Brain and spinal cord Injury research programs at VA

May 22, 2014 College News - The Medical College of Wisconsin and the Clement J. Zablocki VA Medical Center are collaborating to improve the lives of those with brain and spinal cord injuries.

Spinal cord injury

Spinal cord injury affects more than 12,000 Americans annually – including returning veterans – and health care for those individuals exceeds $6 billion. The Department of Neurosurgery’s spinal cord injury research program located at the VA includes a group of investigators with varied areas of expertise working together to make improvements in care and find new therapies for patients with spinal cord injuries. 

Imaging water to predict recovery: diffusion imaging of the spinal cord

With current methods or clinical exams, it is difficult to predict how, when, and if patients will recover from a spinal cord injury.  Researchers are using specialized magnetic resonance imaging (MRI) methods to more accurately detect the severity of an injury and predict how much recovery will take place.  The techniques measure how water molecules interact with the spinal cord tissue.  Previous and ongoing work indicates the technique is highly sensitive to the severity of an injury.  The long-term goal is to use these methods to predict recovery in patients and speed up the discovery for effective therapies for spinal cord injury. The researchers also believe that the detailed structural information that will be available with diffusion imaging might assist surgeons in designing better delivery of drugs and other substances that might help regenerate spinal cord tissue.

The brain in spinal cord injury

Researchers are evaluating the plasticity of the nervous system by performing combined modality imaging of the brain in spinal cord injury patients. There is evidence that the brain “rewires itself” in an individual that has sustained a spinal cord injury with consequent paralysis. Understanding how this rewiring occurs might help design improved rehabilitation regimens for spinal cord injury patients. The goal of the imaging research projects are to design novel “biomarkers” that will help diagnosis, prognostication and treatment design for spinal cord injury patients

Regeneration of the spinal cord

Researchers are also engaged in determining whether it is possible to harness stem cells from the bone marrow to repair the injured spinal cord. The advantage of using bone marrow-derived cells is that there are no “graft rejection” issues (as they are the patient’s own cells) and that ethical issues evident with embryonic stem cells are avoided. Researchers in the Department of Neurosurgery are working collaboratively with industry to “convert” human bone marrow derived stem cells into nervous system cells that would help regenerate the injured spinal cord.

Traumatic Brain Injury

Traumatic brain injury (TBI) is a worldwide health concern, with 3.8 million people suffering from a head injury annually.  The number of military personnel suffering from a head injury has dramatically risen in recent years, and TBI is often considered the “signature wound” of the current military conflicts. Researchers in the Department of Neurosurgery’s basic science brain injury research program located at the VA are using many different approaches to investigate TBI.  The goals of the program are to devise more effective prevention strategies and develop better treatment and recovery options.

Brains in a dish

Researchers are using sections of brain tissue grown in culture to visualize the effects of trauma directly on the neurons and other cells of the nervous system.  These models will help in understanding how the cells respond to different forces and types of trauma.  Promising therapies, including stem cell treatments, are being evaluated to understand how they could be used to improve recovery from a traumatic brain injury.

A window to the brain

Magnetic resonance imaging is being used to examine the effects of brain trauma in living subjects.  New techniques are being developed that can monitor microscopic changes in the brain that are too small to be seen in a typical clinical exam.  These promising technologies may be used in the future to diagnose TBI.  The same methods are also being used to see how the brain recovers from injury and to evaluate how drugs or rehabilitation might change the brain in ways that promote recovery.

Building a better model

Mild injury or concussion is the most common type of head injury, but most laboratory studies of head injury model severe or blunt trauma injuries.  A more relevant model of mild TBI has been developed to better understand how the brain is injured in a mild head impact and how it recovers from the injury.  These efforts are being used to understand how to prevent head injury and how even a mild head injury might cause long-lasting consequences.

Funding for these projects has come from the Department of Veterans Affairs, the National Institutes of Health, Advancing a Healthier Wisconsin, the Clinical and Translational Science Institute of Southeast Wisconsin, The Craig H. Neilsen Foundation, and the Bryon Riesch Paralysis Foundation, which donated $1 million to MCW to support spinal cord injury research and establish the Bryon Riesch Paralysis Foundation Laboratories.

Faculty members involved in these research projects include:

Dennis J. Maiman, MD, PhD, Chairman and Sanford J. Larson, MD, PhD Professor of Neurosurgery; Frank A. Pintar, PhD, Professor of Neurosurgery and Director of the Neuroscience Research Labs; Brian D. Stemper, PhD, Associate Professor of Neurosurgery; Matthew Budde, PhD, Assistant Professor of Neurosurgery; Aleksandra Glavaski-Joksimovic, PhD, Assistant Professor of Neurosurgery; and Shekar Kurpad, MD, PhD, Associate Professor of Neurosurgery, Director of the Spinal Cord Injury Lab at the VA and Medical Director of the Spinal Cord Injury Center at Froedtert Hospital.

Staff involved in these research projects include Brandy Aperi, Research Technologist; James Budzinski, Research Associate; Rachel Chiariello, Research Technologist; Alok Shaw, Engineer; Christy Stadig, Program Manager; Kyle Stehlick, Research Technologist; Justine Treuden, Research Technologist; Natasha Wilkins, Lab Technician

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