Journal
MOLECULAR NEUROBIOLOGY
Volume 58, Issue 11, Pages 5494-5516Publisher
SPRINGER
DOI: 10.1007/s12035-021-02484-w
Keywords
Spinal cord injury; Corticospinal motor circuit; Neuroplasticity; Neuromodulation; Rehabilitation
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Funding
- Department of Neurosurgery, University of New Mexico (UNM) Hospital, Albuquerque, NM, USA
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Spinal cord injury is a devastating condition affecting millions worldwide. While axonal regeneration in the adult CNS is limited, there is evidence of spontaneous neural reorganization and plasticity in the corticospinal motor circuitry, showing promise for functional recovery after SCI. Various therapeutic approaches, including neuromodulation and rehabilitative training, have been used to harness this neuroplasticity for improved outcomes in both animal models and clinical studies.
Spinal cord injury (SCI) is a devastating condition that affects approximately 294,000 people in the USA and several millions worldwide. The corticospinal motor circuitry plays a major role in controlling skilled movements and in planning and coordinating movements in mammals and can be damaged by SCI. While axonal regeneration of injured fibers over long distances is scarce in the adult CNS, substantial spontaneous neural reorganization and plasticity in the spared corticospinal motor circuitry has been shown in experimental SCI models, associated with functional recovery. Beneficially harnessing this neuroplasticity of the corticospinal motor circuitry represents a highly promising therapeutic approach for improving locomotor outcomes after SCI. Several different strategies have been used to date for this purpose including neuromodulation (spinal cord/brain stimulation strategies and brain-machine interfaces), rehabilitative training (targeting activity-dependent plasticity), stem cells and biological scaffolds, neuroregenerative/neuroprotective pharmacotherapies, and light-based therapies like photodynamic therapy (PDT) and photobiomodulation (PMBT). This review provides an overview of the spontaneous reorganization and neuroplasticity in the corticospinal motor circuitry after SCI and summarizes the various therapeutic approaches used to beneficially harness this neuroplasticity for functional recovery after SCI in preclinical animal model and clinical human patients' studies.
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