And yet it moves : Recovery of volitional control after spinal cord injury
Taccola, Giuliano (University of California. Department of Integrative Biology and Physiology)
Sayenko, Dimitry (University of California. Department of Integrative Biology and Physiology)
Gad, Parag (University of California. Department of Integrative Biology and Physiology)
Gerasimenko, Y. (Pavlov Institute of Physiology, St. Petersburg)
Edgerton, Victor (Institut Germans Trias i Pujol. Institut Guttmann)

Date:	2018
Abstract:	Preclinical and clinical neurophysiological and neurorehabilitation research has generated rather surprising levels of recovery of volitional sensory-motor function in persons with chronic motor paralysis following a spinal cord injury. The key factor in this recovery is largely activity-dependent plasticity of spinal and supraspinal networks. This key factor can be triggered by neuromodulation of these networks with electrical and pharmacological interventions. This review addresses some of the systems-level physiological mechanisms that might explain the effects of electrical modulation and how repetitive training facilitates the recovery of volitional motor control. In particular, we substantiate the hypotheses that: (1) in the majority of spinal lesions, a critical number and type of neurons in the region of the injury survive, but cannot conduct action potentials, and thus are electrically non-responsive; (2) these neuronal networks within the lesioned area can be neuromodulated to a transformed state of electrical competency; (3) these two factors enable the potential for extensive activity-dependent reorganization of neuronal networks in the spinal cord and brain, and (4) propriospinal networks play a critical role in driving this activity-dependent reorganization after injury. Real-time proprioceptive input to spinal networks provides the template for reorganization of spinal networks that play a leading role in the level of coordination of motor pools required to perform a given functional task. Repetitive exposure of multi-segmental sensory-motor networks to the dynamics of task-specific sensory input as occurs with repetitive training can functionally reshape spinal and supraspinal connectivity thus re-enabling one to perform complex motor tasks, even years post injury.
Note:	GT is supported by funding from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie (grant agreement No 661452). This review is funded in part by NIH R01EB007615, the Christopher & Dana Reeve Foundation, Broccoli Foundation, WalkAbout Foundation and Russian Foundation for Fundamental Research (Grant No. 16-29-08173-ofi-m).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article de revisió ; Article ; Versió publicada
Subject:	CPG, central pattern generator ; DLF, dorsal lateral funiculus ; DR, dorsal root ; Eemc, electrical Enabling motor control ; ER, early response ; MR, middle response ; LR, late response ; SCI, spinal cord injury ; SCS, spinal cord stimulation ; Tscs, transcutaneous electrical spinal cord stimulation ; Neuromodulation ; Electrical stimulation ; Spinal networks ; Motor training
Published in:	Progress in neurobiology, Vol. 160 (january 2018) , p. 64-81, ISSN 1873-5118

DOI: 10.1016/j.pneurobio.2017.10.004
PMID: 29102670

None, 17.3 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Published articles