Detecting Early Neurological Decline to Prevent Paralysis

This year’s Stepping Strong Innovator Awards finalists are addressing complex challenges related to trauma research. Each of the three finalists hopes to receive the $100,000 Stepping Strong Innovator Awards, which will be announced online on Monday, Oct. 17. Read about their work below, and vote for your choice.

Jay Zampini, MD

Detecting Early Neurological Decline to Prevent Paralysis – Jay Zampini, MD

What challenge does your project address?

Spinal cord injury represents one of the most devastating and long-reaching effects of trauma. Injuries can range from a subtle loss of sensation and muscle function to complete paralysis. More than 273,000 people in the U.S. are living with spinal cord injury, the ranks of which grow by over new 12,000 cases each year.

Typically, patients sustain a spinal cord injury due to a car accident, fall, sports injury or violence. They are transported to a trauma center, where spine surgeons provide treatment designed to optimize the restoration of neurologic function. In other instances, a hospital patient with normal neurologic function may experience a loss of sensation or muscle function for various reasons. Ideally, caregivers can identify these changes rapidly enough to initiate treatment to reverse the symptoms or prevent their progression. Today, a neurologic exam is the only method of detecting changes.

The most challenging group of patients to treat for neurologic decline are those whose mental status and ability to cooperate are compromised. They may be unconscious, confused, agitated or delirious. For these patients, a neurologic exam alone cannot rapidly detect a potentially devastating change in neurologic function.

We plan to develop a device that automatically detects changes in neurologic function, alerting clinicians to start life- or function-saving treatment.

What is a compelling aspect of your project?

Assessing active muscle function is the most critical aspect of a neurologic exam, requiring patients to move their hands, feet and muscles. Several methods of measuring muscle activity are available. For instance, electromyography uses needles and skin-surface electrodes to stimulate and monitor muscle activity in patients to assess nerve injury. Similar techniques are available for patients under anesthesia, and accelerometers in the iPhone, FitBit and other athletic monitors can differentiate between activities like running, golf, and elliptical training.

The device we propose will adapt available technology for an application that has never been considered before. Our device also takes a time-consuming task of a neurologic examination and automates it, allowing clinicians to better serve their patients.

How will your project benefit future patients who suffer from trauma-related injuries?

Our device has the potential to not only benefit patients who are injured and neurologically intact, but also those whose potential neurologic decline is difficult to detect. We hope it will become the standard of care for neurologic monitoring in hospitalized, at-risk patients.

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