In a groundbreaking study, researchers from The Ohio State University Wexner Medical Center and College of Medicine have unveiled critical insights into the acute and systemic muscle wasting that occurs following a spinal cord injury (SCI). Published in the journal Science Translational Medicine, their findings not only deepen our understanding of this debilitating consequence of SCI but also open new avenues for clinical interventions.Â
Patients with acute spinal cord injuries often experience significant loss of body weight and muscle mass. This phenomenon persists despite the high-calorie diets provided in intensive care units. The research team, led by Jan Schwab, MD, PhD, and Markus Harrigan, has decoded the early stages of muscle loss post-SCI, revealing its rapid and severe nature.
Unlike previous assumptions, this muscle wasting is not solely a result of inactivity or denervation (loss of nerve supply). Instead, it is a systemic issue, deeply influenced by hormonal changes in the body.Â
The severity of muscle wasting is intricately linked to the location of the spinal cord injury. Particularly, it depends on whether the adrenal gland becomes denervated after a high thoracic injury (above T5) or remains intact (after a low thoracic injury). The study highlights that when the adrenal glands lose central nervous system control, there’s a skewed hormonal balance, leading to hypercortisolism (excess cortisol release) post-injury. This hormonal imbalance then triggers muscle loss throughout the body.Â
Understanding this mechanism is crucial for improving patient outcomes. “Patients with a low body mass index (BMI) have a much higher risk of dying shortly after suffering a spinal cord injury,” explains Dr. Schwab. By interfering with the glucocorticoid pathway, it might be possible to preserve muscle tissue and enhance rehabilitation responses.Â
Moreover, this research sheds light on maintaining muscle integrity to reduce the risk of pressure ulcers, a common and severe complication in SCI patients. The team’s future research aims to block these complications and protect the adrenal gland from receiving incorrect autonomic nervous system signals from below the lesion site.Â
This study is a collaborative effort involving researchers from Berlin, Germany, Nationwide Children’s Hospital in Columbus, Ohio, and the University of Missouri. It builds on previous research by Ohio State into the effects of SCI on the immune system, furthering our understanding of how spinal cord injuries can lead to widespread bodily effects.Â
In conclusion, this study marks a significant step in understanding and potentially mitigating the devastating effects of acute spinal cord injuries. It not only provides a new perspective on the systemic nature of muscle wasting post-SCI but also opens up possibilities for targeted treatments that could significantly improve the quality of life for patients suffering from these injuries.Â
Journal Reference Â
Harrigan, M. E., Filous, A. R., Vadala, C. P., Webb, A., Pietrzak, M., Sahenk, Z., … Schwab, J. M. (2023). Science Translational Medicine, 15(727). doi:10.1126/scitranslmed.adh2156Â
