Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan.
Trends Neurosci. 2017 Oct;40(10):625-636. doi: 10.1016/j.tins.2017.08.002. Epub 2017 Sep 8.
Damage to corticospinal fibers in the cervical spinal cord is known to impair dexterous hand movements. However, accumulating evidence has shown that precision grip can recover considerably through rehabilitative training. Recent multidisciplinary studies have revealed that, at the spinal level, this recovery is possible due to an indirect neural pathway through propriospinal neurons (PNs), which relay cortical commands to hand motoneurons. Although this indirect spinal pathway is heavily involved in recovery, its role is dwarfed by a simultaneous large-scale network reorganization spanning motor-related cortices and mesolimbic structures. This large-scale network reorganization is key to the regulation of recovery and future therapeutic strategies will need to take into account the involvement of these supraspinal centers in addition to the known role of the spinal cord.
众所周知，颈脊髓皮质脊髓纤维损伤会损害灵巧的手部运动。然而，越来越多的证据表明，通过康复训练，精确抓握可以得到很大程度的恢复。最近的多学科研究表明，在脊髓水平上，这种恢复是由于通过本体感受神经元（PNs）的间接神经通路实现的，PNs 将皮质命令传递到手运动神经元。尽管这个间接的脊髓通路在恢复中起着重要作用，但它的作用相对于跨越运动相关皮质和中脑边缘结构的大规模网络重组来说相形见绌。这种大规模的网络重组是调节恢复的关键，未来的治疗策略除了考虑到已知的脊髓作用外，还需要考虑到这些皮质中枢的参与。
