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A Foundation of Hope

Reprinted from PN/Paraplegia News April 2015

More than $1 million from PVA helps researchers in their efforts to better understand, treat and possibly find a cure for SCI/D.

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Researchers across North America are working on various projects to improve life for people with spinal-cord injury or disease (SCI/D) and possibly even cure it thanks to help from Paralyzed Veterans of America (PVA).

The PVA Research Foundation has again awarded more than $1 million in grants to researchers in Canada and the United States in support of innovative research and fellowships that improve the lives of those with SCI/D.

Grants are awarded in four categories, including basic science, clinical, design and fellowships. This year’s research projects range from looking at breathing complications to helping ease pain to vitamin D levels to improving air travel.

Here’s a look at this year’s recipients and their respective studies:

Basic Science

Alterations in Spinal Respiratory Networks After Cervical SCI

Michael Fehlings, MD, PhD, FRCSC, FACS
University Health Network (Toronto)
$145,044 (two years)

Breathing is a vital function, and disruption of the neural assemblies responsible for respiration can have serious and deleterious implications. Pulmonary dysfunction significantly impacts patient quality of life and is the leading cause of death following acute traumatic spinal-cord injury (SCI).

Respiratory complications in SCI can result from disruption of respiratory neural circuitry and the subsequent loss of respiratory muscle function. In contrast, individuals with age-related progressive spinal-cord damage [Cervical Spondylotic Myelopathy (CSM)], in which the cervical spinal cord is progressively compressed over time, face milder respiratory dysfunction despite the significant disruption of their cervical neural network.

This surprising observation is thought to occur due to poorly understood remodeling of the spinal cord respiratory neural network that overcomes the injury to maintain adequate ventilation.

Using a novel mouse model of slow compressive cervical SCI, this proposal will investigate the specific and detailed sculpting of the spinal cord respiratory circuitry that occurs over time. A deeper understanding of these changes will provide new knowledge about the respiratory networks capacity for remodeling and aid in the development of better treatments for the traumatic and non-traumatic SCI population faced with respiratory insufficiency.

Conquering SCI Pain & Improving Opioid Efficacy

Linda Watkins, PhD
The Regents of the University of Colorado
$150,000 (two years)

This work will study a new therapeutic in rats that is expected to be ready for testing in human clinical trials in 2015.

This therapeutic is unlike any other drug now available for spinal-cord injury (SCI) chronic pain. Unlike all other drugs, it treats pain amplification by cells called glia. When glia becomes activated, they amplify pain caused by spinal trauma.


Mary Filipi, PhD and her team investigate the role of the CYP2J2 gene and serum vitamin D levels in multiple sclerosis (MS).

There are two goals. First, we will test if this new glia therapeutic can treat SCI pain. Second, as we found that morphine given early after trauma actually makes chronic pain worse and longer lasting, we will test if this glia-targeting therapeutic can improve opioid pain control as well as prevent or reverse the long-term negative effects of early opioid treatment.

Clinical

Improving Acute SCI Assessment with Cine MRI & Epidural Electrophysiology

Maxwell Boakye, MD, MPH, MBA
University of Louisville Research Foundation
$150,000 (two years)

Our goal in this proposal is to use advanced magnetic resonance imaging (MRI) and intraoperative epidural electro-physiological techniques to improve assessment of acute spinal-cord injury (SCI) during the critical period when the cord is at greatest risk for secondary injury.

Phase-contrast or Cine Flow MRI (C-MRI) will be used to measure cerebrospinal fluid flow rates and velocities around the spinal injury site. Intraoperative epidural electrophysiological data will be used to identify the presence or absence of a conduction block at the injury site and confirm injury completeness.

The overall rationale for the study is to establish that these tests can significantly increase the accuracy of current predictive models of SCI outcomes. They would also prevent unnecessary interventions in those patients with little or no chance of neurological recovery and provide objective highly reproducible verification of long-term functional status.

Assessing the Role of the CYP2J2 Gene & Serum Vitamin D Levels in Multiple Sclerosis

Mary Filipi, PhD
Board of Regents of the University of Nebraska
$110,839 (two years)

The goal of this study is to determine if the human equivalent of the CYP2J2 gene is associated with low vitamin D levels and the presence of multiple sclerosis (MS).

The relationship of other indicators found in the blood to vitamin D levels will also be explored to determine if there are other existing conditions which would cause changes. This will be done by:

1. Obtaining serum from 220 subjects with a laboratory-supported diagnosis of MS and compare the presence of the CYP2J2 gene with 220 unaffected subjects acting as controls.

2. Obtaining serum to test for calcium, vitamin D-binding protein, prolactin and bone-specific alkaline phosphates levels. Samples will be collected within three months to eliminate seasonal bias. Correlation will be done with these values and the gene markers.

This will be the only study of its kind. It is believed that the CYP2J2 gene may be used as a disease indicator or assist in treatment selection for those with MS. The gene may also be linked with other autoimmune diseases.

Design

Airline Travel: Assistive Technology for Non-Ambulatory Passengers

Peter Axelson, MSME
Beneficial Designs
$141,863 (two years)

This grant focuses on three aspects of airline travel for people who are non-ambulatory:

1. Using a boarding chair or lift system to get down the aisle of a plane and into the airline seat.

2. Sitting on a standard economy airline seat for the duration of greater than a two-hour flight.

3. Transporting and protecting the wheelchair stowed in the belly of the aircraft.

Data collection will include consumer input, participation in a simulated boarding process assessing passenger and flight attendant posture and safety, pressure mapping and postural tendencies after transferring into an airline seat, and detailed methodology of manual and powered wheelchairs being transported to and stored in the belly of the aircraft.

The outcomes will provide design concepts and parameters of assistive technology to improve the safety, comfort and quality of the flight for the passenger and wheelchair.

Personalized Accessibility Location Services (PALS) for Wheelchair Users

Hassan Karimi, PhD
University of Pittsburgh
$144,121 (two years)

In this project, we will develop a prototype of Personalized Accessibility Location Services (PALS). The purpose of PALS is to assist wheelchair users with wayfinding and navigation outdoors. PALS has three components:

1. A Personalized Accessibility Map (PAM)

2. A Social Navigation Network (SoNavNet)

3. A Personalized Navigation Service (PNS)

The purpose of PAM is to provide the location of accessible routes in the wheelchair user’s environment. The purpose of SoNavNet is to allow members (wheelchair users) to share and exchange their wayfinding and navigation experiences with other members. The purpose of PNS is to provide real-time guidance to wheelchair users on chosen routes.

The prototype PALS will be tested for system performance and by wheelchair users. The goal of the proposed project is to prototype PALS so that it meets the specific needs and preferences of wheelchair users, including veterans.

Fellowships

2015 Fritz Krauth Memorial Fellow Award Recipient

Role of Vasopressin in Spinal Cord Injury Induced Polyuria

Lynnette Montgomery, PhD
University of Louisville Research Foundation
$100,000 (two years)

Spinal-cord injury (SCI) affects thousands of individuals in the United States every year. One disorder seen after SCI is excessive urine production (polyuria).

This leads to disrupted sleep and frequent bladder catheterizations, putting the individual at risk for developing urinary complications. While alleviating polyuria will improve the quality of life in SCI individuals, this area remains understudied.

The amount of urine produced is controlled by vasopressin (ADH). When there is a lot of water in the blood, ADH secretion decreases, causing increased urination. When there is little water (i.e. during exercise), ADH secretion increases, causing decreased urination.

Preliminary work in our lab shows that ADH decreases following SCI. My project aims to investigate the mechanisms by which this decrease occurs and whether medication or exercise aimed at increasing ADH levels following SCI will alleviate signs of polyuria following SCI.

Use of Sensory Inputs for Brain-Computer Interface Training

Shivayogi Hiremath, PhD
University of Pittsburgh
$99,931 (two years)

Individuals with spinal-cord injury or disease (SCI/D) have loss of function and independence in performing activities of daily living.

Electrocorticography-based brain-computer interface (BCI) devices have the potential to improve the quality of life of individuals with SCI/D by providing an alternative pathway between the brain and external assistive devices to replace the function of an arm or leg.

The objective of the proposed study is to evaluate the cortical activity pattern across the premotor, primary motor and somatosensory cortical areas of the brain during passive, observed and attempted movement paradigms in individuals with epilepsy.

The knowledge gained from this study will allow researchers to translate neural decoders computed during passive or observed movement paradigms to the attempted movement paradigm in individuals with SCI/D who cannot actively move their limbs during BCI training due to paralysis.

For more information on the PVA Research Foundation, visit pva.org.

 

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A Foundation of Hope

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