This Midwest Regional Spinal Cord Injury Care System project is a collaboration with other Spinal Cord Injury Care Systems: Rocky Mountain Regional Spinal Injury System; Baylor Scott and White Spinal Cord Injury Model System; Minnesota Regional Spinal Cord Injury Model System (including Mayo Clinic and the Courage Kenny Rehabilitation Institute).
This project aims to assess the potential of spasticity and brain-derived neurotrophic factor (BDNF) as biomarkers of neurologic and functional recovery in patients with subacute spinal cord injury (SCI). Accurate prediction of neurologic and functional recovery of individuals with SCI is important for clinical and research applications. The heterogeneous nature of SCI makes predicting long-term outcomes from initial characteristics a challenging task; yet, there is a pressing need to improve prediction of SCI recovery. Accumulating evidence suggest that spasticity is associated with better functional recovery and that residual descending connectivity is present in patients with motor severe SCI who have spasticity. In addition, BDNF promotes neuroplasticity after SCI and changes in levels of BDNF have been associated with functional recovery after SCI. We propose to assess spasticity and BDNF levels, which are measures that clinicians can obtain swiftly and with minimal patient discomfort and risk.
We will enroll participants from across all participating SCIMS sites. Inclusion criteria are age 18 years and older and traumatic SCI resulting from a T12 or higher lesion. Each participant will undergo the following tests: evaluation of spasticity in the quadriceps muscle bilaterally using the Modified Ashworth Scale, the Pendulum Test and the SCI Spasticity Evaluation Tool, and a patient-reported instrument that assesses the experience and consequences of spasticity.
Blood samples will be drawn from each participant to measure levels of BDNF..
Functional status will be measured using self-care and mobility data collected on the SCI Model System Form I (Functional Abilities [CARE]) and SCI Functional Index using Assistive Technology, and the International Standards for Neurological Classification of SCI exam.
Results of this study will determine if spasticity and BDNF levels are useful biomarkers for predicting neurologic and functional recovery after SCI. Biomarkers that clinicians can obtain swiftly and with minimal patient discomfort and risk will allow improved prediction of neurologic recovery with immediate clinical and research applications.
Monica Perez, PT, PhD, Scientific Chair, Arms + Hands Lab, Shirley Ryan AbilityLab and Professor of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, and Milap Sandhu, PT, PhD, Research Scientist II, Shirley Ryan AbilityLab and Assistant Professor of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, are co-principal investigators on this project.
This project is funded by National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) grant 90SIMS0015.