Engaging Spinal Networks to Mitigate Supraspinal Dysfunction After CP

Although children with cerebral palsy seem to have the neural networks necessary to generate most movements, they are markedly dysfunctional, largely attributable to abnormal patterns of muscle activation, often characterized as spasticity, largely reflecting a functionally abnormal spinal-supraspinal connectivity. While it is generally assumed that the etiologies of the disruptive functions associated with cerebral palsy can be attributed primarily to supraspinal networks, we propose that the more normal connectivity that persists between peripheral proprioception-cutaneous input to the spinal networks can be used to guide the reorganization of a more normal spinal-supraspinal connectivity. The level of plasticity necessary to achieve the required reorganization within and among different neural networks can be achieved with a combination of spinal neuromodulation and specific activity-dependent mechanisms. By engaging these two concepts, we hypothesize that bidirectional reorganization of proprioception-spinal cord-brain connectivity to higher levels of functionality can be achieved without invasive surgery.

Automated summary

Children with cerebral palsy have dysfunctional neural networks largely due to abnormal muscle activation patterns, such as spasticity, reflecting abnormal spinal-supraspinal connectivity. The study suggests that reorganization of spinal-supraspinal connectivity towards higher functionality can be achieved through non-invasive methods by utilizing the existing peripheral proprioception-cutaneous input to guide the process. The required plasticity for this reorganization can be achieved through a combination of spinal neuromodulation and specific activity-dependent mechanisms.