Graduate School of Health Psychology, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy.
IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy.
Int J Mol Sci. 2024 Feb 13;25(4):2224. doi: 10.3390/ijms25042224.
A spinal cord injury (SCI) causes changes in brain structure and brain function due to the direct effects of nerve damage, secondary mechanisms, and long-term effects of the injury, such as paralysis and neuropathic pain (NP). Recovery takes place over weeks to months, which is a time frame well beyond the duration of spinal shock and is the phase in which the spinal cord remains unstimulated below the level of injury and is associated with adaptations occurring throughout the nervous system, often referred to as neuronal plasticity. Such changes occur at different anatomical sites and also at different physiological and molecular biological levels. This review aims to investigate brain plasticity in patients with SCIs and its influence on the rehabilitation process. Studies were identified from an online search of the PubMed, Web of Science, and Scopus databases. Studies published between 2013 and 2023 were selected. This review has been registered on OSF under (n) 9QP45. We found that neuroplasticity can affect the sensory-motor network, and different protocols or rehabilitation interventions can activate this process in different ways. Exercise rehabilitation training in humans with SCIs can elicit white matter plasticity in the form of increased myelin water content. This review has demonstrated that SCI patients may experience plastic changes either spontaneously or as a result of specific neurorehabilitation training, which may lead to positive outcomes in functional recovery. Clinical and experimental evidence convincingly displays that plasticity occurs in the adult CNS through a variety of events following traumatic or non-traumatic SCI. Furthermore, efficacy-based, pharmacological, and genetic approaches, alone or in combination, are increasingly effective in promoting plasticity.
脊髓损伤 (SCI) 会导致大脑结构和功能发生变化，这是由于神经损伤的直接影响、继发性机制以及损伤的长期影响，如瘫痪和神经性疼痛 (NP)。恢复发生在数周到数月之间，这是一个远远超过脊髓休克持续时间的时间段，也是脊髓在损伤水平以下未受刺激的阶段，与整个神经系统发生的适应有关，通常称为神经元可塑性。这种变化发生在不同的解剖部位，也发生在不同的生理和分子生物学水平。本综述旨在探讨 SCI 患者的大脑可塑性及其对康复过程的影响。研究通过在线搜索 PubMed、Web of Science 和 Scopus 数据库确定。选择了 2013 年至 2023 年期间发表的研究。本综述已在 OSF 上注册，注册号为(n) 9QP45。我们发现，神经可塑性可以影响感觉运动网络，不同的方案或康复干预可以以不同的方式激活这个过程。SCI 患者的运动康复训练可以引起白质可塑性，表现为髓鞘水含量增加。本综述表明，SCI 患者可能会自发或由于特定的神经康复训练而经历可塑性变化，这可能导致功能恢复的积极结果。临床和实验证据令人信服地显示，成人中枢神经系统在创伤性或非创伤性 SCI 后通过多种事件发生可塑性。此外，基于疗效的药理学和遗传学方法单独或联合使用，越来越有效地促进可塑性。
