title: Cerebrospinal fluid concentrations of nitric oxide metabolites in spinal cord injury.
abstract: METHODS
  Multiple center study to evaluate cerebrospinal fluid (CSF) concentrations of nitric oxide metabolites [NOx] in relation to neurologic severity and prognosis in spinal cord injury (SCI).
  
  
  OBJECTIVE
  To examine whether CSF [NOx] correlates with neurologic severity and recovery in SCI.
  
  
  BACKGROUND
  Inducible nitric oxide synthase is expressed in rat spinal cord immediately after SCI. Excessive nitric oxide production is cytotoxic, causing neuronal apoptosis with subsequent neurodysfunction in the spinal cord. We previously reported a significant correlation between initial [NOx] after incomplete cervical cord injury (CCI) and neurologic recovery at the final follow-up in 25 cases.
  
  
  METHODS
  Ninety-six cases (SCI group), including 76 patients with CCI and 20 patients with thoracic cord injury were examined. Mean follow-up period was 11 months. The control group comprised 40 cases (3 healthy volunteers and 37 patients with neither pain nor neurologic disorders). CSF [NOx] were measured using the Griess method. Severity of neurologic impairment was assessed using Frankel's classification and the American Spinal Injury Association motor score (ASIA MS). Degree of neurologic recovery was assessed using Frankel's classification and the ASIA motor recovery percentage.
  
  
  RESULTS
  CSF [NOx] did not differ significantly among the control, CCI, and thoracic cord injury groups at the initial examination. In the CCI group, [NOx] in the Frankel A and B classes were significantly higher than [NOx] in the control group at 5 to 14 days, in the Frankel A and B classes at 0 to 4 days, and in the Frankel C and D classes at 5 to 14 days. Also, in the CCI group at 5 to 14 days, [NOx] correlated significantly with ASIA MS and motor recovery percentage.
  
  
  CONCLUSIONS
  There was a significant correlation between CSF [NOx] at the pathologic early subacute stage (approximately 5-14 days) and neurologic severity and recovery in SCI.
authors.affiliation: Rehabilitation Center, Niigata University Medical and Dental Hospital, Niigata-shi, Niigata, Japan. skimura@med.niigata-u.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Kimura
authors.forename: Noboru
authors.initials: N
authors.lastname: Hosaka
authors.forename: Itaru
authors.initials: I
authors.lastname: Yuge
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Yamazaki
authors.forename: Kohta
authors.initials: K
authors.lastname: Suda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Taneichi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Denda
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009569:Nitric Oxide / Q000134:cerebrospinal fluid*; D020127:Recovery of Function; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000134:cerebrospinal fluid* / Q000150:complications / Q000503:physiopathology; D013997:Time Factors; D055815:Young Adult
chemical_list: D009569:Nitric Oxide