Severe Spinal Cord Injury Patients Research Articles

Intravenous Infusion of Autologous Mesenchymal Stem Cells Expanded in Auto Serum for Chronic Spinal Cord Injury Patients: A Case Series

Objective: The safety, feasibility, and potential functional improvement following the intravenous infusion of mesenchymal stem cells (MSCs) were investigated in patients with chronic severe spinal cord injury (SCI). Methods: The intravenous infusion of autologous MSCs cultured in auto-serum under Good Manufacturing Practices (GMP) was administered to seven patients with chronic SCI (ranging from 1.3 years to 27 years after the onset of SCI). In addition to evaluating feasibility and safety, neurological function was evaluated using the American Spinal Injury Association Impairment Scale (AIS), International Standards for Neurological Classification of Spinal Cord Injury (ISCSCI-92), and Spinal Cord Independence Measure III (SCIM-III). Results: No serious adverse events occurred. Neither CNS tumors, abnormal cell growth, nor neurological deterioration occurred in any patients. While this initial case series was not blinded, significant functional improvements and increased quality of life (QOL) were observed at 90 and 180 days post-MSC infusion compared to pre-infusion status. One patient who had an AIS grade C improved to grade D within six months after MSC infusion. Conclusions: This case series suggests that the intravenous infusion of autologous MSCs is a safe and feasible therapeutic approach for chronic SCI patients. Furthermore, our data showed significant functional improvements and better QOL after MSC infusion in patients with chronic SCI. A blind large-scale study will be necessary to fully evaluate this possibility.

An EOG-Based Human-Machine Interface to Control a Smart Home Environment for Patients With Severe Spinal Cord Injuries.

This paper presents an asyn-chronous electrooculography (EOG)-based human-machine interface (HMI) for smart home environmental control with the purpose of providing daily assistance for severe spinal cord injury (SCI) patients. The proposed HMI allows users to interact with a smart home environment through eye blinking. Specifically, several buttons, each corresponding to a control command, randomly flash on a graphical user interface. Each flash of the buttons functions as a visual cue for the user to blink. To issue a control command, the user can blink synchronously with the flashes of the corresponding button. Through detecting blinks based on the recorded EOG signal, the target button and its corresponding control command are determined. Seven SCI patients participated in an online experiment, during which the patients were required to control a smart home environment including household electrical appliances, an intelligent wheelchair, as well as a nursing bed via the proposed HMI. The average false operation ratio in the control state was 4.1%, whereas during the idle state, no false operations occurred. All SCI patients were able to control the smart home environment using the proposed EOG-based HMI with satisfactory performance in terms of the false operation ratio in both the control and the idle states. The proposed HMI offers a simple and effective approach for patients with severe SCIs to control a smart home environment. Therefore, it is promising to assist severe SCI patients in their daily lives.

Effect of intrathecal baclofen on evoked pain perception: An evoked potentials and quantitative thermal testing study

Somatic antinociceptive effects of baclofen have been demonstrated in animal models. We hypothesized that if enhanced thermal or pain sensitivity is produced by loss of gamma-aminobutyric acid (GABA)-ergic tone in the central nervous system, spinal administration of GABA agonists might be predicted to be effective in thermal and/or pain perception changes and pain-related evoked potentials in candidates for intrathecal baclofen (ITB) treatment. Eleven patients with severe spinal cord injury (SCI) who suffered from severe spasticity were evaluated during a 50-μg ITB bolus test. Warm and heat pain thresholds, evoked heat pain perception, and contact heat-evoked potentials (CHEPs) were determined above SCI level from the right and left sides. Nine age- and gender-matched healthy volunteers undergoing repeat testing without any placebo injection served as control group. In patients, heat pain perception threshold increased, and evoked pain perception and amplitude of CHEPs decreased significantly after ITB bolus application in comparison with baseline (p < 0.005), with no change in warm perception threshold. In controls, no significant changes were observed in repeat testing over time. Our findings indicate that ITB modulates heat pain perception threshold, evoked heat pain perception and heat pain-related evoked potentials without inducing warm perception threshold changes in SCI patients. This phenomenon should be taken into account in the clinical evaluation and management of pain in patients receiving baclofen.