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Thread: ASIA Rating/Surviving Axons/ Remyelination/Recovery

  1. #1
    Senior Member Schmeky's Avatar
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    ASIA Rating/Surviving Axons/ Remyelination/Recovery

    Remyelination therapies, from all indications, are beginning to surface. So the logical question would seem to be who could potentially benefit the most or consequently the least.

    Since the objective of remyelination therapies are to re-insulate surviving denuded axons that traverse the injury site, then obviously the greater the number of potentially repairable axons you have, the greater the recovery.

    Therefore my objective is to try to determine which ASIA rating would potentially be a "yes" for remyelination therapies, and where or if a "no" exists. Based on this deduction, one would assume an ASIA A would benefit the least, but how much could an ASIA B benefit, or a C for that matter? Ambulation is attainable at ASIA D.

    We need a combination therapy that not only remyelinates, but also grows new axons as well. We're not there yet, but single modality remyelination therapies appear to be emerging.

  2. #2
    Schmecky, re-myelination therapies have been here for a while, at the experimental stage of course. Like I have often said, many pieces of the puzzle are already here, at the experimental or inception stage.

    What happens is that SCI is a highly heterogeneous injury, and the treatment combo will have to be designed in a customized manner for every patient.

    I think it is entirely possible that an ASIA A can have lots of axons that, if remyelinated, could turn this person into an ASIA D. Conversely, we can have an ASIA C whose main problem is not remyelination. So I believe ASIA will not be a predictor of who is going to benefit.

    If I am going to chose an experimental therapy for myself, I want to have a clear MRI picture of what´s going on with the cord, as well as info derived from the physical examination. Then I would pick and choose among the numerous therapies already available.

    Brain
    Cord: gap? tethering? scar? septation? cysts? etc
    Spinal roots
    Nerves (some SCIs have accompanying peripheral nerve damage, unknown to them)
    Myelin
    Muscles
    Joints

    No reason why one cannot address all of these sequentially. Because I have always believed that good, solid, effective combos are 20-30 years away.

  3. #3
    I think I might just be smiling! CRPA going forward and Schmecky sharing his sense of hope that science is emerging with therapies that will bring about a cure.

    Bring on 2007!

    My resolution for the new year was to spend more time advocating for a cure. I think I'm getting an early start!

    Thanks for your positive outlook Schmecky! I respect your viewpoints and love the optimism.
    "Our lives begin to end the day
    we become silent about things that matter."
    - Martin Luther King Jr

  4. #4
    Senior Member Scott Buxton's Avatar
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    See my posts earlier tonight too. Momentum is building. I try to keep abreast because my best friend has a C5 Partial injury. The same wreck (in which we were passengers) gave me a traumatic brain injury. I'm taking 4-AP, so far only with good results, so I'm all for remyelination or the effect of it. Scott.

  5. #5
    Senior Member Schmeky's Avatar
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    Quote Originally Posted by Cripply
    No reason why one cannot address all of these sequentially. Because I have always believed that good, solid, effective combos are 20-30 years away.
    Cripply,

    If you are relating this to Dr. Young's long standing definition of a cure as "a third party observer would not be able to tell you were ever SCI", then yes, I agree. 20++ years minimum.

    However, with a dirge of SCI research being applied to humans now (overseas that is), it is possible functional recovery could be observed in less than 5 years. But such recovery will leave us still severly impaired, but nonethelss, a quantum leap from only 5 years ago.

  6. #6
    Quote Originally Posted by Schmeky
    Cripply,

    If you are relating this to Dr. Young's long standing definition of a cure as "a third party observer would not be able to tell you were ever SCI", then yes, I agree. 20++ years minimum.

    However, with a dirge of SCI research being applied to humans now (overseas that is), it is possible functional recovery could be observed in less than 5 years. But such recovery will leave us still severly impaired, but nonethelss, a quantum leap from only 5 years ago.
    That s what I meant. Address sequentially now, or wait 30 years for treatment. I agree with you.

  7. #7
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    Quote Originally Posted by Cripply
    Schmecky, re-myelination therapies have been here for a while, at the experimental stage of course. Like I have often said, many pieces of the puzzle are already here, at the experimental or inception stage.

    What happens is that SCI is a highly heterogeneous injury, and the treatment combo will have to be designed in a customized manner for every patient.

    I think it is entirely possible that an ASIA A can have lots of axons that, if remyelinated, could turn this person into an ASIA D. Conversely, we can have an ASIA C whose main problem is not remyelination. So I believe ASIA will not be a predictor of who is going to benefit.

    If I am going to chose an experimental therapy for myself, I want to have a clear MRI picture of what´s going on with the cord, as well as info derived from the physical examination. Then I would pick and choose among the numerous therapies already available.

    Brain
    Cord: gap? tethering? scar? septation? cysts? etc
    Spinal roots
    Nerves (some SCIs have accompanying peripheral nerve damage, unknown to them)
    Myelin
    Muscles
    Joints

    No reason why one cannot address all of these sequentially. Because I have always believed that good, solid, effective combos are 20-30 years away.
    I think an MRI can provide a lot of good info about gap, tethering, scar, septation, cysts, etc, however, it can't tell anything about myelination. The MRI resolution is 1 mm, the neurons/axons are ~5 microns. The only way to see if myelination will help is to try 4-a-p.

  8. #8
    Is there anything that grows axons?

  9. #9

    efficacy of remylination re ASIA rating

    Hi Schmeky,

    I had exactly the same question as you. I am an ASIA C with only a slight visible bruise on my cord at C7. I thought it was reasonably likely that I had some surviving nerves/axons that if remyelinated could result in some recovery. I tried 4HP with no apprent success. Assuming the 4AP was successful in remyelination it was not the answer for me.

  10. #10
    Member nik's Avatar
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    I don't understand the referenced to '4HP'.

    what is it and what does it do?

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