Understanding the Measurement of Pressure Within the Spinal Cord to Optimize Spinal Cord Perfusion Pressure Using a Porcine Model of Spinal Cord Injury

使用猪脊髓损伤模型了解脊髓内的压力以优化脊髓灌注压力

Recent studies have reported that monitoring spinal cord perfusion pressure (SCPP) using a pressure probe to measure "intraspinal pressure" (ISP) within the subdural space at the injury site may improve the hemodynamic management of acute spinal cord injury (SCI) patients. This study aimed to investigate, within a pig model of SCI, the relationship between the ISP measured within the subdural space and the "spinal cord pressure" (SCP) measured within the spinal cord itself. The results suggest that changes in ISP and SCP after SCI are influenced by native spinal cord morphometry and that the location of measurement is important to consider, particularly in situations where the swelling of the injured cord results in an occlusion of the cerebrospinal fluid (CSF) flow through the subdural space.

最近的研究报道，使用压力探针监测脊髓灌注压 (SCPP) 以测量损伤部位硬膜下腔内的 “椎管内压力” (ISP) 可以改善急性脊髓损伤 (SCI) 患者的血液动力学管理。本文旨在研究在猪SCI模型中，硬膜下腔内测得的ISP与脊髓本身内测得的 “脊髓压力” (SCP) 之间的关系。结果表明，SCI后ISP和SCP的变化受脊髓形态的影响，并且测量位置很重要，尤其是在受伤的脊髓肿胀导致脑脊液 (CSF) 循环不畅的情况下。

REF: Streijger F, Allard Brown A, Grassner L, et al. Understanding the Measurement of Pressure Within the Spinal Cord to Optimize Spinal Cord Perfusion Pressure Using a Porcine Model of Spinal Cord Injury. J Neurotrauma. 2025;42(3-4):165-181. doi:10.1089/neu.2024.0308 PMID: 39761133

由人工翻译修正

Evolution of Lipid Metabolism in the Injured Mouse Spinal Cord

小鼠脊髓损伤中脂质代谢的演变

Following spinal cord injury (SCI), there is a short-lived recovery phase that ultimately plateaus. Understanding changes within the spinal cord over time may facilitate targeted approaches to prevent and/or reverse this plateau and allow for continued recovery. Untargeted metabolomics revealed distinct metabolic profiles within the injured cord during recovery (7 days postinjury [DPI]) and plateau (21 DPI) periods in a mouse model of severe contusion SCI. Alterations in lipid metabolites, particularly those involved in phospholipid (PL) metabolism, largely contributed to overall differences. PLs are hydrolyzed by phospholipases A2 (PLA2s), yielding lysophospholipids (LPLs) and fatty acids (FAs). PL metabolites decreased between 7 and 21 DPI, whereas LPLs increased at 21 DPI, suggesting amplified PL metabolism during the plateau phase. Expression of various PLA2s also differed between the two time points, further supporting dysregulation of PL metabolism during the two phases of injury. FAs, which can promote inflammation, mitochondrial dysfunction, and neuronal damage, were increased regardless of time point. Carnitine can bind with FAs to form acylcarnitines, lessening FA-induced toxicity. In contrast to FAs, carnitine and acylcarnitines were increased at 7 DPI, but decreased at 21 DPI, suggesting a loss of carnitine-mediated mitigation of FA toxicity at the later time point, which may contribute to the cessation of recovery post-SCI. Alterations in oxidative phosphorylation and tricarboxylic acid cycle metabolites were also observed, indicating persistent although dissimilar disruptions in mitochondrial function. These data aid in increasing our understanding of lipid metabolism following SCI and have the potential to lead to new biomarkers and/or therapeutic strategies.

脊髓损伤 (SCI) 后，有一个短暂的恢复阶段，最终达到平台期。了解脊髓随时间的变化可能有助于用针对性的方法来预防或逆转这种平台期，并继续恢复。非靶向代谢组学揭示了严重挫伤SCI小鼠模型在恢复 (损伤后7天 [DPI]) 和平台期 (21 dpi) 期间，受损脊髓内不同的代谢特征。脂质代谢物的改变，尤其是参与磷脂 (PL) 代谢的那些，在很大程度上导致了总体差异。Pl被磷脂酶A2 (PLA2s) 水解，产生溶血磷脂 (lpl) 和脂肪酸 (FAs)。PL代谢物在7至21 DPI之间减少，而LPLs在21 DPI时增加，表明在平台期PL代谢增加。各种pla2的表达在两个时间点之间也不同，进一步支持在两个损伤期间PL代谢的失调。FAs可促进炎症、线粒体功能障碍和神经元损伤，无论时间点如何，FAs均增加。肉碱可以与FAs结合形成酰基肉碱，减轻FA诱导的毒性。与FAs相反，肉碱和酰基肉碱在7 DPI时增加，但在21 DPI时减少，表明在较晚的时间点肉碱介导的FA毒性减轻的损失，这可能有助于SCI后恢复的停止。还观察到氧化磷酸化和三羧酸循环代谢物的改变，表明线粒体功能持续但不相似的破坏。这些数据有助于增加我们对SCI后脂质代谢的理解，并有可能导致新的生物标志物和/或治疗策略。

REF: Scholpa NE, Simmons EC, Snider JM, Barrett K, Buss LG, Schnellmann RG. Evolution of Lipid Metabolism in the Injured Mouse Spinal Cord. J Neurotrauma. 2025;42(3-4):182-196. doi:10.1089/neu.2024.0385 PMID: 39686743

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Therapeutic Efficacy of Hemodynamic Management Using Norepinephrine on Cardiorespiratory Function Following Cervical Spinal Cord Contusion in Rats

去甲肾上腺素对大鼠颈部脊髓挫伤后心肺功能的治疗作用

Cervical spinal cord injury usually leads to cardiorespiratory dysfunction due to interruptions of the supraspinal pathways innervating the phrenic motoneurons and thoracic sympathetic preganglionic neurons. Although clinical guidelines recommend maintaining the mean arterial pressure within 85-90 mmHg during the first week of injury, there is no pre-clinical evidence from animal models to prove the therapeutic efficacy of hemodynamic management. Accordingly, the present study was designed to investigate the therapeutic efficacy of hemodynamic management in rats with cervical spinal cord contusion. Adult male rats underwent cervical spinal cord contusion and the implantation of osmotic pumps filled with saline or norepinephrine (NE) (125 μg/(kg·h) for 1 week). The cardiorespiratory function of unanesthetized rats was examined using a non-invasive blood pressure analyzer and double-chamber plethysmography. Cervical spinal cord contusion caused a long-term reduction in the mean arterial pressure and tidal volume. This hypotensive response was significantly reversed in contused rats receiving NE (1 day: 88 ± 19 mmHg; 2 weeks: 96 ± 13 mmHg) compared with contused rats receiving saline (1 day: 72 ± 15 mmHg; 2 weeks: 82 ± 10 mmHg). NE also significantly improved the tidal volume 1 day post-injury (contused + NE: 0.7 ± 0.2 mL; contused + saline: 0.5 ± 0.1 mL). Immunofluorescence staining results revealed that injury-induced reductions of noradrenergic and glutamatergic fibers within the thoracic spinal cord were significantly improved by NE. These results provided the evidence demonstrating that hemodynamic management using NE significantly improves cardiorespiratory function by alleviating neural pathway damage after cervical spinal cord contusion.

颈部脊髓损伤通常会导致心肺功能障碍，这是由于支配运动神经元和胸交感节前神经元的脊髓上途径中断所致。尽管临床指南建议在受伤的第一周内将平均动脉压保持在85-90mmhg内，但没有来自动物模型的临床前证据证明血液动力学管理的治疗效果。因此，本研究旨在研究颈部脊髓挫伤大鼠的血流动力学管理的治疗效果。成年雄性大鼠接受颈部脊髓挫伤，并植入充满盐水或去甲肾上腺素 (NE) (125 μ g/(kg·h)，持续1周) 的渗透泵。使用无创血压分析仪和双室体积描记法检查未麻醉大鼠的心肺功能。颈部脊髓挫伤导致平均动脉压和潮气量长期降低。与接受盐水的挫伤大鼠 (1天: 72 ± 15 mmHg; 2周: 82 ± 10 mmHg) 相比，接受NE的挫伤大鼠 (1天: 88 ± 19 mmHg; 2周: 96 ± 13 mmHg) 的低血压反应显着逆转。NE还显着改善了受伤后1天的潮气量 (NE: 0.7 ± 0.2 mL; 盐水: 0.5 ± 0.1 mL)。免疫荧光染色结果显示，NE显着改善了损伤诱导的胸脊髓内去甲肾上腺素能和谷氨酸能纤维的减少。这些结果提供了证据，证明使用NE的血液动力学管理通过减轻颈部脊髓挫伤后的神经通路损伤来显着改善心肺功能。

REF: Chen RY, Lee KZ. Therapeutic Efficacy of Hemodynamic Management Using Norepinephrine on Cardiorespiratory Function Following Cervical Spinal Cord Contusion in Rats. J Neurotrauma. 2025;42(3-4):197-211. doi:10.1089/neu.2024.0342 PMID: 39661956

由人工翻译修正

Identification of a Therapeutic Window for Neurovascular Unit Repair after Experimental Spinal Cord Injury

实验性脊髓损伤后神经血管单元修复治疗窗口的确定

Traumatic spinal cord injury (SCI) is a devastating condition for which effective neuroregenerative and neuroreparative strategies are lacking. The post-traumatic disruption of the blood-spinal cord barrier (BSCB) as part of the neurovascular unit (NVU) is one major factor in the complex pathophysiology of SCI, which is associated with edema, inflammation, and cell death in the penumbra regions of the spinal cord adjacent to the lesion epicenter. Thus, the preservation of an intact NVU and vascular integrity to facilitate the regenerative capacity following SCI is a desirable therapeutic target. This study aims to identify a therapeutic window of opportunity for NVU repair after SCI by characterizing the timeframe of its post-traumatic disintegration and reintegration with implications for functional spinal cord recovery. With this study, a therapeutic window to address the impaired NVU starting from the first days to two weeks after SCI is identified. A number of lines of evidence including in vivo 2PM, assessment of NVU integrity, and neurobehavioral assessments point to the critical nature of targeting the NVU to enhance axonal preservation and regeneration after SCI. Continuous multifactorial therapy applications targeting the integrity of the NVU over the identified therapeutic window of opportunity appears promising to ameliorate functional vessel perseverance and the spinal cord's regenerative capacity.

创伤性脊髓损伤 (SCI) 是一种毁灭性的疾病，缺乏有效的神经再生策略。作为神经血管单元 (NVU) 一部分的血脊髓屏障 (BSCB) 被破坏是SCI复杂病理生理学中的一个主要因素，其与损伤中心附近的脊髓半暗带区域的水肿，炎症和细胞死亡有关。因此，保持完整的NVU和血管完整性以促进SCI后的再生能力是期望的治疗目标。这项研究旨在通过表征创伤后解体和重新融合的时间框架，确定SCI后NVU修复的治疗时间窗，并对功能性脊髓恢复产生影响。通过这项研究，确定了从SCI后的第一天到两周开始解决NVU受损的治疗窗口。NVU完整性评估和神经行为评估在内的许多证据表明靶向NVU以增强SCI后轴突保存和再生的关键性质。在确定的治疗窗口内针对NVU完整性的连续多因素治疗应用似乎有望改善血管和脊髓的再生能力。

REF: Hubertus V, Meyer L, Waldmann L, et al. Identification of a Therapeutic Window for Neurovascular Unit Repair after Experimental Spinal Cord Injury. J Neurotrauma. 2025;42(3-4):212-228. doi:10.1089/neu.2024.0233 PMID: 39585767

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Bladder Responses to Thoracolumbar Epidural Stimulation in Female Urethane-Anesthetized Rats with Graded Contusion Spinal Cord Injuries

膀胱对胸腰段硬膜外刺激的雌性氨基甲酸乙酯麻醉大鼠的膀胱反应

Spinal cord epidural stimulation (scES) is a therapeutic option that promotes functional improvements in sensory, motor, and autonomic functions following spinal cord injury (SCI). Previous scES mapping studies targeting the lower urinary tract (LUT) in rats demonstrated functional response variability based upon lumbosacral level, parameters used, extent of injury (spinally intact vs. chronic anatomically complete spinal transections), and sex. In the current study, female rats with clinically relevant graded incomplete T9 contusion injuries were mapped with scES at 60 days post-injury at three spinal levels (T13, L3, L6) with a novel miniature 15-electrode array designed to deliver optimal specificity. The results obtained during bladder fill and void cycles conducted under urethane anesthesia indicate frequency dependent sub-motor threshold effects on LUT function with a single row of electrodes positioned across the full medio-lateral extent of the dorsal cord. The findings of improved storage and emptying, represented by significantly longer inter-contractile intervals with T13 scES and L3 scES and by a significantly increased estimated void efficiency with L6 scES, respectively, are consistent with previous studies using intact and chronic complete transected male and female rats. The data support the efficacy of selective spinal network stimulation to drive functionally relevant networks for storage versus emptying phases of the urinary cycle. The current findings further demonstrate the translational promise of scES for SCI individuals with LUT dysfunctions, regardless of injury severity.

脊髓硬膜外刺激 (scES) 是一种治疗选择，可促进脊髓损伤 (SCI) 后感觉，运动和自主神经功能的功能改善。先前针对大鼠下尿路 (LUT) 的scES映射研究表明，基于脊柱水平，使用的参数，损伤程度 (脊柱完整与慢性解剖学上完整的脊柱横切) 和性别。在目前的研究中，具有临床相关分级的不完全T9挫伤的雌性大鼠在损伤后60天在三个脊柱水平 (T13，L3，L6) 用于提供最佳特异性的新型微型15电极阵列与scES作图。在麻醉下进行的膀胱充盈和排空周期中获得的结果表明，单排电极位于背索的整个中外侧范围内，频率依赖性亚运动阈值对LUT功能的影响。分别以T13 ses和L3 ses的收缩间隔显着延长以及L6 ses的空隙效率显着增加为代表的改善存储和排空的发现，与以前使用完整和慢性完全横断的雄性和雌性大鼠研究一致。数据支持选择性脊髓网络刺激的效果，以驱动功能相关的网络进行存储与排空尿。当前的发现进一步证明了scES对LUT功能障碍的SCI个体的转化前景，而与损伤的严重程度无关。

REF: Wilkins NL, Medina-Aguiñaga D, Hoey RF, Fell J, Harkema SJ, Hubscher CH. Bladder Responses to Thoracolumbar Epidural Stimulation in Female Urethane-Anesthetized Rats with Graded Contusion Spinal Cord Injuries. J Neurotrauma. 2025;42(3-4):229-241. doi:10.1089/neu.2024.0209 PMID: 39264865

由人工翻译修正

Safety and Feasibility of Early Activity-Based Therapy Following Severe Traumatic Spinal Cord Injury: Results from a Single-Arm Pilot Trial

严重创伤性脊髓损伤后早期基于活动的治疗的安全性和可行性: 来自单臂试验的结果

Early activity-based therapy (E-ABT) has the potential to decrease complications and radically improve neurofunctional recovery following traumatic spinal cord injury (TSCI). Unfortunately, E-ABT after TSCI has never been attempted in humans due to practical obstacles and potential safety concerns. This study aims to report on the safety and feasibility outcomes of the Protocol for Rapid Onset of Mobilization in Patients with Traumatic SCI (PROMPT-SCI) trial: the first-ever trial of E-ABT in critically ill patients who suffered a severe TSCI. The present results also suggest that improved collaboration with intensive care unit staff, including intensivists and nurses, could improve these rates even further.

早期活动治疗 (e-abt) 有可能减少创伤性脊髓损伤 (TSCI) 后的并发症并从根本上改善神经功能恢复。不幸的是，由于实际障碍和潜在的安全问题，TSCI后的e-abt从未在人体中尝试过。这项研究旨在报告创伤性SCI患者快速动员方案 (PROMPT-SCI) 试验的安全性和可行性结果: e-abt在患有严重TSCI的重症患者中的首次试验。目前的结果表明，加强与重症监护病房工作人员的合作，可以进一步提高这些比率。

REF: Dionne A, Magnuson D, Richard-Denis A, et al. Safety and Feasibility of Early Activity-Based Therapy Following Severe Traumatic Spinal Cord Injury: Results from a Single-Arm Pilot Trial. J Neurotrauma. 2025;42(3-4):242-249. doi:10.1089/neu.2024.0297 PMID: 39611653

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Altered Dynamic Brain Functional Network Connectivity Related to Visual Network in Spinal Cord Injury

脊髓损伤中与视觉网络相关的动态脑功能网络连接的改变

Visual feedback training (VFT) plays an important role in the motor rehabilitation of patients with spinal cord injury (SCI). However, the neural mechanisms are unclear. We aimed to investigate the changes in dynamic functional network connectivity (FNC) related to visual networks (VN) in patients with SCI and to reveal the neural mechanism of VFT promoting motor function rehabilitation. Our findings indicated that SCI could result in VN-related FNC alterations, revealing the possible mechanism for VFT in rehabilitation of patients with SCI and increasing the training efficacy and promoting rehabilitation for SCI.

视觉反馈训练 (VFT) 在脊髓损伤 (SCI) 患者的运动康复中起着重要作用。然而，神经机制尚不清楚。本研究旨在探讨SCI患者动态功能网络连接 (FNC) 与视觉网络 (VN) 相关的变化，揭示VFT促进运动功能康复的神经机制。我们的研究结果表明，SCI可能导致VN相关的FNC改变，揭示了VFT在SCI患者康复中的可能机制，并提高了训练效果，促进了SCI的康复。

REF: Xin H, Yang B, Wang Y, et al. Altered Dynamic Brain Functional Network Connectivity Related to Visual Network in Spinal Cord Injury. J Neurotrauma. 2025;42(3-4):250-261. doi:10.1089/neu.2024.0318 PMID: 39558745

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Evolution of Real-World Clinical Practice in Time to Surgery Following Thoracolumbar Spinal Cord Injury: An Observational Study of North American Trauma Centers from 2010 to 2020

胸腰段脊髓损伤后手术时间的真实世界临床实践的演变: 2010年至2020年北美创伤中心的观察性研究

This study aims to estimate real-world clinical practice trends in time to surgery following thoracolumbar spinal cord injury (SCI) in trauma centers across North America over the last decade (2010-2020). This study provides real-world data on practice pattern trends with respect to time to spine surgery following traumatic thoracolumbar SCI. Over the years from 2010 to 2020, we found a significant reduction in time to surgery across trauma centers in North America.

本研究旨在评估过去十年 (2010-2020) 北美创伤中心胸腰段脊髓损伤 (SCI) 后手术时间的真实临床实践趋势。这项研究提供了关于创伤性胸腰椎SCI后脊柱手术时间的实践模式趋势的真实数据。从2010年到2020年，我们发现北美创伤中心的手术时间显着减少。

REF: Essa A, Malhotra AK, Shakil H, et al. Evolution of Real-World Clinical Practice in Time to Surgery Following Thoracolumbar Spinal Cord Injury: An Observational Study of North American Trauma Centers from 2010 to 2020. J Neurotrauma. 2025;42(3-4):262-271. doi:10.1089/neu.2024.0125 PMID: 39506651

由人工翻译修正

Time to Surgery Following Complete Cervical Spinal Cord Injury: Evolution of Clinical Practice Patterns Over a Decade from 2010 to 2020 Across North American Trauma Centers

完全颈部脊髓损伤后的手术时间: 2010至2020十年间北美创伤中心临床实践模式的演变

This study aims to quantify the change in time to surgery for treatment of complete traumatic cervical spinal cord injury (SCI) patients in American College of Surgeons accredited trauma centers across North America over the last decade (2010-2020). This study provides compelling real-world based quantification of the change in time to surgical intervention following traumatic cervical SCI. A significant decreasing annual trend pertaining to surgical timing across trauma centers in North America over the past decade was demonstrated.

这项研究旨在量化过去十年 (2010-2020) 美国外科医师学院认可的北美创伤中心对完全创伤性颈部脊髓损伤 (SCI) 患者进行手术治疗的时间变化。这项研究提供了令人信服的基于现实世界的数据，以量化创伤性颈部SCI后手术干预的时间变化。在过去的十年中，与北美创伤中心的手术时机有关的年度趋势显着下降。

REF: Essa A, Shakil H, Malhotra AK, et al. Time to Surgery Following Complete Cervical Spinal Cord Injury: Evolution of Clinical Practice Patterns Over a Decade from 2010 to 2020 Across North American Trauma Centers. J Neurotrauma. 2025;42(3-4):272-279. doi:10.1089/neu.2024.0025 PMID: 39501890

由人工翻译修正