Hofstetter
Laboratory
University of Washington
Department of Neurological Surgery
OUR RESEARCH
Our laboratory focuses on the spinal cord. In particular, we target systems of the spinal cord that may have a direct positive impact on patient care at the University of Washington Medical Center. We have a variety of ongoing projects.
Ultrasound biomarkers for acute spinal cord injury
We are pioneering the use of advanced Ultrafast Contrast-Enhanced Ultrasound (CEUS) imaging to revolutionize assessment and prognostic capabilities following traumatic spinal cord injury (tSCI). Our cutting-edge approach combines high-frequency plane-wave ultrasound imaging with contrast agents, allowing us to visualize and measure spinal cord tissue perfusion, disruptions in vascular architecture, and changes in blood flow velocities with remarkable spatial and temporal precision.
Our recent studies have demonstrated that CEUS-derived metrics, including the perfusion area deficit (PAD) and the spinal perfusion index (SPI), strongly correlate with injury severity and long-term functional outcomes in both preclinical rodent models and human clinical cases. This novel imaging modality provides unprecedented insight into tissue viability and has the potential to significantly enhance clinical decision-making immediately following injury. By enabling early identification of tissue at risk for secondary damage, this technology could substantially improve therapeutic interventions and patient recovery outcomes.
This innovative research is conducted in collaboration with Dr. Matthew Bruce at the University of Washington's Applied Physics Laboratory.
PIONEERING ULTRASOUND TECHNOLOGY FOR SPINAL CORD INJURIES
Our work with high-frequency ultrafast ultrasound has advanced the study of acute spinal cord injuries in rodents. Clinically, contrast-enhanced ultrasound shows promise as a prognostic tool for acute spinal cord injuries, potentially improving early diagnosis and treatment trials. This research has secured renewed funding from the Department of Defense, supporting our clinical team in its second year of using ultrasound to monitor perfusion during decompression surgeries.
Our novel ultrasound-based biomarker allows us to study the expansion of an acute spinal cord injury precisely. This will enable us to monitor the effectiveness of novel treatments
ADVANCES IN SPINAL CORD RESEARCH
We are developing electrical stimulation as a treatment for spasticity and functional recovery after spinal cord injury (SCI). Spasticity affects nearly two-thirds of people with traumatic SCI, causing involuntary muscle contractions that impair daily activities, such as grasping, eating, writing, and quality of life. Since no standard treatment exists, we first optimize the approach in animal models before translating it to humans. Dr. Sadeghi has developed unique devices to measure spasticity in rodents, enabling us to study stimulation effects. Collaborating with experts in the field, specifically Dr. Chet Moritz from the Department of Neurorehabilitation, and Dr. Steve Perlmutter from the Department of Biophysics and Physiology, we have shown that non-invasive spinal cord stimulation, combined with rehabilitation, reduces spasticity and improves motor control in chronic cervical SCI patients, with lasting benefits even after treatment ends.
Schematic view of the spinal reflex arc and electrophysiological measurement of the Hoffmann reflex (H-reflex). Change in H-reflex and loss of Rate-dependent depression (RDD) of H-reflex, are characterized as the electrophysiological hallmark of spasticity
EXPLORING THERAPEUTIC TARGETS THROUGH COLLABORATIVE RESEARCH
The Hofstetter lab has expanded their research through a collaboration with Dr. Price at the University of Texas, focusing on single-cell RNA analysis of C1-2 DRGs from patients with acute or chronic neck pain. This work aims to uncover potential therapeutic targets and has been recognized by the NIH, earning a prestigious U19 grant to extend our research into chronic low back pain. The unwavering support from our esteemed surgeons, Drs. Karandikar, Khan and Amin, has been instrumental in driving forward our research initiatives and advancing clinical breakthroughs.
Read about the C1-2 and Chronic Lower Back Pain here