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Kwon B.K.,University of British Columbia | Okon E.,University of British Columbia | Hillyer J.,University of British Columbia | Mann C.,University of British Columbia | And 4 more authors.
Journal of Neurotrauma

An increasing number of therapies for spinal cord injury (SCI) are emerging from the laboratory and seeking translation into human clinical trials. Many of these are administered as soon as possible after injury with the hope of attenuating secondary damage and maximizing the extent of spared neurologic tissue. In this article, we systematically review the available pre-clinical research on such neuroprotective therapies that are administered in a non-invasive manner for acute SCI. Specifically, we review treatments that have a relatively high potential for translation due to the fact that they are already used in human clinical applications, or are available in a form that could be administered to humans. These include: erythropoietin, NSAIDs, anti-CD11d antibodies, minocycline, progesterone, estrogen, magnesium, riluzole, polyethylene glycol, atorvastatin, inosine, and pioglitazone. The literature was systematically reviewed to examine studies in which an in-vivo animal model was utilized to assess the efficacy of the therapy in a traumatic SCI paradigm. Using these criteria, 122 studies were identified and reviewed in detail. Wide variations exist in the animal species, injury models, and experimental designs reported in the pre-clinical literature on the therapies reviewed. The review highlights the extent of investigation that has occurred in these specific therapies, and points out gaps in our knowledge that would be potentially valuable prior to human translation. © 2011 Mary Ann Liebert, Inc. Source

Furlan J.C.,University of Western Ontario | Furlan J.C.,Krembil Neuroscience Center | Bracken M.B.,Yale University | Fehlings M.G.,University of Western Ontario | And 2 more authors.
Neurobiology of Aging

Given the potential impact of age on mortality, neurological outcomes and the extent of post-traumatic neural degeneration, we examined these issues using a large, prospectively accrued clinical database (n = 485) supplemented by analysis of postmortem spinal cord tissue (n = 12) to compare axonal survival and white matter degeneration in younger versus elderly individuals with spinal cord injury (SCI). Elderly individuals (≥65 years) had significantly greater mortality rates than younger individuals at 30 days, at 6 months and at 1 year following SCI (46.88% versus 4.86%, respectively; p < 0.0001). However, among survivors, age was not significantly associated with motor and sensory outcomes at 6 weeks, 6 months and 1 year post-SCI in univariate and multivariate analyses. Correspondingly, neuroanatomical analysis of postmortem spinal cord tissue revealed no significant age-related differences for extent of myelin degeneration or number of intact axons within sensory, motor and autonomic spinal cord tracts post-SCI. Treatment protocols for SCI need to identify preventable predictors of mortality in the elderly post-SCI, recognizing that the potential for neurological recovery among elderly survivors of SCI is similar to that of younger individuals. © 2008 Elsevier Inc. All rights reserved. Source

Fehlings M.G.,Krembil Neuroscience Center
Critical Care in Spinal Cord Injury

Injuries to the spinal cord can be truly devastating for the individual and more widely impose a substantial burden on healthcare funding and resourcing. This book, authored by renowned experts, provides a clear and concise introduction to spinal cord injury with up-to-date information in an ever-evolving field. There are chapters on epidemiology, pathophysiology, assessment, use of imaging technologies, diagnosis and classification, available treatments and prognosis. Longer-term care, rehabilitation and prognosis are also highlighted. The book concludes with an overview of emerging therapies offering promise in terms of outcomes and quality of life for patients with spinal cord injury. © 2013 Future Medicine Ltd. All rights reserved. Source

O'Higgins M.,Krembil Neuroscience Center | Roberts I.S.J.,University of London | Glover V.,Imperial College London | Taylor A.,Imperial College London | Taylor A.,Kings College London
Archives of Women's Mental Health

Some mothers experience neutral or negative feelings toward their new infant. This study examined the association between symptoms of postnatal depression and mother-infant bonding and the persistence of these feelings over the first year. Bonding was assessed using the Mother-Infant Bonding Scale (MIBQ), at four times postnatal, "early weeks" (1-4 weeks), 9 weeks, 16 weeks and 1 year, in 50 depressed, Edinburgh Postnatal Depression scale (EPDS) ≥13 at 4 weeks post natal, and 29 non-depressed mothers. A significant association between the EPDS score at 4 weeks and bonding score at 1-4 weeks, 9 weeks, and at 1 year postnatal, χ 2(1) = 9.85, p < 0.01, 5.44, p < 0.05 and 5.21, p < 0.05, respectively, was found, with a trend at 16 weeks. There was a strong association between bonding in the early weeks and all later time points χ 2(1) = 17.26, p < 0.001, 7.89, p < 0.01 and 13.69, p < 0.001, respectively. Regression showed early bonding rather than early depression was the major predictor of bonding at 1 year. Women who are depressed postnatally can fail to bond well with their baby and this can persist for a year. Early identification and intervention for poor bonding is indicated. © 2013 Springer-Verlag Wien. Source

Willoughby K.A.,University of Toronto | Mcandrews M.P.,University of Toronto | Mcandrews M.P.,Krembil Neuroscience Center | Rovet J.,University of Toronto
Journal of the International Neuropsychological Society

Abstract Memory deficits and hippocampal abnormalities have been described in individuals with thyroid hormone (TH) insufficiencies; however, no study has yet examined their autobiographical memory (AM) abilities, which are known to be compromised by hippocampal damage. Investigations in adults have shown that AM consists of both episodic and semantic components and that the hippocampus is preferentially involved in episodic AM. The present study used the Children's Autobiographical Interview (CAI) to study episodic and semantic AM in 79 children aged 9 to 14 years, including 26 with early-treated congenital hypothyroidism (CH), 23 born to women with inadequately treated hypothyroidism during pregnancy (HYPO), and 30 typically developing controls. Results showed that relative to controls, CH and HYPO groups both exhibited weaknesses in episodic AM, but not semantic AM. In particular, CH and HYPO groups showed difficulty in recalling event details (i.e., the main happenings) and visual details from past experiences. Overall, this study highlights the importance of TH for early neurodevelopment and provides critical new insight into the effects of early treated TH deficiency on long-term memory performance. Furthermore, the present study indicates that the CAI is an effective tool for investigating episodic AM impairment in clinical pediatric populations. (JINS, 2013, 19, 1-11) Copyright © INS. Source

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