Cortical reorganization after spinal cord injury: always for good?

Neuroscience, 2014 · DOI: 10.1016/j.neuroscience.2014.06.056 · Published: December 26, 2014

Spinal Cord Injury Neurology Neuroplasticity

Simple Explanation

Plasticity in the brain allows for behavioral changes and neural network adjustments following experiences, including injuries. This reorganization can aid in recovery from sensory and motor dysfunction after spinal cord injury. Cortical reorganization after spinal cord injury isn't static; it's a dynamic process that starts immediately after the injury. The extent of this reorganization varies depending on factors like species, age at injury, time after injury, and therapies used. Understanding when and why brain reorganization is beneficial or detrimental is crucial for developing effective therapies. These therapies aim to maximize functional recovery while minimizing negative outcomes like neuropathic pain after spinal cord injury.

Study Duration

Not specified

Participants

Humans, non-human primates, and rats

Evidence Level

Review

Key Findings

1
Cortical reorganization after spinal cord injury is species-dependent, with varying degrees and patterns observed in humans, non-human primates, and rats.
2
The age of the animal at the time of injury significantly influences the brain's ability to reorganize, with neonatal injuries often leading to greater functional recovery compared to injuries in adulthood.
3
Pharmacological therapies, particularly those involving serotonin agonists, can promote cortical reorganization and improve behavioral recovery after spinal cord injury.

Research Summary

Plasticity is the basis for behavioral changes, involving neural network shaping and synaptic remodeling. Brain reorganization after CNS lesions plays a role in recovery and rehabilitation but can also be maladaptive. Brain reorganization is a dynamic process initiated immediately after spinal cord injury. The impact of injury, with or without therapy, is a complex balance between supraspinal reorganization and spinal recovery. Understanding how the brain reorganizes after injury, and clarifying when reorganization is 'good' or 'bad,' is crucial for developing effective therapies to maximize functional recovery and minimize neuropathic pain.

Practical Implications

Therapeutic Development

Understanding the factors influencing cortical reorganization can lead to the development of targeted therapies to maximize functional recovery after SCI.

Personalized Treatment

Considering species, age, time after injury, and therapy regimes can inform personalized treatment plans to optimize outcomes for SCI patients.

Combined Therapies

Exploring combined therapies, such as pharmacotherapy and exercise, may synergistically promote beneficial cortical reorganization and locomotor recovery.

Study Limitations

1
Variability in cortical reorganization across species and individuals.
2
Complexity of interactions between different factors influencing cortical plasticity.
3
Need for more research on the long-term effects of various therapeutic interventions.

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