a previous scoping review of the scientific and gray literature. Seventy-four people, with various academic and professional backgrounds, completed the survey: 57 researchers (77.0%) and 17 clinicians (23.0%). Regarding the importance they attributed to commonly measured outcomes, the most highly rated outcome identified by both groups was “distance traveled.” There were significant differences between the groups’ perspectives in rating and ranking the importance of “pressure-relief activities”, “seat pressure” and “acceleration.” In terms of challenges or barriers associated with the use of data loggers for monitoring manual wheelchair use, it appears that researchers and clinicians have relatively similar needs and preferences. However, only clinicians reported that the time they wanted to, or could, allocate to review recorded information was a potential hardship. Our hope is that these results will help further development and increase the functionality and applicability of data loggers for manual wheelchairs in research and clinical contexts.

Validity of the Elite HRV Smart Phone Application for Examining Heart Rate Variability in a Field Based Setting

Authors: Perrotta AS, Jeklin A, Hives BA, Meanwell LE, Warburton DE.
Published in: J Strength Cond Res. 2017 Feb 8. doi: 10.1519/JSC.0000000000001841. [Epub ahead of print]
About: The introduction of smart phone applications has allowed athletes and practitioners to record and store R-R intervals on smart phones for immediate heart rate variability (HRV) analysis. This user-friendly option should be validated in the effort to provide practitioners confidence when monitoring their athletes before implementing such equipment.The objective of this investigation was to examine the relationship between a vagal related HRV index, rMSSD when derived from a smart phone application accessible with most smart phone operating systems against Kubios HRV 2.2R-R intervals were recorded immediately upon awakening over 14 consecutive days using the Elite HRV smartphone application. R-R recordings were then exported into Kubios HRV 2.2 for analysis. The relationship between rMSSDln derived from Elite HRV and Kubios HRV 2.2 was examined using a Pearson Product Moment Correlation and a Bland-Altman Plot.An extremely large relationship was identified (r = 0.92; p < 0.0001; CI 95% = 0.90;0.93). A total of 6.4% of the residuals fell outside of the 1.96 ±SD (CI 95% = -12.0%; 7.0%) limits of agreement. A negative bias was observed (mean: -2.7%; CI 95% = -3.10%;-2.30%) whose CI 95% failed to fall within the line of equality.Our observations suggest Elite HRV as a non-valid smart phone application for examining rMSDDLn when compared to Kubios HRV 2.2. We propose further research is warranted to confirm our observations and to identify if this smart phone application may be reliable rather than valid when assessing parasympathetic modulation.

Distinct eye movement patterns enhance dynamic visual acuity

Authors: Palidis DJ, Wyder-Hodge PA, Fooken J, Spering M.
Published in: PLoS One. 2017 Feb 10;12(2):e0172061. doi: 10.1371/journal.pone.0172061. eCollection 2017.
About: Dynamic visual acuity (DVA) is the ability to resolve fine spatial detail in dynamic objects during head fixation, or in static objects during head or body rotation. This ability is important for many activities such as ball sports, and a close relation has been shown between DVA and sports expertise. DVA tasks involve eye movements, yet, it is unclear which aspects of eye movements contribute to successful performance. Here we examined the relation between DVA and the kinematics of smooth pursuit and saccadic eye movements in a cohort of 23 varsity baseball players. In a computerized dynamic-object DVA test, observers reported the location of the gap in a small Landolt-C ring moving at various speeds while eye movements were recorded. Smooth pursuit kinematics-eye latency, acceleration, velocity gain, position error-and the direction and amplitude of saccadic eye movements were linked to perceptual performance. Results reveal that distinct eye movement patterns-minimizing eye position error, tracking smoothly, and inhibiting reverse saccades-were related to dynamic visual acuity. The close link between eye movement quality and DVA performance has important implications for the development of perceptual training programs to improve DVA.

Measurement properties of the Wheelchair Skills Test for scooters among experienced users

AuthorsMortenson WB, Hurd Clarke L, Goldsmith CH, Jang S, Kirby RL.
Published inDisabil Rehabil Assist Technol. 2017 Feb 5:1-6. doi: 10.1080/17483107.2017.1280546. [Epub ahead of print]
About: The purpose of this study is to investigate the score distribution, reliability, and validity of the objective Wheelchair Skills Test (WST) for scooter user.

Effects of early and delayed initiation of exercise training on cardiac and haemodynamic function after spinal cord injury

Authors: Popok DW, West CR, McCracken L, Krassioukov AV.
Published in: Exp Physiol. 2017 Feb 1;102(2):154-163. doi: 10.1113/EP085978.
About: Spinal cord injury (SCI) reduces physical activity and alters descending supraspinal cardiovascular control, predisposing this population to early onset of cardiovascular disease. We used a T3 SCI rodent model to investigate the effect of early versus delayed passive hindlimb cycling (PHLC), as well as the effect of detraining on cardiac dysfunction and blood pressure control, including autonomic dysreflexia (AD).

2015 ParaPan American Games: Autonomic Function, But Not Physical Activity, Is Associated with Vascular-Cognitive Impairment in Spinal Cord Injury

Authors: Phillips AA, Squair JR, Currie KD, Tzeng YC, Ainslie PN, Krassioukov AV.
Published in: J Neurotrauma. 2017 Jan 27. doi: 10.1089/neu.2016.4751. [Epub ahead of print]
About: The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

MR measurement of luminal water in prostate gland: Quantitative correlation between MRI and histology

Authors: Sabouri S, Fazli L, Chang SD, Savdie R, Jones EC, Goldenberg SL, Black PC, Kozlowski P.
Published in: J Magn Reson Imaging. 2017 Jan 27. doi: 10.1002/jmri.25624. [Epub ahead of print]
About: The purpose of this study is to determine the relationship between parameters measured from luminal water imaging (LWI), a new magnetic resonance imaging (MRI) T2 mapping technique, and the corresponding tissue composition in prostate.

Effects of weld damage on the dynamics of energy absorbing lanyards

Authors: Katona DN, Bennett CR, McKoryk M, Brisson AL, Sparrey CJ.
Published in: Int J Occup Saf Ergon. 2017 Jan 26:1-24. doi: 10.1080/10803548.2017.1282236. [Epub ahead of print]
About: Manufacturers recommend removing fall protection system components from service for any indication of weld spatter or tool damage; however, little is known about the specific effects of lanyard damage on fall arrest dynamics. Thirty-two energy absorbing lanyards were drop tested after being damaged with weld spatter, plasma torches and cutting tools and compared with new, undamaged lanyards. Two lanyards damaged with a plasma torch failed completely without deploying the energy absorber while weld spatter damage and tool cuts, up to 2/3 through the width of the webbing, had no effect on fall arrest dynamics. The results highlight the catastrophic implications of high temperature damage to lanyard webbing resulting from plasma torches – which require immediate removal from service. In addition, the integrated energy absorber design in bungee style lanyards makes them more susceptible to damage anywhere along its length. We therefore recommended against bungee lanyards for ironworkers and welders.

Paralympic Medicine: The Road to Rio

Authors: Phillips AA, Squair JW, Krassioukov AV.
Published in: J Neurotrauma. 2017 Jan 24. doi: 10.1089/neu.2016.4715. [Epub ahead of print]
About: The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

Exercise and the Multidisciplinary Holistic Approach to Adolescent Dysautonomia

Authors: Armstrong K, De Souza AM, Sneddon P, Potts JE, Claydon VE, Sanatani S.
Published in: Acta Paediatr. 2017 Jan 23. doi: 10.1111/apa.13750. [Epub ahead of print]
About: The purpose of this study is to determine if an 8-week strength training program as part of a multidisciplinary approach would minimize symptoms and improve quality of life in patients with dysautonomia.

Interrater and intrarater reliability of the wheelchair skills test version 4.2 for power wheelchair users

Authors: Smith EM, Low K, Miller WC.
Published inDisabil Rehabil. 2017 Jan 23:1-9. doi: 10.1080/09638288.2016.1271464. [Epub ahead of print]
About: The purpose of this study is to estimate the interrater and intrarater reliability of the Wheelchair Skills Test (WST) Version 4.2 for powered wheelchairs operated by adult users.

Mean Arterial Blood Pressure Management of Acute Traumatic Spinal Cord Injured Patients during the Pre-Hospital and Early Admission Period

Authors: Tee JW, Altaf F, Belanger L, Ailon T, Street J, Paquette S, Boyd M, Fisher CG, Dvorak MFKwon BK.
Published in: J Neurotrauma. 2017 Jan 13. doi: 10.1089/neu.2016.4689. [Epub ahead of print]
About: The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

Thermal grill conditioning: Effect on contact heat evoked potentials

Authors: Jutzeler CR, Warner FM, Wanek J, Curt A, Kramer JL.
Published in: Sci Rep. 2017 Jan 12;7:40007. doi: 10.1038/srep40007.
About: The ‘thermal grill illusion’ (TGI) is a unique cutaneous sensation of unpleasantness, induced through the application of interlacing warm and cool stimuli. While previous studies have investigated optimal parameters and subject characteristics to evoke the illusion, our aim was to examine the modulating effect as a conditioning stimulus. A total of 28 healthy control individuals underwent three testing sessions on separate days. Briefly, 15 contact heat stimuli were delivered to the right hand dorsum, while the left palmar side of the hand was being conditioned with either neutral (32 °C), cool (20 °C), warm (40 °C), or TGI (20/40 °C). Rating of perception (numeric rating scale: 0-10) and evoked potentials (i.e., N1 and N2P2 potentials) to noxious contact heat stimuli were assessed. While cool and warm conditioning decreased cortical responses to noxious heat, TGI conditioning increased evoked potential amplitude (N1 and N2P2). In line with other modalities of unpleasant conditioning (e.g., sound, visual, and olfactory stimulation), cortical and possibly sub-cortical modulation may underlie the facilitation of contact heat evoked potentials.

Fibrin hydrogels induce mixed dorsal/ventral spinal neuron identities during differentiation of human induced pluripotent stem cells

Authors: Edgar JM, Robinson M, Willerth SM.
Published in: Acta Biomater. 2017 Jan 11. pii: S1742-7061(17)30040-5. doi: 10.1016/j.actbio.2017.01.040. [Epub ahead of print].
About: We hypothesized that generating spinal motor neurons (sMNs) from human induced pluripotent stem cell (hiPSC)-derived neural aggregates (NAs) using a chemically-defined differentiation protocol would be more effective inside of 3D fibrin hydrogels compared to 2D poly-L-ornithine(PLO)/laminin-coated tissue culture plastic surfaces. We performed targeted RNA-Seq using next generation sequencing to determine the substrate-specific differences in gene expression that regulate cell phenotype. Cells cultured on both substrates expressed sMN genes CHAT and MNX1, though persistent WNT signaling contributed to a higher expression of genes associated with interneurons in NAs cultured in 3D fibrin scaffolds. Cells in fibrin also expressed lower levels of astrocyte progenitor genes and higher levels of the neuronal-specific gene TUBB3, suggesting a purer population of neurons compared to 2D cultures.

Optimizing Clinical Decision Making in Acute Traumatic Spinal Cord Injury

Authors: Fehlings M, Noonan V, Atkins D, Burns AS, Cheng CL, Singh A, Dvorak MF.
Published in: J Neurotrauma. 2017 Jan 5. doi: 10.1089/neu.2016.4926. [Epub ahead of print]

Patterns of community participation across the seasons: A year-long case study of three Canadian wheelchair users

Authors: Ripat J, Borisoff JF, Grant LE, Chan FH.
Published inDisabil Rehabil. 2017 Jan 5:1-10. doi: 10.1080/09638288.2016.1271463. [Epub ahead of print]
About: The aim of this study was to explore the patterns of wheelchair users’ community participation across a one-year period, including periods with substantial differences in weather conditions. We sought to develop a detailed understanding of the patterns of, and influences on, wheelchair use and participation within wheelchair users’ own communities.

Journal Club: Pregnancy outcome following maternal exposure to pregabalin may call for concern

Authors: Jutzeler CR, Cragg JJ, Warner FM, Archibald J, Thomas CP, Elliott S, Kramer JL.
Published in: Neurology. 2017 Jan 3;88(1):e5-e7. doi: 10.1212/WNL.0000000000003458.
About: Evidence from animal studies implicates pregabalin as a potential teratogen. Although human data are scarce, pregabalin is a Category C drug: risks cannot be ruled out, but potential benefits may justify the risks of pregabalin during pregnancy. Suggested teratogenic mechanisms include reproductive toxicity, skeletal malformation, neural deficits, spontaneous abortions, growth retardation, and behavioral abnormalities. To shed light on this issue, Winterfeld et al. recently investigated adverse pregnancy outcomes following maternal exposure to pregabalin. Considering the high prevalence of women of childbearing age with neuropathic pain and epilepsy, it is important to explore potential teratogenic effects of first-line treatments. Moreover, as pregnant women are considered vulnerable, it is difficult to assess risks during the drug development process. This study provides an elegant example of an observational study used to assess fetal risks resulting from exposure to pregabalin. This work has important implications for clinical practice guidelines for a range of neurologic disorders.

Coordinated Control of Three-Dimensional Components of Smooth Pursuit to Rotating and Translating Textures

Authors: Edinger J, Pai DK, Spering M.
Published in: Invest Ophthalmol Vis Sci. 2017 Jan 1;58(1):698-707. doi: 10.1167/iovs.16-21038.
About:The neural control of pursuit eye movements to visual textures that simultaneously translate and rotate has largely been neglected. Here we propose that pursuit of such targets-texture pursuit-is a fully three-dimensional task that utilizes all three degrees of freedom of the eye, including torsion.

Open Access Platforms in Spinal Cord Injury

AuthorsKramer JL, Geisler F, Ramer L, Plunet W, Cragg JJ.
Published in: Neurorehabil Neural Repair. 2017 Jan 1:1545968316688801. doi: 10.1177/1545968316688801. [Epub ahead of print]
About: Recovery from acute spinal cord injury (SCI) is characterized by extensive heterogeneity, resulting in uncertain prognosis. Reliable prediction of recovery in the acute phase benefits patients and their families directly, as well as improves the likelihood of detecting efficacy in clinical trials. This issue of heterogeneity is not unique to SCI. In fields such as traumatic brain injury, Parkinson’s disease, and amyotrophic lateral sclerosis, one approach to understand variability in recovery has been to make clinical trial data widely available to the greater research community. We contend that the SCI community should adopt a similar approach in providing open access clinical trial data.

 A list of our older publications can be found here.