Blood Biomarkers to Predict Outcome after Spinal Cord Injury: A Precision-Medicine Approach
Funded in: 2018, 2019, 2020
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Problem: Accurately predicting the extent of recovery after spinal cord injury has proven immensely challenging
Target: To evaluate the role of blood biomarkers in predicting long-term neurological function following spinal cord injury
Goal: Improved prediction of long-term functional outcome after SCI
Accurately predicting the extent of recovery after spinal cord injury has proven immensely challenging. So far, the only strong indication for how much a person is likely to recover is sensory and motor sparing, measured according to a conventional neurological exam. These conventional neurological exams are subjective and rely on active engagement of the patient (i.e., verbally and physically). One third of acute spinal cord injury patients admitted to the emergency department, however, are intoxicated, sedated, and/or severely injured making an early assessment impossible. This is particularly problematic for clinical trials testing acute therapies where it is desirable to only enroll patients who are relatively homogeneous in terms of their early neurological status, as well as their prognosis for achieving a defined clinical endpoint.
Hence, the overarching objective of the proposed study is to evaluate the role of blood biomarkers in predicting long-term neurological function following spinal cord injury. In a first step, we will apply machine-based learning statistical techniques to existing clinical trial data. In order to address limitations of using existing clinical data, our next step will involve the collection of a contemporary validation cohort by prospectively collecting blood data. Our work will complement the current existing standards to better predict long term outcome following acute spinal cord injury. In the long-term, the information gained from our investigation will also play a pivotal role in designing prospective clinical trials testing the efficacy of interventions in patients with acute spinal cord injury.