Philippa M. Warren, Case Western Reserve University and MetroHealth Medical Centre, Cleveland, USA

Promoting respiratory motor function after acute and chronic cervical contusion

Funded in: 2014, 2015, 2016

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Problem: Patients with cervical SCI suffer severe problems with breathing due to the interrupted respiratory neural circuits and scar formation.

Target: Monitoring changes associated with breathing after contusion and removing the scar tissue (ChABC).

Goal: Understanding how high cervical contusion injuries affect breathing and finding a treatment.

The most common spinal cord injuries are at the cervical level and are contusions. A contusion describes a severe impact to the cord from a blunt object. The consequences of such injuries are devastating to many systems and functions within the patient. Two significant and outcomes of this type of injury are:
•    The patient suffers severe problems with breathing, usually requiring mechanical ventilation to remain alive.
•    A scar forms at the site of injury to limit the spread of damage and preserve any remaining function. However, after time this scar tissue acts as a barrier to functional recovery.
However, to date very few studies have been published on the assessment of respiration following contusion injury, and none at the chronic stages. This is despite such injuries and being very common.

Dr. Warren aims to fill these major gaps in our understanding and treatment of cervical spinal cord contusion injuries by two means:
•    Assessing how the contusion impacts breathing over time (from acute to chronic injuries). Nerve function, muscle activity, respiration patterns, and changes in neuroanatomy will be monitored to see exactly how contusion injury affects breathing and how this changes.
•    To encourage repair of damaged pathways, plasticity, and functional recovery of respiration by treating spinal cord contusion injuries at both acute and chronic time points by removing the scar tissue that has formed.

The ultimate goal of this study is to understand how these severe and commonplace high cervical contusion injuries effect breathing and then treat this debilitating problem. This would have a major impact on scientific understanding and potentially effect how and when treatments are applied to patients. Additionally, it has the potential of facilitating the clinical translation of a treatment strategy for spinal cord injury.