Abstract

restoration of the spinal cord function presents a most severe biomedical issue nowadays. The aim of the study was to detect the macroporous poly(N-[2-hydroxypropyl]-methacrylamide hydrogel (PHPMA-hydrogel, HG) restorative effect dependence on the severity of the laceration spinal cord injury in young organisms. The male rats sample (~1-month-old, ~50 g, inbred Wistar line) was represented with 4 experimental groups: 1) spinal cord lateral hemisection at the level of ~Т12–Т13 segments (Sect; n=11); 2) spinal cord lateral hemiexcision ~1 mm long at the similar level (Exc; n=8); 3) spinal cord lateral hemisection at the similar level with immediate implantation of the hydrogel fragment into the trauma region (HGsect; n=11); 4) spinal cord lateral hemiexcision at the similar level with immediate implantation of the hydrogel fragment into the affected region (HGexс; n=6). The motor function and spasticity of the paretic hindlimb was estimated respectively by the technically modified Basso–Beattie–Bresnahan (ВВВ) and Ashworth, conditionally blinded to individual characteristics of all operated animals and previous study results. The observation lasted for ~5 months. The criteria of non-inclusion were as follows: the ipsilateral hindlimb function level in a week after the injury >9 points ВВВ, and the contralateral hindlimb function level during prolonged period ≤14 points ВВВ. The results were interpreted and presented according to the standardized time scale with interpolatory representation of the motor function and spasticity individual level in certain cases. Asymptotic stage differences between the studied groups and subgroups were stated during the first three weeks as well as in 8 weeks and 3 months after the injury. We found out that in a week after injury the motor function level in group Exc made up 0.9±0.5 points ВВВ, in group HGexc — 3.6±1.2 points, in group Sect — 5.9±1.1 points, in group HGsect — 6.0±1.0 points. In 5 months the motor function level in group Sect made up 9.5±1.0 points ВВВ, in group HGsect — 9.5±1.1 points, in group Exc — 0.8±0.3 points, in group HGexc — 4.5±1.8 points. At the same study stage the spasticity level in groups Sect and HGsect was, respectively, 0.8±0.2 and 0.8±0.3 points Ashworth, in group HGexc — 1.8±0.7 points, in group Exc — 3.6±0.3 points. Throughout the study no significant differences in groups Sect and HGsect have been detected, and in groups Exc і HGexc such differences were detected only in 5 weeks after the injury. The considerable difference of spasticity in groups Sect and HGsect was noted in 1 week after the injury, in groups HGexc and Exc — during first 2 months of the experiment. In groups Sect and Exc reliable difference of both motor function and spasticity level was found at all study stages. In groups HGsect and HGexc considerable difference of the motor function level was characteristic at all stages, except for the end of the 1st and 7th weeks, whereas spasticity level differences throughout the study remained insignificant. So, the tested hydrogel in young organisms shows positive effect only with severe trauma stages accompanied with extensive spinal cord defect.

Highlights

  • Spinal cord injury (SCI) in most cases represents a complex nervous system injury, which significantly deteriorates life quality and decreases life span of the patients (DeVivo, 2012; Pretz, Kozlowski, Chen, Charlifue & Heinemann, 2016)

  • The estimated annual global SCI occurrence equals ~1 million people, with ~27 million people affected (GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators, 2019), which more often relates to the middle-aged males (Singh, Tetreault, Kalsi-Ryan, Nouri & Fehlings, 2014) and causes lifelong disability in half of all cases (DeVivo, 2012)

  • The gravest consequence of the SCI, not to mention its quite significant mortality (DeVivo, 2012), is manifested as the loss of motor and other spinal cord functions below the affected region, which is accompanied with the autonomic imbalance (Hou & Rabchevsky, 2014; Hamid et al, 2018), spasticity syndrome (Nielsen, Crone & Hultborn, 2007; Holtz, Lipson, Noonan, Kwon & Mills, 2017), chronic pains (Finnerup et al, 2014), as well as affective (Lee, Nam, Kim & Hwang, 2019; Wan, Chien, Chung, Yang & Tzeng, 2020) and even cognitive disorders (Sachdeva, Gao, Chan & Krassioukov, 2018)

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Summary

Introduction

Spinal cord injury (SCI) in most cases represents a complex nervous system injury, which significantly deteriorates life quality and decreases life span of the patients (DeVivo, 2012; Pretz, Kozlowski, Chen, Charlifue & Heinemann, 2016). An alternative technology — bionic prosthetics used for the SCI, «powered exoskeletons» is developing more effectively (Mekki, Delgado, Fry, Putrino & Huang, 2018; Dijkers, Akers, Dieffenbach & Galen, 2019; Shah et al, 2020). Though, it can be applied only with the minimum conscious paretic extremities motor activity as well as the coordinated function of the urinary system and absent spasticity syndrome, i.e

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