Spinal Cord Injury Progress, Promise, and Priorities (2005) / Chapter Skim
Currently Skimming:
7 Research Organization: Creating an Environment to Accelerate Progress
7 Research Organization: Creating an Environment to Accelerate Progress
Pages 183-204
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From page 183... ...
As the field is currently configured, it cannot quickly capitalize on research leads because there are few centers for collaborative translational research on spinal cord injuries. Progress in spinal cord injury research will require adequate research funding; well-trained and innovative investigators with career development opportunities; translational efforts that move preclinical findings to clinical trials with humans, insofar as it is safe and appropriate; and an environment that promotes and encourages interdisciplinary collaboration.
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From page 184... ...
candidates in neuroscience) , but the data on the specific infrastructure for spinal cord injury research (such as the number of doctoral candidates who pursue research careers focused on spinal cord injuries)
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From page 185... ...
. The levels of NIH funding for spinal cord injury research have shown steady but modest increases since 1987 (Figure 7-1)
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Although the data on funding for spinal cord injury research indicate that the funding is steady, additional resources have not been forthcoming, including funding for the research infrastructure needed to accelerate research progress. NIH sponsors a number of fellowships that provide additional education and training to predoctoral and postdoctoral students.
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From page 187... ...
. These contracts, first funded in 2002, have been used to create a course in spinal cord injury research methods, provide resources for established researchers and postdoctoral trainees to work together in studying animal models of spinal cord injuries, support a series of replication studies of promising therapeutic strategies by using models of acute and chronic injuries, and enable the development of new functional outcome evaluations (NINDS, 2002)
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From page 188... ...
NINDS funds four ongoing P30 Center Core Grants that provide support to laboratories studying spinal cord injuries. These centers conduct research into a range of neurological disorders, including spinal cord injuries; and as mentioned in Chapter 3, the Ohio State University program also has an extensive training program in spinal cord injury research methods and techniques.
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From page 189... ...
Department of Defense. The spinal cord injury research funded by VA focuses primarily on rehabilitation and engineering approaches, but also includes some basic research on the restoration of nerve function.
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. Many of the states that fund spinal cord injury research do so through surcharges on fines for traffic violations.
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From page 191... ...
; the Wisconsin-based Bryon Riesch Paralysis Foundation, established in 2001, has provided more than $400,000 to spinal cord injury research, with particular emphases on remyelination, axon regeneration, and drug therapies (Bryon Riesch Paralysis Foundation, 2002, 2004) ; and the Paralysis Project of America, established in 1987, provides research support to postdoctoral fellows and senior investigators investigating the pathophysiology of spinal cord injuries and the development of treatments for spinal cord injuries (Paralysis Project of America, 2004)
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This program is dedicated to injury prevention policy and public education efforts. The next section highlights the efforts of a few nonprofit organizations dedicated to furthering spinal cord injury research.
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From page 193... ...
The association funds clinical fellowships at several universities and VA hospitals and has worked to establish three professional associations, the American Paraplegia Society, the American Association of Spinal Cord Injury Psychologists and Social Workers, and the American Association of Spinal Cord Injury Nurses, each of which has a program that provides seed grants for research. International Efforts Many international efforts are focused on research on spinal cord injuries and collaborative initiatives.
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. NEXT STEPS IN ACCELERATING PROGRESS Given the multiple and varied sources of funding and support for spinal cord injury research and the numerous potential therapeutic approaches and interventions at various stages of the research process (Chapters 4 and 5)
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The active involvement of all relevant institutes and support from institute management are critical to ensuring the sustainability of such an initiative. Enhancing Research Collaborations Although a number of funding sources are interested in spinal cord injury research, no concerted national effort is in place to push toward the cures that are needed for spinal cord injuries.
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From page 196... ...
Several multidisciplinary spinal cord injury research programs already exist, including the Miami Project to Cure Paralysis, the Kentucky Spinal Cord Injury Research Center, the Reeve-Irvine Research Center, and NIH-funded research centers (discussed earlier in this chapter and in Chapter 8)
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The centers of excellence should serve as the cornerstone of a National Spinal Cord Injury Research Network designed to coordinate and support spinal cord injury research efforts. Developing a National Spinal Cord Injury Research Network Key to accelerating progress in the treatment of spinal cord injuries is the development of a coordinated, focused, and centralized network that connects individual investigators, research programs, and research centers; facilitates collaborative and replicative projects; encompasses relevant research from diverse fields; and builds on the unique strengths of each research effort to move toward effective therapies.
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From page 198... ...
The National Spinal Cord Injury Research Network envisioned by the committee should begin its work by convening a consensus conference to prioritize and promote the pre-clinical and translational efforts needed to bring experimental therapies to the clinic; this includes treatments to improve functional deficits and reduce pain and spasticity as well as those focused on neuronal injury and repair. The conference should explore incentives to encourage the pre-clinical studies that are needed to move initial promising discoveries to the point of a clinical trial.
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From page 199... ...
In summary the National Spinal Cord Injury Research Network should: · convene an initial consensus conference to identify research and funding priorities and continue on a periodic basis to convene researchers and clinicians to update progress, prioritize research strategies, facilitate multicenter clinical trials, and engage in other collaborative efforts; · facilitate research on the range of outcomes and complications (including sensory, motor, bowel, bladder, autonomic, and sexual function and pain) that individuals with spinal cord injuries face; · enhance career development opportunities for young researchers by providing transitional support and other career-path opportunities, including participation in laboratory-based spinal cord injury training courses; · create and support virtual networking centers to facilitate the sharing of resources online and enhance collaborations with researchers not working in research centers and foster international collaborations; · convene annual or semiannual colloquia that particularly focus on research outside the traditional areas of spinal cord injury research to examine the approaches being used to address other complex health problems and to address the utility of that research to the treatment of spinal cord injuries; and · develop standardized protocols for patient registry systems so that registries can be coordinated and used to assist in identifying candidates for clinical trials and provide information on upcoming clinical trials to individuals with spinal cord injuries.
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Enhancing career opportunities for researchers at all points in their careers is vital to accelerating progress in spinal cord injury research. The committee believes that strengthening the research infrastructure through the development of new comprehensive research centers will be the impetus needed to attract and retain midcareer and senior-level researchers.
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Recommendation 7.2: Establish Spinal Cord Injury Research Centers of Excellence The National Institutes of Health should designate and support five to seven Spinal Cord Injury Research Centers of Excellence with adequate resources to sustain multidisciplinary basic, translational, and clinical research on spinal cord injuries. This would involve establishing two to three new Centers of Excellence and designating three to four current spinal cord injury research programs as Centers of Excellence.
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: Another step forward for spinal cord injury research. Spinal Cord 42(5)
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2004. Report of International Clinical Trials Workshop on Spinal Cord Injury February 20-21, 2004, Vancouver, Canada.
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2002. Contributions from the Model Systems Programs to spinal cord injury research.
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