国家慢性脊髓和创伤性脑损伤（NCTT）的测试中心
Developed by Dong Kim with Georgene Hergenroeder, R.N., M.H.A, and Pramod Dash, Ph.D.,国家慢性脊髓和创伤性脑损伤（NCTT）的测试中心is a multicenter research network that aims to develop treatments to improve the neurological and motor functions of persons living with spinal cord injuries (SCI) and traumatic brain injuries (TBI) and to reduce the premature mortality rates associated with these conditions. As a national network, the NCTT will collaborate with established patient support and advocacy groups as well as other medical institutions.
该中心开发治疗方法的方法涉及多个并发计划。NCTT获得了详细的病史，进行检查和功能测试，并审查了合格患者的可用成像研究。还对潜在受试者的血液样本进行了库存和分析，以便可以评估患者对损伤的反应以及治疗如何与他们的遗传背景有关。每个患者都按照损伤的类型和严重程度（例如抑郁症，神经性疼痛，反复感染，皮肤崩溃）和当前神经系统功能水平对每个患者进行了彻底的分类。结合起来，上述步骤使NCTT能够对受试者的研究兴趣和伤害特征进行分类，以便为它们提供适当，理想的研究机会。beplay苹果手机能用吗
Among the upcoming NCTT research programs is a project that aims to investigate the positive impact of Transcranial Magnetic Stimulation on persons with TBI and SCI. After suffering trauma to the brain or spinal cord, these patients may have impaired motor and/or sensory function, ranging from weakness and weakened coordination and balance to paralysis. Neuromotor abnormalities have been found in more than 30% of severe TBI subjects two years post injury; moreover, 59% of persons with SCI are tetraplegic and 41%, paraplegic. Compounding the motor dysfunction are issues of chronic pain, which is present in over 50% of both TBI and SCI cases. Currently, treatment options for impaired motor function and pain are limited and those that do exist offer variable, suboptimal effectiveness.
有证据表明，重复的经颅磁刺激（RTMS）可能是改善运动功能并减轻中央神经性疼痛的有前途的治疗方法。RTMS是一种无创神经刺激技术，其中位于大脑附近的线圈会产生一个横穿头骨并诱导脑电流的电磁场。RTMS的耐受性良好且相对安全，并且已在包括神经精神病，神经运动和神经性疼痛在内的多种疾病中进行了测试。利用RTM与职业疗法结合使用的慢性中风的研究表明，上肢运动的改善和痉挛减少。但是，在患有急性后SCI或TBI的受试者中仅进行了少量研究。此外，从未评估过RTM的多个时间疗程对运动功能和慢性疼痛的影响。通过RTMS的利用，本研究将评估RTMS对SCI或TBI患者的运动功能和中央神经性疼痛的影响。我们假设RTMS将在手部功能方面产生改善，并在SCI和TBI受试者中促进镇痛作用，而手部功能丧失和/或神经性疼痛在损伤水平以下。
While these aforementioned research and therapeutic endeavors augment those on-going at other acute intervention networks, NCTT is vastly more cost-effective because enough patients can be enrolled in a few centers and on-call teams are unnecessary. Patients can enroll in more than one trial, separated by time. Thus, NCTT can systematically and simultaneously test viable treatments such as Transcranial Magnetic Stimulation or the use of stem cells.
Alongside these NCTT initiatives are other on-going projects such as “HOPES,” a multicenter, randomized clinical trial investigating the effect of HypOthermia for Patients requiring Evacuation of Subdural Hematoma. Traumatic brain injury (TBI) resulting in subdural hematoma (severe bleeding in the brain) occurs in over 40,000 Americans annually with up to 70% of these injuries resulting in death or severe disability. Hypothermia (extreme cooling) has been proposed as a novel therapy to reduce the effects of this injury. HOPES is a prospective, controlled, multi-center trial that aims to test whether treating TBI patients with hypothermia prior to surgical evacuation of a subdural hematoma improves their long-term prognosis. This trial seeks to confirm that early induction and maintenance of therapeutic hypothermia in patients with TBI undergoing hematoma evacuation will see improved global neurologic outcomes as measured by Glasgow Outcome Scale (GOSE) at six months.
If you are interested in participating in the NCTT or have any questions about the enrollment process, please call us at(713) 486-7771or email,nctt.wec@uth.tmc.edu.