P U B L I C AT I O N S
O F N OTE
Mark VW, Taub E, Uswatte
G, Bashir K, Cutter GR,
Bryson CC, Bishop-McKay S,
Bowman MH. “Constraintinduced movement therapy for
the lower extremities in multiple
sclerosis: case series with 4-year
follow-up.” Arch Phys Med
Rehabil. 2013 Apr;94(4):753-60.
Labbe DR, Vance DE, Wadley
V, Novack TA. “Predictors of
Driving Avoidance and Exposure
Following Traumatic Brain Injury.”
J Head Trauma Rehabil. 2013 Mar
7. Epub ahead of print.
Barker MD, Whyte J, Pretz CR,
Sherer M, Temkin N, Hammond
FM, Saad Z, Novack TA.
“Application and Clinical Utility
of the Glasgow Coma Scale
Over Time: A Study Employing
the NIDRR Traumatic Brain Injury
Model Systems Database.” J Head
Trauma Rehabil. 2013 Mar 26.
Epub ahead of print.
Day NL, Floyd CL, D’Alessandro
TL, Hubbard WJ, Chaudry IH.
“17ß-estradiol confers protection
following traumatic brain injury in
the rat and involves activation of g
protein-coupled estrogen receptor
1 (GPER).” J Neurotrauma. 2013
Sept 1;30(17):1531-41.
UAB Medicine News
UAB PM&R Joins Small Group of
Centers Committed to Transverse
Myelitis Research, Treatment
Funding from a foundation set up by a patient with a 46-year
history of transverse myelitis (TM) is propelling UAB into the
small group of centers in this rare inflammatory demyelinating
disease. TM affects myelin specifically in the spinal cord.
Researcher Tara DeSilva, PhD, recently joined the PM&R
faculty to conduct research on this and other neuroimmunological
diseases that affect nerve fiber insulation. Multiple sclerosis (MS)
is the prototype of this type of disease and is the most common
disease that affects myelin in the brain and spinal cord.
“Understanding how the mechanisms work that underlie the
immune system’s destruction of myelin is relevant to both of these
devastating diseases,” she says.
Her laboratory has demonstrated that the essential brain
neurotransmitter glutamate plays an important signaling role in the
myelin insulating process. DeSilva has shown that damage occurs
to the myelin sheath when proper glutamate concentrations in the
brain are disrupted.
A physical therapist helps Mike Jezdimir during a therapy session.
that can be targeted for intervention,” DeSilva says.
Jezdimir contracted TM in 1967 and has been followed by
physiatrist Amie McLain, MD, chair of PM&R, for several years.
Funding from the Mike L. Jezdimir Transverse Myelitis
Foundation has given her research group the opportunity to
study human samples from patients with MS and TM. The study
His foundation supports UAB research on nontraumatic spinal
cord injury.
DeSilva’s lab also is interested in brain repair mechanisms.
DeVivo Paper Is ‘Most Cited’ in Spinal Cord
A review of trends in spinal cord injury (SCI) rehabilitation
by Michael DeVivo, DrPH, has been named as 2012’s most
cited paper from the journal Spinal Cord [epub January
2012], the premier international peer-reviewed journal
devoted to SCI research. DeVivo, director emeritus of the
National SCI Statistical Center housed at UAB, based the
article on his invited 2011 presentation to the State of the
Science in SCI Rehabilitation: Informing a New Research
Agenda conference prior to the joint annual meeting of
the International Spinal Cord Society and the American
Spinal Injury Association. A professor in the Department of
Physical Medicine and Rehabilitation, he served as manager
of analytic services, co-director, and eventually as director of
the National SCI Statistical Center from its founding in 1983
until his retirement in 2005. He also was senior scientist,
UAB Injury Prevention Research Center, coordinator of the
Urological Rehabilitation and Research Center, and manager
of analytic services for the UAB SCI Care System and
Medical Rehabilitation Research and Training Center. He
earned his MPH, MBA, and DrPH degrees from UAB.
Spina Bifida Transition Clinic Grows
A clinic for former pediatric patients with spina bifida
who are transitioning to adult care is growing in size.
UAB Physical Medicine and Rehabilitation partners with
the departments of Urology and Neurosurgery and with
physicians at Children’s of Alabama for this specialized
clinic. UAB and Children’s added a faculty member soon
after inaugurating the clinic in 2012, and now a second
monthly clinic has been scheduled to care for the current 105
patients. Physiatrist Amie McLain, MD, says the transition
clinic helped make 2012 the first year that more patients
exited the pediatric spina bifida clinic than entered it. “A s a
spina bifida patient ages out of pediatric care, both patient
and family members are highly anxious about leaving their
childhood physicians,” says McLain. “We are able to provide
accurate evaluation and direction into future care that helps
ease this transition.”
Search On for Neuropathic Pain Etiology
Investigator Elizabeth Richardson, PhD, recently was
awarded an NIH early career award to help better understand
the complex biopsychosocial factors involved in the
development of chronic post-SCI neuropathic pain (NP). She
will explore the relationship of NP to emotional dysfunction
such as in the body’s stress response system as well as to
brain function. Using a combination of variables, her team
will try to determine how psychological functioning preinjury
and acutely following SCI affects the development of NP.
She also will seek to identify relationships between neural
markers of somatosensory cortical reorganization and SCIrelated NP outcomes just after and at up to 2 years of injury,
and to examine cortical structural and functional resting
state neural patterns that may correlate with SCI-related
pain outcomes. “Identification of predictors will advance
understanding of causal mechanisms and hopefully lead to
new treatments and, potentially, prevention of neuropathic
pain in this population,” she says.
N OTEWORTHY
P RESE N TAT I O N S
Amie B. McLain, MD, “Overcoming
Physical Limitations to Obtaining Care.”
Moving Beyond Pediatric Incontinence:
The Challenges of Transitional Care
Conference, University of Toronto,
Toronto, June 8, 2013.
Michael J. DeVivo, DrPh, “Suicide in
an aging spinal cord injury population.”
Annual Meeting of the International
Spinal Cord Society, Istanbul, October
28-30, 2013.
Yuying Chen, MD, PhD, “Endocrine,
nutritional and metabolic diseases
after spinal cord injury: mortality risk
and trends.” Annual Meeting of the
International Spinal Cord Society,
Istanbul, October 28-30, 2013.
Candace L. Floyd, PhD, “Mn
porphryins in spinal cord injury and
will attempt to elucidate biomarkers for early detection and
“Glial progenitor cells that can produce myelin show up in areas
intervention. TM has an acute onset, so therapeutic interventions
where myelin has been destroyed,” she says. “We are showing that
are required immediately. The disease is often misdiagnosed as MS,
certain signaling pathways in glial progenitor cells are necessary
complicating patient management. “Understanding the molecular
to restart the myelination process, providing a possible target for
differences in these diseases will be critical for early detection and
therapy for brain repair.” She is also on the faculty of the UAB
Phthalocyanines, Istanbul,
treatment as well as to provide new insights in disease processes
Center for Glial Biology in Medicine.
June 22-27, 2014.
continued from cover
spinal cord related pain — lessons
from preclinical models.” International
Conference on Porphyrins and
Amie B. McLain, MD, “The Use of
tech VR goggles and sophisticated software, which
study position their wheelchair in front of the monitor
proved costly and not easy for pilot study participants
to align with the video.
The 3D video of an actor
walking makes patients
feel as though they are
walking, too.
Neurologic Examination to Predict
Awareness and Control of Lower
Urinary Tract Function post SCI.”
have found a partial reversal of the functional brain
to use. “We asked for ideas from a patient panel of
changes associated with the pain, providing a possible
volunteers, and wound up with a low-cost, portable
bore and the method of mapping the somatosensory
Injury Association, Chicago, May 6-8,
physiological basis for why the pain is occurring,”
system based on a 3D monitor, 3D glasses, and a
cortex, only persons with paraplegia are being
2013.
Richardson says.
Blu-ray player that most people can easily operate at
recruited for the 2-week home-based trial. Persons
home.”
with high-level injuries (tetraplegia) are eligible to
She says the virtual reality aspect of the trial
emerged from a study in Australia in which four of five
The system makes use of a video that shows a
subjects showed good pain relief and, as subjects spent
walking actor in the first-person view from the upper
more time with the system, of extended duration.
chest to the ground. “Seeing it,” she says, “you
That trial employed mirrors to help with the
illusionary effect. Richardson’s team started with high-
2
F o r R e f e rra l s : 8 0 0 . 8 2 2 . 6 4 7 8
Because of the limiting physical nature of an MRI
Annual Meeting of the American Spinal
participate in a 1-day trial, which involves viewing one
session of the 3D stimulus in the laboratory setting.
The 2-week trial includes daily pain diaries and
imagine you’re looking down at your own legs and
surveys by study staff, who will follow subjects for 6
walking.” The participants in the treatment arm of the
months with extensive telephone surveys.
M o r e I n f o rma t i o n : u a b m e d i c i n e . o r g / p h y s i c i a n
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