Eliciting inﬂammation enables successful rehabilitative training in chronic spinal cord injury

Brain, 2018 · DOI: 10.1093/brain/awy128 · Published: May 30, 2018

Spinal Cord Injury Immunology Rehabilitation

Simple Explanation

This study explores whether inducing mild neuroinflammation can improve the results of rehab training after a spinal cord injury. They tested whether this could be achieved in rats with chronic (8 weeks) dorsolateral quadrant sections of the cervical spinal cord (C4) by inducing mild neuroinﬂammation. The researchers injected rats with a low dose of lipopolysaccharide (LPS) and then put them through a rehab training program focused on forelimb function. They found that inducing mild neuroinﬂammation may be used to enhance the efﬁcacy of rehabilitative training after chronic spinal cord injury. The results showed that a combination of systemic lipopolysaccharide and high-intensity training restored original function (reparative plasticity) rather than enhancing new motor strategies (compensatory plasticity).

Study Duration

8 weeks (chronic injury) + 7-8 weeks (training)

Participants

132 adult female Lewis rats

Evidence Level

Level 2; Animal Study

Key Findings

1
Systemic injection of a low dose of lipopolysaccharide improved the efﬁcacy of rehabilitative training on forelimb function, as assessed using a single pellet reaching and grasping task.
2
In contrast to training alone, the combination of systemic lipopolysaccharide and high-intensity training restored original function (reparative plasticity) rather than enhancing new motor strategies (compensatory plasticity).
3
Electrophysiological and tract-tracing studies demonstrated a recovery in the cortical drive to the affected forelimb muscles and a restructuration of the corticospinal innervation of the cervical spinal cord.

Research Summary

The study investigated whether inducing mild neuroinflammation could enhance the effectiveness of rehabilitative training in rats with chronic spinal cord injury. Rats with chronic cervical spinal cord injuries received systemic injections of lipopolysaccharide (LPS) combined with training in a reaching and grasping task. The results showed that the combination of systemic LPS and high-intensity training restored original function, suggesting reparative plasticity. Electrophysiological and tract-tracing studies confirmed a recovery in cortical drive to the affected forelimb muscles and a restructuring of corticospinal innervation. The findings suggest that techniques eliciting mild neuroinflammation could enhance the efficacy of rehabilitative training after chronic spinal cord injury by promoting restorative rather than compensatory motor improvements.

Practical Implications

Enhanced Rehabilitation Strategies

Eliciting mild neuroinflammation through techniques like systemic LPS injection, in conjunction with high-intensity training, may improve motor function recovery after chronic SCI.

Restorative vs. Compensatory Recovery

Combining inflammation induction with training can facilitate the restoration of original motor functions rather than the development of compensatory strategies, leading to more effective and natural movements.

Clinical Translation

The study's findings could potentially be translated to clinical settings to improve rehabilitation outcomes for individuals with chronic spinal cord injuries, stroke, and other traumatic CNS injuries.

Study Limitations

1
The study was conducted on rats, and results may not directly translate to humans.
2
The optimal timing and dosage of LPS administration, and the duration of neuroinflammation, require further investigation.
3
The specific mechanisms by which LPS promotes neural plasticity and functional recovery need further elucidation.

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