Top 5 Challenges in SCI Repair

Here are the top five challenges in the race for a cure for SCI:

1. Post-injury survival – Keep nerve cells that survive the initial injury alive and healthy
2. Regeneration and growth – Promote the re-growth of injured nerve cells and their fibers
3. Axon pathfinding – Guide growing axons toward their normal targets (i.e., muscles or other neural tissues)
4. Electrical conduction – Nerve cells must conduct electrical impulses with reliability and fidelity to carry information needed to execute complex tasks
5. Synaptic connection –  Axons that reach their targets must connect and stabilize a line of communication

Progress: In my opinion, in more than 10 years in this field, I firmly believe that we’ve grown exponentially in terms of knowledge and application for milestones #1, 2,  3, and 4. And this is great news because this means that we are more than halfway toward fixing SCI. In fact, there are ongoing clinical trials in various parts of the globe investigating ways to increase the survival of nerve cells (a critical first step!), enhancing the growth of spared fibers, and guiding those axons toward their normal targets.

Next Steps: While less is known about how to promote re-connections between injured nerve cells and their targets (#5), we have a firm grasp on the molecular mechanisms involved in this challenge. We know that specific proteins interact in the growing nervous system (i.e., those that functioned when you were still in the womb, or just an infant) and that they turn-off, don’t work, or are non-existent in adulthood. So, in essence, we need to learn how to turn these switches back on, or replace them with functional ones. While no easy task, there are emerging tools to do this, including genetic therapies which has become a huge advancement and addition to our repair tool box.

What I expect: In the next few years, we will see some very big pushes on various research fronts in the SCI battle space. I think the biggest successes and those soonest to arrive will be in the form of new strategies designed to overcome many of the serious quality-of-life issues associated with SCI, including pain, reflex disorders, and poor autonomic function. Hang on; stay alert; stay hopeful!

Writing Prose-y

Of late, I’ve been writing a lot. These have been of the erudite sort, research papers and such. Hence, my predisposition to thinking about the process and how my toolbox of writing “utensils” has grown over the years.

A few years ago I read a book about writing that changed my approach to putting words on a page. The Elements of Style, by Strunk & White, opened my eyes to how BAD my writing skills were (not hitting greatness yet either).

To keep my ego in check, I’ll just say that I’m a lot better at seeing the errors I make. I can see where I make mistakes and know how to improve poorly written sentences, etc. As important, I know how to help other people with their writing, because of the tips and tricks that Strunk & White in their awesome wisdom have imparted on me.

Of course, as an academic, the things I write are (for the most part) very technical and, to the layman, boring. That is because we write to convey information in its purest form. I can be creative only in that I don’t sacrifice objective communication. No fancy prose. For example, I can’t say this:

“After spinal cord injury, neurons met a spectacular end, never to regrow again–that is, until we came along.”

I’d lose my job if I wrote stuff like that. Instead, I have to resort to mediocre stuff like: “We observed neuronal death following spinal cord injury.”

Yes, science is predicated upon good, wholesome facts from-me-to-you writing styles. I guess this is where this blog post comes into play. I have the freedom to write whatever about my work (or my life and opinions) without the editorial axe murderer chopping my head off for prose-y things.

Anyway, writing should be fun, refreshing, a place of security and vulnerability at the same time; and for many of us who like to do it a lot; somewhat painful in a very, very good way.

Writing sounds a bit like love. 

Related articles

• Neuropathic Pain and Memory (neurovantage.wordpress.com)
• Strunk and White (writerswritedaily.wordpress.com)