Do Pharmacological Treatments Act in Collaboration with Rehabilitation in Spinal Cord Injury Treatment? A Review of Preclinical Studies

Rehabilitation is essential for spinal cord injury (SCI) recovery, but its effects are limited. Researchers are exploring pharmacological treatments to enhance rehabilitation outcomes. This review summarizes the combined effects of rehabilitation with various medical agents, focusing on neuromodulation, neurotrophic factors, and counteracting inhibitory factors. The recovery processes promoted by rehabilitation involve regeneration, neuroprotection, scar tissue reorganization, and spinal circuit plasticity. These processes can be additive, complementary, or synergistic with medication. However, some cases show no interaction or even competition between medication and rehabilitation. Many combinatorial mechanisms remain unclear, and few studies examine complex agent combinations or target chronically injured spinal cords. Further research is needed to elucidate these mechanisms and develop effective treatments for chronic SCI.

• 1
  Rehabilitation promotes various recovery processes, including regeneration of tracts, neuroprotection, scar tissue reorganization, plasticity of spinal circuits, and enforcement of the musculoskeletal system, which can be enhanced by medication.
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  There are instances where medication and rehabilitation lack interaction or even compete with each other, indicating that the combination of treatments needs to be carefully considered.
• 3
  A large fraction of the mechanisms underlying the combinatorial effects of rehabilitation and pharmacological treatments remains to be elucidated, highlighting the need for further research.