Kazim Syed Faraz, Bowers Christian A, Cole Chad D, Varela Samantha, Karimov Zafar, Martinez Erick, Ogulnick Jonathan V, Schmidt Meic H
Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque, NM, 87131, USA.
School of Medicine, University of New Mexico (UNM), Albuquerque, NM, 87131, USA.
Mol Neurobiol. 2021 Nov;58(11):5494-5516. doi: 10.1007/s12035-021-02484-w. Epub 2021 Aug 3.
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.
脊髓损伤（SCI）是一种极具破坏性的疾病，在美国约有29.4万人受其影响，全球则有数百万人。皮质脊髓运动回路在控制哺乳动物的熟练运动以及规划和协调运动方面发挥着重要作用，并且可能因脊髓损伤而受损。虽然在成体中枢神经系统中，受损纤维的长距离轴突再生很少见，但在实验性脊髓损伤模型中，已显示在 spared 皮质脊髓运动回路中存在大量自发的神经重组和可塑性，这与功能恢复相关。有益地利用皮质脊髓运动回路的这种神经可塑性，是改善脊髓损伤后运动结果的一种极具前景的治疗方法。迄今为止，已为此目的使用了几种不同的策略，包括神经调节（脊髓/脑刺激策略和脑机接口）、康复训练（针对活动依赖性可塑性）、干细胞和生物支架、神经再生/神经保护药物疗法，以及光动力疗法（PDT）和光生物调节（PMBT）等光基疗法。本综述概述了脊髓损伤后皮质脊髓运动回路中的自发重组和神经可塑性，并总结了在临床前动物模型和临床人类患者研究中用于有益地利用这种神经可塑性促进脊髓损伤后功能恢复的各种治疗方法。
