Acute Management of Nutritional Demands after Spinal Cord Injury

Thibault-Halman, Ginette; Casha, Steven; Singer, Shirley; Christie, Sean

doi:10.1089/neu.2009.1155

Cited by 45 publications

(26 citation statements)

References 22 publications

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“…Although all animals started off within the same weight range (250–270 g), we acknowledge that the rise in weight with FTM HUCPVCs may also account for some of the improvements in fore limb grip strength. Nevertheless, as weight loss and the need for nutritional support remains a major concern following SCI , this finding still supports general improvements in animal wellbeing following FTM HUCPVCs treatment.…”

Section: Discussionmentioning

confidence: 56%

Early Intravenous Infusion of Mesenchymal Stromal Cells Exerts a Tissue Source Age-Dependent Beneficial Effect on Neurovascular Integrity and Neurobehavioral Recovery After Traumatic Cervical Spinal Cord Injury

Vawda

Badner

Hong

et al. 2019

Stem Cells Translational Medicine

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Localized vascular disruption after traumatic spinal cord injury (SCI) triggers a cascade of secondary events, including inflammation, gliosis, and scarring, that can further impact recovery. In addition to immunomodulatory and neurotrophic properties, mesenchymal stromal cells (MSCs) possess pericytic characteristics. These features make MSCs an ideal candidate for acute cell therapy targeting vascular disruption, which could reduce the severity of secondary injury, enhance tissue preservation and repair, and ultimately promote functional recovery. A moderately severe cervical clip compression/contusion injury was induced at C7‐T1 in adult female rats, followed by an intravenous tail vein infusion 1 hour post‐SCI of (a) term‐birth human umbilical cord perivascular cells (HUCPVCs); (b) first‐trimester human umbilical cord perivascular cells (FTM HUCPVCs); (c) adult bone marrow mesenchymal stem cells; or (d) vehicle control. Weekly behavioral testing was performed. Rats were sacrificed at 24 hours or 10 weeks post‐SCI and immunohistochemistry and ultrasound imaging were performed. Both term and FTM HUCPVC‐infused rats displayed improved ( p < .05) grip strength compared with vehicle controls. However, only FTM HUCPVC‐infusion led to significant weight gain. All cell infusion treatments resulted in reduced glial scarring ( p < .05). Cell infusion also led to increased axonal, myelin, and vascular densities ( p < .05). Although post‐traumatic cavity volume was reduced with cell infusion, this did not reach significance. Taken together, we demonstrate selective long‐term functional recovery alongside histological improvements with HUCPVC infusion in a clinically relevant model of cervical SCI. Our findings highlight the potential of these cells for acute therapeutic intervention after SCI.

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Section: Discussionmentioning

confidence: 56%

Early Intravenous Infusion of Mesenchymal Stromal Cells Exerts a Tissue Source Age-Dependent Beneficial Effect on Neurovascular Integrity and Neurobehavioral Recovery After Traumatic Cervical Spinal Cord Injury

Vawda

Badner

Hong

et al. 2019

Stem Cells Translational Medicine

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“…6 Immediately following a SCI, individuals experience weight loss due to increased metabolic demand related to severe trauma. 7 Infection, decreased caloric intake, and psychological factors, such as adjustment disorder and depression, are factors that may also contribute to weight loss after SCI. In clinical practice, patients are often encouraged to increase their caloric intake to offset the injury-stress response, but may not be adequately counseled on appropriate nutrition and weight control after stabilization of their injury.…”

Section: Introductionmentioning

confidence: 99%

Weight change after spinal cord injury

Powell

Affuso

Chen

2016

The Journal of Spinal Cord Medicine

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Objectives: To study the patterns of weight change after spinal cord injury (SCI) and identify associated risk factors. Study design: Cohort study. Setting: Sixteen Spinal Cord Injury Model Systems (SCIMS), USA. Participants: One thousand and ninety-four individuals with an SCI who were entered into the SCIMS and had a 1-year follow-up between October 2006 and November 2012. Intervention: Not applicable. Outcome measure: Change in body mass index (BMI) during the first year of injury. Height and weight were assessed during inpatient rehabilitation and 1 year after injury. Results: Mean BMI decreased from 26.3 to 25.8 kg/m² during the first year after SCI (mean change: −0.5 kg/m² (standard deviation: 3.58)). Weight loss was mainly observed among individuals classified as overweight or obese during rehabilitation (n = 576) with a BMI decrease of 1.4 kg/m², which varied significantly by sex, education, neurological level, and the presence of vertebral injury. Weight gain was noted among individuals classified as underweight or normal weight during rehabilitation (n = 518) with a BMI increase of 0.5 kg/m², with the greatest increase among individuals of Hispanic origin (1.2 kg/m²), other marital status (1.2 kg/m²), age group 31-45 years (1.1 kg/m²), with less than high school education (1.1 kg/m²), without spinal surgery (0.9 kg/m²), and with motor functionally incomplete injury (0.8 kg/m²). Conclusion: Our findings suggest that strategies for weight management should be addressed after a SCI to ameliorate the potential for unhealthful weight change, particularly among at-risk groups.

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“…This form of nutritional support may provide a safe alternative for feeding for those who are unable to tolerate an oral diet due to swallowing safety impairments [19]. The placement of feeding tubes, whether nasogastric or percutaneous endoscopic gastrostomy, is a common trend evident in current literature describing the management of swallowing impairment for individuals with a spinal injury.…”

Section: Discussionmentioning

confidence: 99%

A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

2016

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Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population.

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Acute Management of Nutritional Demands after Spinal Cord Injury

Cited by 45 publications

References 22 publications

Early Intravenous Infusion of Mesenchymal Stromal Cells Exerts a Tissue Source Age-Dependent Beneficial Effect on Neurovascular Integrity and Neurobehavioral Recovery After Traumatic Cervical Spinal Cord Injury

Early Intravenous Infusion of Mesenchymal Stromal Cells Exerts a Tissue Source Age-Dependent Beneficial Effect on Neurovascular Integrity and Neurobehavioral Recovery After Traumatic Cervical Spinal Cord Injury

Weight change after spinal cord injury

A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

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