"SCRIBBLE" Spinal Cord Injury Blood Biomarker Longitudinal Evaluation

Overview

Prospective, single center study designed to assess blood biomarkers for classifying injury severity and predict neurologic recovery in traumatic spinal cord injured (SCI) patients.

Study will also establish the accuracy of point to care devices for SCI blood biomarkers and support the biospecimen collection for the International Spinal Cord Injury Biobank (ISCIB).

Description

This single center study at Vancouver General Hospital (VGH) will enroll patients with acute traumatic cervical and thoracic SCI who will have blood samples obtained daily for the first week post-injury. They will then have follow-up neurologic assessments at 6 and 12 months post-injury. The specific aims of the study are to:

1. Validate serum Neurofilament Light Chain (NF-L) and Glial Fibrillary Acidic Protein (GFAP) as biomarkers of acute SCI for classifying injury severity and predicting neurologic recovery.
2. Establish the relationship between serum and plasma levels of NF-L and GFAP.
3. Establish the accuracy of point-of-care devices for measuring GFAP.
4. Support biospecimen collection for the International Spinal Cord Injury Biobank (ISCIB).

Eligibility

Inclusion Criteria

        SCI Participants. Patients who suffer a traumatic spinal cord injury who meet the following
        inclusion criteria are eligible for admission into the study as "SCI participants":
          -  Male or Female ≥ 19 years of age
          -  Blunt (non-penetrating) traumatic spinal cord injury
          -  Baseline neurologic impairment deemed "complete"(AIS A) or "incomplete" (AIS B, C, D)
          -  Bony spinal level involvement between C0 and L1 inclusive
          -  Ability to have initial blood sample drawn within 24 hours of injury
          -  Have either an arterial line, central line, or intravenous line for collecting blood
             samples
          -  Able and willing to provide informed consent
        Non-SCI Spine Trauma Control Participants. Patients who suffer a fracture or dislocation of
        their spinal column without neurologic injury who meet the following inclusion criteria are
        eligible for admission into the study as "Non-SCI Spine Trauma Control Participants":
          -  Male or Female ≥ 19 years of age
          -  Traumatic spinal fracture between C0 and L1 without spinal cord injury
          -  Collection of initial blood sample within 24 hours of injury
          -  Have either an arterial line, central line, or intravenous line for collecting blood
             samples
          -  Able and willing to provide informed consent
        Exclusion Criteria
        Patients who fulfill any of the following criteria are not eligible for admission into the
        study:
          -  Penetrating spinal cord injury (e.g. gunshot, stab)
          -  Spinal cord injury with sensory deficit only (i.e. no motor deficit)
          -  Spinal injury below L1
          -  Isolated radiculopathy without fracture
          -  Isolated cauda equina injury
          -  Pre-existing thromboembolic disease or coagulopathy (disorders related to blood
             clotting), such as haemophilia or von Willebrand's disease
          -  Have any other medical condition that in the investigator's opinion would render the
             study procedures dangerous or impair their ability to receive treatment