Supraspinal Plasticity of Axonal Projections From the Motor Cortex After Spinal Cord Injury in Macaques.

During recovery following spinal cord injury in the macaque, the sensorimotor cortex on the same side as the injury (ipsilesional, unaffected) becomes activated and plays a role in guiding movements of the affected hand. Effective regulation of these movements by the ipsilesional sensorimotor cortex would depend not only on its ability to send motor commands directly to target muscles but also on coordinated functioning with higher-level motor planning systems such as the cortico-basal ganglia and cortico-cerebellar loops. In this study, using anterograde viral tracers, we analyzed the axonal trajectories of corticofugal fibers from the contralesional (affected) primary motor cortex (M1) at the brainstem level in two macaque monkeys with sub-hemisection spinal cord injury at the mid-cervical level. They showed considerable recovery of grasping movements after injury. We found an increase in axonal projections from the contralesional M1 to the contralateral putamen, ipsilateral lateral reticular nucleus, and contralateral pontine nucleus compared to projections from the ipsilesional (unaffected) M1. We propose that these increased projections from the contralesional M1 to the striatum and precerebellar nuclei on the nondominant side may function to recruit the ipsilesional M1 through the cortico-basal ganglia and cortico-cerebellar loops to control hand movements on the affected side during recovery.