Elevated Autoantibodies in Subacute Human Spinal Cord Injury Are Naturally Occurring Antibodies.

Spinal cord injury (SCI) results in long-term neurological and systemic consequences, including antibody-mediated autoimmunity, which has been related to impaired functional recovery. Here we show that autoantibodies that increase at the subacute phase of human SCI, 1 month after lesion, are already present in healthy subjects and directed against non-native proteins rarely present in the normal spinal cord. The increase of these autoantibodies is a fast phenomenon-their levels are already elevated before 5 days after lesion-characteristic of secondary immune responses, further supporting their origin as natural antibodies. By proteomics studies we have identified that the increased autoantibodies are directed against 16 different nervous system and systemic self-antigens related to changes known to occur after SCI, including alterations in neural cell cytoskeleton, metabolism and bone remodeling. Overall, in the context of previous studies, our results offer an explanation to why autoimmunity develops after SCI and identify novel targets involved in SCI pathology that warrant further investigation.

Modulation of thermal somatosensory thresholds within local and remote spinal dermatomes following cervical repetitive magnetic stimulation.

BACKGROUND: Repetitive magnetic stimulation (rMS) modulates thermal somatosensory function at both low (0.2-1.0Hz) and high (5.0-20.0Hz) frequencies within the conditioned dermatome. However the effects of 1Hz and 20Hz cervical (C6-C7) rMS on thermosensory thresholds and contact heat evoked potentials (CHEPs) tested within local and remote spinal dermatomes are not known. METHODS: Thirty healthy subjects participated in the study. Warm and cold detection threshold, heat and cold pain thresholds, and Cz/Fz CHEPs were evaluated within the C6, T10 and extrasegmental V3 control dermatome, before and after random assignment of subjects to sham, 1 or 20Hz C6-C7 rMS. RESULTS: Following both 1 and 20Hz cervical rMS, warm detection threshold increased within the local C6 dermatome. Furthermore 1Hz cervical rMS increased warm detection threshold within the remote T10 dermatome, but not within the V3-trigeminal control area. Cervical rMS failed to modulate cold detection threshold, heat and cold pain threshold or Cz/Fz CHEP amplitude from the dermatomal test sites. CONCLUSION: Both 1 and 20Hz cervical rMS modulated warm detection threshold within the locally conditioned C6 dermatome. The concomitant increase in warm detection threshold within the T10 dermatome following 1Hz rMS provides evidence for remote neuromodulation of thermosensory function via intraspinal control mechanisms.

Assessment of disability in spinal cord injury.

PURPOSE: Spinal cord injury (SCI) implies a drastic change in the quality of life of an individual, and this fact must be considered by the physiatrist. The aim of this study was to assess the degree of disability shown by patients with spinal cord injury at 5 years post-SCI. For this purpose we used the Craig Handicap Assessment and Reporting Technique (CHART) scale which included the evaluation of occupation, physical independence, mobility, social integration and economic self-sufficiency. METHOD: A questionnaire was mailed to 243 patients who were admitted over a one-year period to the Hospital Nacional de Parapléjicos in Toledo, Spain. From these, we received 90 answers. No significant differences were observed when they were compared to the 90 patients who answered the questionnaire. RESULTS: 30% of the patients had less than 333 points on the scale, meaning that they could be considered severely disabled, while a score higher than 438 points was seen in 46.7% of the patients: most of these individuals were younger than 18 and had less severe neurologic injuries. CONCLUSIONS: Despite the enormous impact of SCI, according to the scale used most patients have scores above the disability level.