We thank the Emory University Division of Animal Resources staff for veterinary care. Funding sources include: ALS Association, Department of Defense, and Neuralstem, Inc.

1. Animal Use
Procedures demonstrated herein have been approved by the Emory University Institutional Animal Care and Use Committee (IACUC). Female Gottingen minipigs weighing approximately 15-20 kg are used.
2. Anesthesia
Animals are fasted approximately 12 hr prior to surgery. Animal sedation and anesthesia induction consist of a cocktail of intramuscular Ketamine (35 mg/kg), Acepromazine (1.1 mg/kg), and Atropine (0.04 mg/kg). Animals are then intubated and maintained on oxygen and 1-3% isoflurane general anesthesia. At this point, the back and head of each animal is shaved. Depth of anesthesia is monitored by the veterinary staff. Absence of interdigital, corneal and palpebral reflexes, as well as heart and respiratory rate, pulse oximetry, direct/indirect blood pressure, end-tidal carbon-dioxide measurements, and muscle tone/response to noxious stimuli are used to monitor depth of anesthesia.
3. Positioning
Animals are taken to the operating room and placed into a prone position on a frame custom designed to mimic patients positioning on a Jackson spinal surgical table. The frame utilizes adjustable slings that are placed under the chest and pelvis of the animal, allowing the abdomen to hang free and, therefore, minimizing pressure on the abdomen and chest and consequent epidural venous bleeding (Figure 1). The frame also provides external immobilization of the spine for the procedure 1.
Additionally, animals are placed on a heated re-circulating pad to maintain body temperature and a marginal ear vein catheterized for fluid administration and any necessary drug delivery during surgery. Finally, the surgical field is prepped with alcohol and Chlorhexadine or Betadine solution and surgical drapes are placed on the surgical field.
4. Laminectomy
An approximately 10-15 cm skin incision is performed and the paraspinal musculature is dissected off the spine bilaterally. Next, a dorsal multi-level laminectomy is performed. The lamina and spinous processes of three vertebrae overlying C3-C5 or L2-L4 segments are removed using rongeurs and a surgical drill.
5. Placement of the Spinal Derrick
We call Spinal Derrick the device designed for the delivery of (gene and cell) therapies into the spinal cord 2-5. Detailed discussion on the design and evolution of this device can be found on Riley et al., 2011. 4
To secure the device to the patient, percutaneous posts are placed through 1cm skin incisions above and below the primary incision and mounted to the lamina above and below the primary incision.
Next, two integrated retractors are attached to the four percutaneous posts above and below the incision site to expose the area of the spine that has undergone laminectomy.
6. Dural Opening
With the aid of a Woodson dental tool and an 11 blade, a 2.5 cm incision is made through the dura, exposing the spinal cord. The dura is reflected away from the pial layer using 4-0 Nurolon suture and secured to the deep paraspinal musculature.
Surgical patties are placed in the rostral and caudal extremes of the opening. These provide a partial barrier to cerebrospinal fluid flow and also provide a safe target for the surgeons to place suckers without damaging the cord. In humans, under surgical microscope magnification, the pial surface is dissected at this point. Due to technical limitations, this procedure is not required or feasible in animals.
7. Spinal Cord Injections and Lateral Displacement of the Spinal Derrick for Additional Injections
Immediately prior to injections, a bolus of Methylprednisolone (125 mg, IV) is given to prevent spinal cord swelling.
At this point, the platform rail system is attached and the side rails are adjusted to fit the appropriate length. The gondola is top-loaded onto the 2 bars and the Z drive is mounted on the universal joint. Next, the loaded cannula is placed onto the microdrive. Using the universal joint on the microinjection platform, the coronal and sagittal angles are adjusted to ensure a trajectory orthogonal to the surface of the spinal Injections follow the placement of the cannula. The needle is positioned accordingly medial to the dorsal root entry zone (DREZ). The DREZ is identified under 3.5X surgical loupe magnification and penetrated on an orthogonal trajectory to the cord surface at a point &lt;1 mm medially.
In humans, a pre-operative MRI provides a baseline assessment of spinal cord dimensions for operative planning. Moreover, the thickness of the spinal cord is measured to determine the target depth of the ventral horn.
The suspension is infused at a depth of 4 mm from pial contact. A flange made of ultem plastic serves as a stopper on the pia surface to prevent the needle from advancing deeper than desired. Once the needle tip is positioned at the target, the rigid metal outer sleeve is pulled up, leaving the flexible tubing exposed. Once the injection is completed, the needle is left in place for an additional 1 min to prevent cell reflux up the cannula injection tract.
Care is taken to avoid surface vasculature by slightly adjusting the microdrive either laterality or rostro-caudally. Some bleeding from penetration sites may occur. When such bleeding is encountered, micro patties are placed over the bleeding puncture site and suction is applied to them to wick blood out of the cannula penetration site and prevent buildup in the cord. This reliably allows for the blood to coagulate. Cautery is avoided as is direct pressure.
Following needle removal, the stereotaxic apparatus is relocated to the next target site along the rostro-caudal axis, separated by 2 or 4 mm or as necessary to avoid visible blood vessels on the dorsal surface of spinal cord. This process is repeated as many times as proposed in a given study.
8. Floating Cannula
A custom infusion cannula of narrow diameter is used for the injections. The cannula consists of a 30-gauge beveled needle of fixed length connected to a 30-gauge flexible silastic tubing of variable length. The distal end is fitted with a Hamilton luer lock that is attached to a microinjector pump. The proximal silastic tubing is ensheathed within a 24-gauge rigid outer cannula that seats on the proximal end of the injection needle flange. This flange both seats the outer cannula and serves as a depth stop for the injection needle. For each injection, the appropriate volume of a therapeutic suspension is infused by a using a pre-calibrated MINJ-PD microINJECTOR pump (Tritech Research, Inc., Los Angeles, CA) at a rate of 5 &mu;l per minute.
9. Closure
Once all injections have been made, the spinal derrick is gently removed and the incisions are closed in four layers. The dura is closed using a 4.0 Nurolon stitch, in a watertight fashion. 0 Vicryl suture is used for the deep muscular layer. Fascia is then closed with 0 Vicryl suture also in a watertight fashion. The dermal layer is finally closed with 2.0 Vicryl, with a running stitch. Skin closure is completed using a 3-0 Nylon suture.
10. Recovery and Pain Management
Animals are extubated and monitored for 2 hr following anesthesia recovery. Next, animals are transferred to individual cages and monitored at least once daily for food consumption, defecation, and micturition.
For pain management, a transdermal Fentanyl patch (75 mcg) is stapled on the back of the animals for three days of post-operative analgesia. Additionally, Buprenorphine (0.05 mg/kg, BID, IM) can also be given for up to three days post-operatively.
11. Results and Representative Outcomes
Clinical and behavior observations are performed before surgery and then recorded on Days 1 through 7 and weekly until endpoint according to the study design. Behavioral data is collected to assess neurological morbidity as previously described 6. Sensory function is assessed by presence or absence of a withdrawal response to mechanical stimulus to the toes of front and hind limbs. Motor function follows the Tarlov score (Table 1): 0 - Paralysis, no movement; 1- Perceptible tonus in the hind limbs, slight movement; 2 - Movement in the hind limbs, but unable to sit or stand; 3 - Ability to stand and walk but ataxic and for short periods; 4 - Complete recovery, normal motor function.
Safety of the procedure is determined by the ability of an animal to return to pre-operative baseline. Transient neurological deficits should mostly resolve between post-operative days 1 and 7, with some variations depending on animals' breeds and procedure (number of injections, among other parameters). Permanent morbidity is defined by lasting neurological deficits which do not resolve by the time animals reach IACUC default endpoint (Figure 2).

<ol>
	<li>Usvald, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+dosing+regimen+and+reproducibility+of+intraspinal+grafting+of+human+spinal+stem+cells+in+immunosuppressed+minipigs.">Analysis of dosing regimen and reproducibility of intraspinal grafting of human spinal stem cells in immunosuppressed minipigs.</a> Cell Transplant. 19, 1103-1122 (2010).</li><li>Riley, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeted+spinal+cord+therapeutics+delivery:+stabilized+platform+and+microelectrode+recording+guidance+validation.">Targeted spinal cord therapeutics delivery: stabilized platform and microelectrode recording guidance validation.</a> Stereotact. Funct. Neurosurg. 86, 67-74 (2008).</li><li>Federici, T., Riley, J., Park, J., Bain, M., Boulis, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preclinical+safety+validation+of+a+stabilized+viral+vector+direct+injection+approach+to+the+cervical+spinal+cord.">Preclinical safety validation of a stabilized viral vector direct injection approach to the cervical spinal cord.</a> Clin. Transl. Sci. 2, 165-167 (2009).</li><li>Riley, J. P., Raore, B., Taub, J. S., Federici, T., Boulis, N. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Platform+and+Cannula+Design+Improvements+for+Spinal+Cord+Therapeutics+Delivery.">Platform and Cannula Design Improvements for Spinal Cord Therapeutics Delivery.</a> Neurosurgery. 69, 147-154 (2011).</li><li>Riley, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cervical+spinal+cord+therapeutics+delivery:+preclinical+safety+validation+of+a+stabilized+microinjection+platform.">Cervical spinal cord therapeutics delivery: preclinical safety validation of a stabilized microinjection platform.</a> Neurosurgery. 65, 754-761 (2009).</li><li>Raore, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cervical+multilevel+intraspinal+stem+cell+therapy:+assessment+of+surgical+risks+in+Gottingen+minipigs.">Cervical multilevel intraspinal stem cell therapy: assessment of surgical risks in Gottingen minipigs.</a> Spine. 36, 164-171 (2011).</li><li>Boulis, N. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Translational+stem+cell+therapy+for+amyotrophic+lateral+sclerosis.">Translational stem cell therapy for amyotrophic lateral sclerosis.</a> Nat. Rev. Neurol. , (2011).</li><li>Riley, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraspinal+Stem+Cell+Transplantation+in+ALS:+A+Phase+I+Safety+Trial,+Technical+Note+&#38;+Interim+Safety+Outcomes.">Intraspinal Stem Cell Transplantation in ALS: A Phase I Safety Trial, Technical Note &#38; Interim Safety Outcomes.</a> Neurosurgery. 71 (2), 405-416 (2012).</li><li>Boulis, N. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lumbar+intraspinal+injection+of+neural+stem+cells+in+patients+with+ALS:+results+of+a+Phase+I+trial+in+12+patients.">Lumbar intraspinal injection of neural stem cells in patients with ALS: results of a Phase I trial in 12 patients.</a> Stem Cells. 30 (6), 1144-1151 (2012).</li></ol>

Dr. Boulis is the inventor of devices to enable safe and accurate injection of the human spinal cord. Neuralstem, Inc. has purchased an exclusive license to this technology. Dr. Boulis received an invento's share of this fee, and has the rights to royalty payments for distribution of this technology. Other authors have nothing to disclose.

Despite approval to proceed with the described technique in humans 7-9, critical questions remain to be answered in order for spinal cord therapies to succeed. A rigorous understanding of spinal cord tolerance to intraparenchymal injection is required to enable the planning and execution of trials developing therapies for demyelinating, degenerative, and traumatic spinal cord disease. Currently, there is no clear understanding of the number of injections that the large mammalian spinal cord can...

<table border="1">
 <tbody>
 <tr>
 <td>Name of the equipment</td>
 <td>Company</td>
 <td>Catalogue number</td>
 <td>Comments (optional)</td>
 </tr>
 <tr>
 <td>Spinal Derrick </td>
 <td>Neuralstem, Inc.</td>
 <td></td>
 <td>Neuralstem, Inc. has purchased an exclusive license to this technology </td>
 </tr>
 <tr>
 <td>MINJ-PD Microinjector pump</td>
 <td>Tritech Research, Inc. </td>
 <td></td>
 <td>Customized for this specific application </td>
 </tr>
 <tr>
 <td>Floating Cannula</td>
 <td>Neuralstem, Inc.</td>
 <td></td>
 <td>Custom-designed for this specific application</td>
 </tr>
 </tbody>
</table>

surgical technique for spinal cord delivery of therapies: demonstration of procedure in gottingen minipigs

This is a compact visual description of a combination of surgical technique and device for the delivery of (gene and cell) therapies into the spinal cord. While the technique is demonstrated in the animal, the procedure is FDA-approved and currently being used for stem cell transplantation into the spinal cords of patients with ALS. While the FDA has recognized proof-of-principle data on therapeutic efficacy in highly characterized rodent models, the use of large animals is considered critical for validating the combination of a surgical procedure, a device, and the safety of a final therapy for human use. The size, anatomy, and general vulnerability of the spine and spinal cord of the swine are recognized to better model the human. Moreover, the surgical process of exposing and manipulating the spinal cord as well as closing the wound in the pig is virtually indistinguishable from the human. We believe that the healthy pig model represents a critical first step in the study of procedural safety.

<table border="1">
	<tbody>
		<tr>
			<td colspan="2">Tarlov Score</td>
		</tr>
		<tr>
			<td>0</td>
			<td>Paralysis, no movement</td>
		</tr>
		<tr>
			<td>1</td>
			<td>Perceptible tonus in the hind limbs, slight movement</td>
		</tr>
		<tr>
			<td>2</td>
			<td>Movement in the hind limbs, but unable to sit or stand</td>
		</tr>
		<tr>
			<td>3</td>
			<td>Ability to stand and walk but ataxic and for short periods</td>
		</tr>
		<tr>
			<td>4</td>
			<td>Com...

Watch this Scientific Journal Video about Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs at JoVE.com

Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs

Short visual description of the surgical technique and device used for the delivery of (gene and cell) therapies into the spinal cord. The technique is demonstrated in the animal but is entirely translatable and currently being used for human application.

This is a  compact visual description of a combination of surgical technique and device  for the  delivery of (gene and cell) therapies into the spinal ...

surgical-technique-for-spinal-cord-delivery-therapies-demonstration

Research

JoVE Journal

Medicine

15.2K Views.  Emory University. Short visual description of the surgical technique and device used for the delivery of (gene and cell) therapies into the spinal cord. The technique is demonstrated in the animal but is entirely translatable and currently being used for human application.

Video: Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs

Acute and Chronic Tactile Sensory Testing after Spinal Cord Injury in Rats

Spinal cord injury (SCI) impairs sensory systems causing allodynia1-8. To identify cellular and molecular causes of allodynia, sensitive and valid sensory testing in rat SCI models is needed. However, until recently, no single testing approach had been validated for SCI so that standardized methods have not been implemented across labs. Additionally, available testing methods could not be implemented acutely or when severe motor impairments existed, preventing studies of the development of SCI-induced allodynia3. Here we present two validated sensory testing methods using von Frey Hair (VFH) monofilaments which quantify changes in tactile sensory thresholds after SCI4-5. One test is the well-established Up-Down test which demonstrates high sensitivity and specificity across different SCI severities when tested chronically5. The other test is a newly-developed dorsal VFH test that can be applied acutely after SCI when allodynia develops, prior to motor recovery4-5. Each VFH monofilament applies a calibrated force when touched to the skin of the hind paw until it bends. In the up-down method, alternating VFHs of higher or lower forces are used on the plantar L5 dermatome to delineate flexor withdrawal thresholds. Successively higher forces are applied until withdrawal occurs then lower force VFHs are used until withdrawal ceases. The tactile threshold reflects the force required to elicit withdrawal in 50% of the stimuli. For the new test, each VFH is applied to the dorsal L5 dermatome of the paw while the rat is supported by the examiner. The VFH stimulation occurs in ascending order of force until at least 2 of 3 applications at a given force produces paw withdrawal. Tactile sensory threshold is the lowest force to elicit withdrawal 66% of the time. Acclimation, testing and scoring procedures are described. Aberrant trials that require a retest and typical trials are defined. Animal use was approved by Ohio State University Animal Care and Use Committee.

We describe two tactile sensory testing methods for acute or chronic periods of spinal cord injury in rats. These validated procedures can detect the development and maintenance of allodynia-like sensations.

Spinal cord injury (SCI) impairs sensory systems causing allodynia1-8. To identify cellular and molecular causes of allodynia, sensitive and valid sensory ...

A Contusion Model of Severe Spinal Cord Injury in Rats

The translational potential of novel treatments should be investigated in severe spinal cord injury (SCI) contusion models. A detailed methodology is described to obtain a consistent model of severe SCI. Use of a stereotactic frame and computer controlled impactor allows for creation of reproducible injury. Hypothermia and urinary tract infection pose significant challenges in the post-operative period. Careful monitoring of animals with daily weight recording and bladder expression allows for early detection of post-operative complications. The functional results of this contusion model are equivalent to transection models. The contusion model can be utilized to evaluate the efficacy of both neuroprotective and neuroregenerative approaches.

A contusion model of severe spinal cord injury is described. Detailed pre-operative, operative and post-operative steps are described to obtain a consistent model.

The translational potential of novel treatments should be investigated in severe spinal cord injury (SCI) contusion models. A detailed methodology is ...

Controlled Cortical Impact Model for Traumatic Brain Injury

Every year over a million Americans suffer a traumatic brain injury (TBI). Combined with the incidence of TBIs worldwide, the physical, emotional, social, and economical effects are staggering. Therefore, further research into the effects of TBI and effective treatments is necessary. The controlled cortical impact (CCI) model induces traumatic brain injuries ranging from mild to severe. This method uses a rigid impactor to deliver mechanical energy to an intact dura exposed following a craniectomy. Impact is made under precise parameters at a set velocity to achieve a pre-determined deformation depth. Although other TBI models, such as weight drop and fluid percussion, exist, CCI is more accurate, easier to control, and most importantly, produces traumatic brain injuries similar to those seen in humans. However, no TBI model is currently able to reproduce pathological changes identical to those seen in human patients. The CCI model allows investigation into the short-term and long-term effects of TBI, such as neuronal death, memory deficits, and cerebral edema, as well as potential therapeutic treatments for TBI.

Traumatic brain injuries (TBIs) remain a serious health problem. Using the controlled cortical impact surgery model, research on the effects of TBI and possible treatment methods may be performed.

Every year over a million Americans suffer a traumatic brain injury (TBI).  Combined with the incidence of TBIs worldwide, the physical, emotional, ...

A Radio-telemetric System to Monitor Cardiovascular Function in Rats with Spinal Cord Transection and Embryonic Neural Stem Cell Grafts

High thoracic or cervical spinal cord injury (SCI) can lead to cardiovascular dysfunction. To monitor cardiovascular parameters, we implanted a catheter connected to a radio transmitter into the femoral artery of rats that underwent a T4 spinal cord transection with or without grafting of embryonic brainstem-derived neural stem cells expressing green fluorescent protein. Compared to other methods such as cannula insertion or tail-cuff, telemetry is advantageous to continuously monitor blood pressure and heart rate in freely moving animals. It is also capable of long term multiple data acquisitions. In spinal cord injured rats, basal cardiovascular data under unrestrained condition and autonomic dysreflexia in response to colorectal distension were successfully recorded. In addition, cardiovascular parameters before and after SCI can be compared in the same rat if a transmitter is implanted before a spinal cord transection. One limitation of the described telemetry procedure is that implantation in the femoral artery may influence the blood supply to the ipsilateral hindlimb.

We present a protocol for using a radio-telemetric system to record cardiovascular parameters in T4 spinal cord transected rats eight weeks after embryonic brainstem neural stem cell grafting into the lesion site. Telemetry is an advanced technique to accurately evaluate cardiovascular function in conscious freely moving spinal cord injured rats.

High thoracic or cervical spinal cord injury (SCI) can lead to cardiovascular dysfunction. To monitor cardiovascular parameters, we implanted a catheter ...

Minimal Invasive Surgical Procedure of Inducing Myocardial Infarction in Mice

Myocardial infarction still remains the main cause of death in western countries, despite considerable progress in the stent development area in the last decades. For clarification of the underlying mechanisms and the development of new therapeutic strategies, the availability of valid animal models are mandatory. Since we need new insights into pathomechanisms of cardiovascular diseases under in vivo conditions to combat myocardial infarction, the validity of the animal model is a crucial aspect. However, protection of animals are highly relevant in this context. Therefore, we establish a minimally invasive and simple model of myocardial infarction in mice, which assures a high reproducibility and survival rate of animals. Thus, this models fulfils the requirements of the 3R principle (Replacement, Refinement and Reduction) for animal experiments and assure the scientific information needed for further developing of therapeutical strategies for cardiovascular diseases.

A highly reproducible model for myocardial infarction in mice with minimal invasive manipulations is described. The model can be easily performed, resulting in a high reproducibility and survival rate. Thus, the described model will reduce the number of required animals as requested by the 3R principle (Replacement, Refinement and Reduction).

Myocardial infarction still remains the main cause of death in western countries, despite considerable progress in the stent development area in the last ...

Calibrated Forceps Model of Spinal Cord Compression Injury

Compression injuries of the murine spinal cord are valuable animal models for the study of spinal cord injury (SCI) and spinal regenerative therapy. The calibrated forceps model of compression injury is a convenient, low cost, and very reproducible animal model for SCI. We used a pair of modified forceps in accordance with the method published by Plemel et al. (2008) to laterally compress the spinal cord to a distance of 0.35 mm. In this video, we will demonstrate a dorsal laminectomy to expose the spinal cord, followed by compression of the spinal cord with the modified forceps. In the video, we will also address issues related to the care of paraplegic laboratory animals. This injury model produces mice that exhibit impairment in sensation, as well as impaired hindlimb locomotor function. Furthermore, this method of injury produces consistent aberrations in the pathology of the SCI, as determined by immunohistochemical methods. After watching this video, viewers should be able to determine the necessary supplies and methods for producing SCI of various severities in the mouse for studies on SCI and/or treatments designed to mitigate impairment after injury.

Spinal cord injury models should be highly reproducible. We demonstrate that the calibrated forceps compression model of spinal cord injury is an easy to use surgical method for generating reproducible injuries to the murine spinal cord.

Compression injuries of the murine spinal cord are valuable animal models for the study of spinal cord injury (SCI) and spinal regenerative therapy. The ...

Contrast Enhanced Ultrasound Imaging for Assessment of Spinal Cord Blood Flow in Experimental Spinal Cord Injury

Reduced spinal cord blood flow (SCBF) (i.e., ischemia) plays a key role in traumatic spinal cord injury (SCI) pathophysiology and is accordingly an important target for neuroprotective therapies. Although several techniques have been described to assess SCBF, they all have significant limitations. To overcome the latter, we propose the use of real-time contrast enhanced ultrasound imaging (CEU). Here we describe the application of this technique in a rat contusion model of SCI. A jugular catheter is first implanted for the repeated injection of contrast agent, a sodium chloride solution of sulphur hexafluoride encapsulated microbubbles. The spine is then stabilized with a custom-made 3D-frame and the spinal cord dura mater is exposed by a laminectomy at ThIX-ThXII. The ultrasound probe is then positioned at the posterior aspect of the dura mater (coated with ultrasound gel). To assess baseline SCBF, a single intravenous injection (400 &#181;l) of contrast agent is applied to record its passage through the intact spinal cord microvasculature. A weight-drop device is subsequently used to generate a reproducible experimental contusion model of SCI. Contrast agent is re-injected 15 min following the injury to assess post-SCI SCBF changes. CEU allows for real time and in-vivo assessment of SCBF changes following SCI. In the uninjured animal, ultrasound imaging showed uneven blood flow along the intact spinal cord. Furthermore, 15 min post-SCI, there was critical ischemia at the level of the epicenter while SCBF remained preserved in the more remote intact areas. In the regions adjacent to the epicenter (both rostral and caudal), SCBF was significantly reduced. This corresponds to the previously described &#8220;ischemic penumbra zone&#8221;. This tool is of major interest for assessing the effects of therapies aimed at limiting ischemia and the resulting tissue necrosis subsequent to SCI.

Contrast Enhanced Ultrasound imaging is a reliable in-vivo tool for quantifying spinal cord blood flow in an experimental rat spinal cord injury model. This paper contains a comprehensive protocol for application of this technique in association with a contusion model of thoracic spinal cord injury.

Reduced spinal cord blood flow (SCBF) (i.e., ischemia) plays a key role in traumatic spinal cord injury (SCI) pathophysiology and is accordingly an ...

The Mouse Round-window Approach for Ototoxic Agent Delivery: A Rapid and Reliable Technique for Inducing Cochlear Cell Degeneration

Investigators have utilized a wide array of animal models and investigative techniques to study the mammalian auditory system. Much of the basic research involving the cochlea and its associated neural pathways entails exposure of model cochleae to a variety of ototoxic agents. This allows investigators to study the effects of targeted damage to cochlear structures, and in some cases, the self-repair or regeneration of those structures. Various techniques exist for delivery of ototoxic agents to the cochlea. When selecting a particular technique, investigators must consider a number of factors, including the induction of inadvertent systemic toxicity, the amount of cochlear damage produced by the surgical procedure itself, the type of lesion desired, animal survivability, and reproducibility/reliability of results. Currently established techniques include parenteral injection, intra-peritoneal injection, trans-tympanic injection, endolymphatic sac injection, and cochleostomy with perilymphatic perfusion. Each of these methods has been successfully utilized and is well described in the literature; yet, each has various shortcomings. Here, we present a technique for topical application of ototoxic agents directly to the round window niche. This technique is non-invasive to inner ear structures, produces rapid onset of reliably targeted lesions, avoids systemic toxicity, and allows for an intra-animal control (the contra-lateral ear). Results stemming from this approach have helped deeper understanding of auditory pathophysiology, cochlear cell degeneration, and regenerative capacity in response to an acute injury. Future investigations may use this method to conduct interventional studies involving gene therapy and stem cell transplantation to combat hearing loss.

Various methods exist for introducing ototoxic agents to the cochleae of animal models. Presented is a surgical protocol for delivery of ototoxic agents to the round window niche. The procedure is reliable, creates targeted intra-cochlear lesions, and avoids mechanical damage to the microarchitecture. Examination of cochlear self-repair/regeneration is possible.

Investigators have utilized a wide array of animal models and investigative techniques to study the mammalian auditory system. Much of the basic research ...

A Neonatal Mouse Spinal Cord Compression Injury Model

Spinal cord injury (SCI) typically causes devastating neurological deficits, particularly through damage to fibers descending from the brain to the spinal cord. A major current area of research is focused on the mechanisms of adaptive plasticity that underlie spontaneous or induced functional recovery following SCI. Spontaneous functional recovery is reported to be greater early in life, raising interesting questions about how adaptive plasticity changes as the spinal cord develops. To facilitate investigation of this dynamic, we have developed a SCI model in the neonatal mouse. The model has relevance for pediatric SCI, which is too little studied. Because neural plasticity in the adult involves some of the same mechanisms as neural plasticity in early life1, this model may potentially have some relevance also for adult SCI. Here we describe the entire procedure for generating a reproducible spinal cord compression (SCC) injury in the neonatal mouse as early as postnatal (P) day 1. SCC is achieved by performing a laminectomy at a given spinal level (here described at thoracic levels 9-11) and then using a modified Yasargil aneurysm mini-clip to rapidly compress and decompress the spinal cord. As previously described, the injured neonatal mice can be tested for behavioral deficits or sacrificed for ex vivo physiological analysis of synaptic connectivity using electrophysiological and high-throughput optical recording techniques1. Earlier and ongoing studies using behavioral and physiological assessment have demonstrated a dramatic, acute impairment of hindlimb motility followed by a complete functional recovery within 2 weeks, and the first evidence of changes in functional circuitry at the level of identified descending synaptic connections1.

This article describes a method for generating a reproducible spinal cord compression injury (SCI) in the neonatal mouse. The model provides an advantageous platform for studying mechanisms of adaptive plasticity that underlie spontaneous functional recovery.

Spinal cord injury (SCI) typically causes devastating neurological deficits, particularly through damage to fibers descending from the brain to the spinal ...

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via recanalization of the coronary artery is the most effective strategy for reducing the size of ischemic myocardium. The coronary microvasculature cannot be visualized and imaged&#160;in vivo, but there are several invasive and noninvasive techniques that can be used to assess parameters which depend directly on coronary microvascular function. The endothelial function after ischemia reperfusion can be assessed also at the level of the coronary circulation via the coronary flow reserve (CFR).&#160;In this study, peak velocity of left anterior descending (LAD) coronary arteries was measured in rats in vivo via Transthoracic Doppler Echocardiography during resting and stress challenge (induced by Dobutamine). A normal heart can increase its coronary blood flow up to four times above the resting values during stress induction. Following ischemia reperfusion, we found a significantly diminished CFR, which can be used as a marker of coronary microvascular dysfunction. CFR has opened a window on the importance of microvascular dysfunction and has been shown to predict cardiovascular risk independent of whether the severe obstructive disease is present.

Coronary flow reserve (CFR), is defined as the ratio of maximal coronary blood flow to the resting coronary blood flow. We present a protocol for evaluating CFR in rats via ultrasound, which offers the opportunity to predict cardiovascular risk factors in the absence of obstructive coronary disease.

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via ...