Locomotor Training in the Pediatric Spinal Cord Injury Population: A Systematic Review of the Literature.

Background: The restoration of walking ability in the spinal cord injury (SCI) population is an increasingly important goal in physical therapy. Locomotor training (LT) is often implemented with the aim to restore ambulation. At this point, there are no guidelines for LT in the pediatric SCI population. Objectives: The aim of this review is to further narrow the effects of LT to the pediatric SCI population and develop recommendations for pediatric LT. Methods: A thorough search was performed using the following databases: Scopus, CINAHL, PubMed, and Ovid. Studies were selected based on the following inclusion criteria: pediatric SCI population, articles published within last 10 years, human subjects, and LT. Studies looking at other neurological disorders and subjects who were not previously ambulatory were excluded. Five students and one Faculty Research Advisor from the university's Doctor of Physical Therapy Program evaluated the inclusion criteria, conducted a risk of bias assessment using the Downs and Black checklist, and extracted the results. Results: Six studies were selected for this review. They showed gains in distance, gait speed, walking independence, and participation. There were variations in results when comparing gains in injury level based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Conclusions: Currently there is insufficient evidence to determine the best clinical practice guidelines for rehabilitation using LT within the pediatric SCI population.

Another look at paradoxical severity effects in head injury with the Personality Assessment Inventory.

Previous investigations of psychiatric symptomatology after head injury using the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) have consistently revealed greater Basic scale elevations in mild injuries versus more severe injuries. In this study, we tested this pattern of paradoxical severity effects using the Personality Assessment Inventory (PAI; Morey, 1991). We gathered PAI and MMPI-2 data from 34 patients with moderate-to-severe head injuries and from 52 patients with mild head injuries. MMPI-2 Basic scale profiles were consistent with the paradoxical severity effect; mild injury patients had significantly more elevated scores on four Basic scales (Scales 1, 2, 3, and 7). PAI Clinical scale profiles showed significantly more elevated scores among mild injury patients on 2 scales, Somatization and Depression, and more elevated scores among moderate-to-severe patients on 2 scales, Antisocial Features and Alcohol Problems. We consider unique contributions of the PAI for the psychological assessment of head injury.

Homer proteins regulate sensitivity to cocaine.

Drug addiction involves complex interactions between pharmacology and learning in genetically susceptible individuals. Members of the Homer gene family are regulated by acute and chronic cocaine administration. Here, we report that deletion of Homer1 or Homer2 in mice caused the same increase in sensitivity to cocaine-induced locomotion, conditioned reward, and augmented extracellular glutamate in nucleus accumbens as that elicited by withdrawal from repeated cocaine administration. Moreover, adeno-associated virus-mediated restoration of Homer2 in the accumbens of Homer2 KO mice reversed the cocaine-sensitized phenotype. Further analysis of Homer2 KO mice revealed extensive additional behavioral and neurochemical similarities to cocaine-sensitized animals, including accelerated acquisition of cocaine self-administration and altered regulation of glutamate by metabotropic glutamate receptors and cystine/glutamate exchange. These data show that Homer deletion mimics the behavioral and neurochemical phenotype produced by repeated cocaine administration and implicate Homer in regulating addiction to cocaine.