Project Summary:
Traumatic spinal cord injury (SCI) is a severe and life-altering event, leaving patients with pronounced functional impairments that result in significant physical and emotional challenges for themselves, their families, and caregivers. Each year, the U.S. experiences around 18,000 new injuries, with over 200 of these cases occurring in Wisconsin.
Approximately 300,000 individuals in the U.S. are currently living with SCI (NSCISC, 2023 SCI Data Sheet). Vehicle crashes and falls are the leading causes of SCI, accounting for approximately 70% of injuries; SCI can affect everyone and every population group, making SCI a general health concern.
Of these SCI patients, approximately 50% suffer from concomitant traumatic brain injury (TBI), most of which are mild TBIs (mTBI). TBI overall resulted in approximately 10,000 emergency room visits and 1,500 deaths in Wisconsin in 2020 (Wisconsin Department of Health Services). Detailed numbers of concomitant SCI and TBI in Wisconsin are currently not available.
Combined SCI and TBI pose challenges for diagnosing the injury and appropriate clinical management. Affected patients are often unable to fully participate in clinical neurological exams. They are typically excluded from SCI clinical trials, resulting in a significant group of SCI patients who are under-evaluated and under-documented.
Despite the high frequency of concomitant injuries, only limited information is available on simultaneous SCI and TBI. Several clinical reports suggest deteriorated functional outcomes, but the retrospective nature of these studies does not permit a distinguishment between the pathophysiological effects of TBI on SCI and effects caused by differences in post-SCI care.
This project’s overarching goal is to establish a reliable model of concomitant neurotrauma of SCI and mTBI to validate the clinical observation of potentiation of injury severity compared to individual events of neurotrauma.
This model will be designed to mimic a relevant injury mechanism and will be indispensable for the mechanistic evaluation of the root cause responsible for the exacerbation of injury severity, thereby providing specific treatment targets. Within the one-year time frame of the proposed project, the project team plans to test the specific hypothesis that concomitant neurotrauma deteriorates functional recovery and exacerbates tissue damage and neuronal loss.
The goal of this project is to obtain information on an underexplored aspect of neurotrauma: the impact of concomitant neurotrauma affecting brain and spinal cord.
A better understanding of the mechanistic impact of concomitant SCI and TBI may be the basis for the development of targeted treatment approaches for neuroprotection and neuronal function. This study will be essential in providing preliminary data for extramural funding applications (NIH, DOD, VA) to allow for a detailed analysis of the mechanistic role of concomitant neurotrauma in tissue damage and the impact on additional health conditions which may include dysfunctions of the autonomous nervous system.