Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD 21201, USA.
University of Maryland Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA.
Cells. 2020 Jun 8;9(6):1420. doi: 10.3390/cells9061420.
Evaluation of the chronic effects of spinal cord injury (SCI) has long focused on sensorimotor deficits, neuropathic pain, bladder/bowel dysfunction, loss of sexual function, and emotional distress. Although not well appreciated clinically, SCI can cause cognitive impairment including deficits in learning and memory, executive function, attention, and processing speed; it also commonly leads to depression. Recent large-scale longitudinal population-based studies indicate that patients with isolated SCI (without concurrent brain injury) are at a high risk of dementia associated with substantial cognitive impairments. Yet, little basic research has addressed potential mechanisms for cognitive impairment and depression after injury. In addition to contributing to disability in their own right, these changes can adversely affect rehabilitation and recovery and reduce quality of life. Here, we review clinical and experimental work on the complex and varied responses in the brain following SCI. We also discuss potential mechanisms responsible for these less well-examined, important SCI consequences. In addition, we outline the existing and developing therapeutic options aimed at reducing SCI-induced brain neuroinflammation and post-injury cognitive and emotional impairments.
脊髓损伤（SCI）的慢性影响评估长期以来一直集中在感觉运动功能障碍、神经性疼痛、膀胱/肠道功能障碍、性功能丧失和情绪困扰上。尽管临床上没有得到很好的重视，但 SCI 会导致认知障碍，包括学习和记忆、执行功能、注意力和处理速度方面的缺陷；它也常导致抑郁。最近的大规模纵向基于人群的研究表明，单纯性 SCI 患者（无并发脑损伤）患与认知障碍相关的痴呆症的风险很高。然而，很少有基础研究涉及损伤后认知障碍和抑郁的潜在机制。除了本身造成残疾外，这些变化还会对康复和恢复产生不利影响，并降低生活质量。在这里，我们回顾了 SCI 后大脑中复杂和多样反应的临床和实验工作。我们还讨论了导致这些研究较少的重要 SCI 后果的潜在机制。此外，我们概述了现有的和正在开发的治疗选择，旨在减少 SCI 引起的脑神经炎症和损伤后的认知和情绪障碍。
