Functional improvements correlate with enhanced quality of life following mesenchymal stromal cell therapy in chronic spinal cord injury

Mesenchymal stromal cell (MSC) therapy is an emerging promising treatment for spinal cord injury (SCI) management. However, and even though sensory and motor evaluations of this treatment are being reported, there is a deficiency in reporting standardized evaluation of the Quality of Life (QoL) measures, especially as it relates to bowel/bladder control in patients. Subtle enhancements in these functions, even though undetectable by routine examination and clinical assessments, may have a significant impact on patients' perceived well-being. In this study, we specifically examine how MSC therapy affected self-reported QoL of measures of SCI patients. A prospective analysis was conducted on 20 chronic SCI patients receiving MSC therapy [bone marrow (BM) or Wharton's jelly (WJ) derived]. Bowel function was assessed using the Neurogenic Bowel Dysfunction Score (NBDS) and Wexner Score, while bladder function and QoL were evaluated via the modified King's Health instrument and WHOQOL-BREF. Follow-up extended for one-year post-treatment. Both BM- and WJ-MSC groups showed progressive improvement in bowel/bladder function, with significant declines in NBDS (P < 0.05) and Wexner scores (P < 0.001). QoL domains (physical, psychological, social, environmental) improved significantly (P < 0.05), with environmental QoL scoring highest in BM-MSC recipients. Bladder control improved in sensory perception but not continence, concurring with prior findings. Our results show that MSC therapy enhances bowel/bladder function and QoL in chronic SCI patients, though individualized assessment tools are essential to capture subtle improvements. These results support MSC therapy as a promising intervention, warranting further long-term studies.