A national strategy is needed to help doctors and scientists improve recovery from spinal cord injury, according to a report released today by the Institute of Medicine (IOM).
Roughly 10,000 to 12,000 people in the United States suffer damage to their spinal cords each year as a result of falls, accidents, or violence. The injuries cause varying degrees of paralysis because they sever the armlike axons of spinal cord neurons, cutting off the lines of communication between the brain and the rest of the body. Physical therapy can help patients recover some mobility, but most of the damage is permanent.
In recent years, however, researchers have chipped away at
several long-held notions about the spinal cord's inability to heal
itself, says neurologist Richard Johnson of Johns Hopkins School of
Medicine in Baltimore, who chaired the panel that produced the IOM
report. Research with animals, for example, has shown that severed
spinal cord axons can in fact regenerate, with a little help. But
Johnson and the panel emphasize that regeneration will only be one
part of the multifaceted approach needed to treat spinal cord
injuries. Not only do axons need to regenerate, he says, they must
repair their damaged myelin insulation and reconnect with other
neurons. And not just any neurons--forming the wrong connections
can lead to neuropathic pain or other complications.Scientists have
been making good progress towards addressing all these challenges,
the report says, but a national strategy is needed to evaluate
combinations of drugs and other therapies that could maximize
recovery--and ensure that scientific progress translates to
treatments as quickly as possible.The panel urges the National
Institutes of Health (NIH) to designate three or four existing
research programs as Spinal Cord Injury Research Centers of
Excellence and to establish two to three new centers. These
extramural centers would form the core of a larger network linking
all researchers working on spinal cord repair.The report's major
recommendations are "right along the lines" of what many at NIH
think is needed to translate research into treatments, says Naomi
Kleitman, program director for spinal cord injury research at the
National Institute of Neurological Disorders and Stroke, who adds
that the suggestions fit well with the agency's "roadmap" for
biomedical research (ScienceNOW,
September 30, 2003).Related sites:
The IOM
report
Information
about spinal cord injury
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