Liu Zhongwu, Xin Hongqi, Chopp Michael
Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.
Department of Neurology, Henry Ford Hospital, Detroit; Department of Physics, Oakland University, Rochester, MI, USA.
Neural Regen Res. 2021 May;16(5):939-943. doi: 10.4103/1673-5374.297060.
Stroke remains the leading cause of long-term disability. Hemiparesis is one of the most common post-stroke motor deficits and is largely attributed to loss or disruption of the motor signals from the affected motor cortex. As the only direct descending motor pathway, the corticospinal tract (CST) is the primary pathway to innervate spinal motor neurons, and thus, forms the neuroanatomical basis to control the peripheral muscles for voluntary movements. Here, we review evidence from both experimental animals and stroke patients, regarding CST axonal damage, functional contribution of CST axonal integrity and remodeling to neurological recovery, and therapeutic approaches aimed to enhance CST axonal remodeling after stroke. The new insights gleaned from preclinical and clinical studies may encourage the development of more rational therapeutics with a strategy targeted to promote axonal rewiring for corticospinal innervation, which will significantly impact the current clinical needs of subacute and chronic stroke treatment.
中风仍然是导致长期残疾的主要原因。偏瘫是中风后最常见的运动功能障碍之一，主要归因于受影响运动皮层的运动信号丧失或中断。作为唯一直接的下行运动通路，皮质脊髓束（CST）是支配脊髓运动神经元的主要通路，因此构成了控制外周肌肉进行自主运动的神经解剖学基础。在此，我们综述了来自实验动物和中风患者的证据，内容涉及CST轴突损伤、CST轴突完整性和重塑对神经恢复的功能贡献，以及旨在促进中风后CST轴突重塑的治疗方法。从临床前和临床研究中获得的新见解可能会推动更合理治疗方法的开发，其策略旨在促进轴突重新布线以实现皮质脊髓神经支配，这将对亚急性和慢性中风治疗的当前临床需求产生重大影响。
