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Novel rehabilitation paradigm for restoration of hand functions after tetraplegia

Neural Regeneration Research 2016年第7期11卷 1058-1059页

作者： Ashraf S.Gorgey mina p.ghatas Spinal Cord Injury Service and Disorders Hunter Holmes McGuire VA Medical Center Richmond VA USA Department of physical Medicine and Rehabilitation Virginia Commonwealth University Richmond VA USA McConnell Brain Imaging Center Montreal Neurological Institute McGill University Montreal QC Canada

The letter by Bouton et al.（2016）“Restoring cortical control of functional movement in a human with quadriplegia”presents a case report of a 24 year old male with tetraplegia（C5–6）.The goal of the work was to bypass the spinal cord injury（SCI）lesion to stimulate the right forearm muscles to perform six movements and daily functional tasks.

关键词： restoration rehabilitation paradigm bypass muscles letter cortical capture challenging stimulate

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Skeletal muscle stiffness as measured by magnetic resonance elastography after chronic spinal cord injury:a cross-sectional pilot study

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Neural Regeneration Research 2021年第12期16卷 2486-2493页

作者： mina p.ghatas M.Rehan Khan Ashraf S.Gorgey Department of Spinal Cord Injury and Disorders Hunter Holmes McGuire VA Medical CenterRichmondVAUSA Department of Radiology Hunter Holmes McGuire VA Medical CenterRichmondVAUSA Department of physical Medicine and Rehabilitation Virginia Commonwealth UniversityRichmondVAUSA

Skeletal muscle stiffness is altered after spinal cord injury(SCI).Assessing muscle stiffness is essential for rehabilitation and pharmaceutical interventions design after *** study used magnetic resonance elastography to assess the changes in stiffness after chronic SCI compared to matched able-bodied controls and determine its association with muscle size,spasticity,and peak torque in persons with *** studies examined the association between muscle stiffness and spasticity,however,we are unaware of other studies that examined the effects of muscle composition on stiffness after *** participants(one female)with chronic SCI and eight(one female)matched able-bodied controls participated in this cross-sectional *** resonance elastography was utilized to monitor stiffness derived from shear waves *** Ashworth scale was used to evaluate spasticity scores in a blinded *** isometric and isokinetic torques were measured using a biodex *** values were non-significantly lower(12.5%;p=0.3)in the SCI group compared to able-bodied ***,stiffness was positively related to vastus lateralis whole muscle cross-sectional area(CSA)(r2=0.64,pppositively correlated to both isometric(r2=0.55-0.57,ppeak(r2=0.46-0.48,ppreliminary findings that muscle stiffness is altered after SCI compared to healthy *** appeared to be influenced by infiltration of intramuscular fat and modestly by the spasticity of the paralyzed *** preliminary data indicated that the relationship between muscle stiffness and peak torque is not altered with changing the frequency of pulses or angular *** study procedures were approved by the Institutional Review Board at the

关键词： chronic spinal cord injury isometric and isokinetic torques magnetic resonance elastography muscle size rehabilitation shear modulus spasticity stiffness

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Semi-automated segmentation of magnetic resonance images for thigh skeletal muscle and fat using threshold technique after spinal cord injury

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Neural Regeneration Research 2018年第10期13卷 1787-1795页

作者： mina p.ghatas Robert M.Lester M.Rehan Khan Ashraf S.Gorgey Department of Spinal Cord Injury and Disorders Hunter Holmes McGuire VA Medical Center Department of Radiology Hunter Holmes McGuire VA Medical Center Department of physical Medicine and Rehabilitation Virginia Commonwealth University

Magnetic resonance imaging is considered the ＂gold standard＂ technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in persons with spinal cord injury. Thigh magnetic resonance images from 18 men（18–50 years old） with traumatic motor-complete spinal cord injury were analyzed in a blinded fashion using the threshold technique. The cross-sectional area values acquired by thresholding were compared to the manual tracing technique. The percentage errors for thigh circumference were（threshold： 170.71 ± 38.67; manual： 169.45 ± 38.27 cm2） 0.74%, subcutaneous adipose tissue（threshold： 65.99±30.79; manual： 62.68 ± 30.22） 5.2%, whole muscle（threshold： 98.18 ± 20.19; manual： 98.20 ± 20.08 cm2） 0.13%, femoral bone（threshold： 6.53 ± 1.09; manual： 6.53 ± 1.09 cm2） 0.64%, bone marrow fat（threshold： 3.12 ± 1.12; manual： 3.1 ± 1.11 cm2） 0.36%, knee extensor（threshold： 43.98 ± 7.66; manual： 44.61 ± 7.81 cm2） 1.78% and % intramuscular fat（threshold： 10.45 ± 4.29; manual： 10.92 ± 8.35%） 0.47%. Collectively, these results suggest that the threshold technique provided a robust accuracy in measuring the seven main thigh compartments, while greatly reducing the analysis time.

关键词： spinal cord injury magnetic resonance imaging semi-automated segmentation subcutaneous adipose tissue intramuscular fat

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Dietary manipulation and testosterone replacement therapy may explain changes in body composition after spinal cord injury: A retrospective case report

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World Journal of Clinical Cases 2019年第17期7卷 2427-2437页

作者： Ashraf S Gorgey Robert M Lester mina p.ghatas Sakita N Sistrun Timothy Lavis Spinal Cord Injury and Disorders Service Hunter Holmes McGuire VAMCRichmondVA 23249United States Department of physical Medicine and Rehabilitation Virginia Commonwealth UniversityRichmondVA 23249United States Bionutrition Service Center for Clinical and Translational ResearchVirginia Commonwealth UniversityRichmondVA 23249United States

BACKGROUND Reduced level of physical activity,high-fat diet and skeletal muscle atrophy are key factors that are likely to contribute to deleterious changes in body composition and metabolic following spinal cord injury (SCI).Reduced caloric intake with lowering percentage macronutrients of fat and increasing protein intake may likely to improve body composition parameters and decrease ectopic adiposity after *** To highlight the effects of dietary manipulation and testosterone replacement therapy (TRT) on body composition after SCI METHODS A 31-year-old male with T5 SCI was administered transdermal TRT daily for 16 *** intake and percentage macronutrients were analyzed using dietary *** resonance imaging and dual-energy x-ray absorptiometry were used to measure changes in body *** Caloric intake and fat percentage were reduced by 445 kcal/d and 6.5%,*** body weight decreased by 8%,body fat decreased by 29%,and lean mass increased by 7%.Thigh subcutaneous adipose tissue cross-sectional area was reduced by 31%.CONCLUSION Manipulation of caloric intake,fat percentage,and protein percentage may have influenced body composition after SCI.

关键词： Spinal cord injury Diet High-protein Low-fat Nutrients Basal metabolic rate Case report

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Long-term effect of intrathecal baclofen treatment on bone health and body composition after spinal cord injury:A case matched report

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World Journal of Orthopedics 2020年第10期11卷 453-464页

作者： Dora E Ifon mina p.ghatas John C Davis Refka E Khalil Robert A Adler Ashraf S Gorgey Spinal Cord Injury and Disorders Center Central Virginia VA Health Care SystemRichmondVA 23249United States Medical Service Central Virginia VA Health Care SystemRichmondVA 23249United States Department of Internal Medicine Division of EndocrinologyDiabetes and MetabolismVirginia Commonwealth UniversityRichmondVA 23298United States Department of physical Medicine and Rehabilitation Virginia Commonwealth UniversityRichmondVA 23298United States

BACKGROUND Severe spasticity may negatively impact functionality and quality of life after spinal cord injury(SCI).Intrathecal baclofen treatment(IBT)is effectively used to manage severe spasticity and reduce ***,long-term IBT may have a negative effect on bone mineral content(BMC),bone mineral density(BMD)and body composition(such as percentage fat mass and lean body mass).We demonstrated the negative effects of long-term IBT use in a single case compared with two non-IBT *** SUMMARY A 46-year old Caucasian male Veteran(case)with a 21 year history of complete tetraplegia(complete C6 SCI)was implanted with IBT for 20 *** case was matched to two participants with different time since injuries[2(match 1)and 13(match 2)years]without *** BMC and BMD at the epiphysis and metaphysis of the distal femur and proximal tibia were evaluated using dual knee and the dual femur modules of GE Lunar iDXA *** and leg body composition assessments were also conducted for the three *** effect of long-term IBT was demonstrated by changes in BMD,consistent with bone demineralization,at the distal femur and proximal tibia and changes in percentage fat mass and lean mass of *** case showed 113%lower BMD at the distal femur,and 78.1%lower at the proximal tibia compared to match 1,moreover the case showed 45%lower BMD at the distal femur,and no observed changes at the proximal tibia compared to match *** case had 27.1%and 16.5%greater leg%fat mass compared to match 1 and match 2,***,the case had 17.4%and 11.8%lower%leg lean mass compared to match 1 and match 2,*** Long-term IBT may impact bone health and body composition parameters in persons with complete *** may be prudent to encourage regular screening of individuals on long-term IBT considering the prevalence of osteoporosis related fractures,cardiovascular diseases,and metabolic disorders in this population.

关键词： Intrathecal baclofen Spasticity Bone mineral density Epiphysis Metaphysis Spinal cord injury Case report

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