Epidural Spinal Cord Stimulation Promotes Motor Functional Recovery by Enhancing Oligodendrocyte Survival and Differentiation and by Protecting Myelin after Spinal Cord Injury in Rats

Spinal cord injuries (SCI) often lead to motor and sensory function loss, and current treatments are limited. This study explores epidural spinal cord stimulation (ESCS) as a potential therapy to improve motor function after SCI by affecting oligodendrocytes, cells that are critical for nerve insulation and function. The research found that ESCS improved hindlimb motor function in rats with SCI. ESCS also increased myelin, the protective sheath around nerve fibers, and reduced cell death in the spinal cord's white matter. These improvements suggest ESCS has a positive impact on nerve health and function after injury. The study also found that ESCS appears to promote the survival and development of oligodendrocytes, and it protects myelin by influencing a specific signaling pathway (BMP4-Smad1/5/9) in the spinal cord. These findings suggest that ESCS could be a valuable approach for promoting recovery after SCI.

• 1
  ESCS improves hindlimb motor function in rats with SCI at 7, 14, 21, and 28 days after injury, indicating a sustained positive effect on motor recovery.
• 2
  ESCS reduces myelin loss in the spinal white matter and decreases the number of apoptotic cells, suggesting that ESCS protects myelin and reduces cell death after SCI.
• 3
  ESCS upregulates the expression of oligodendrocyte markers (CNPase and MBP) and increases the percentage of newly differentiated oligodendrocytes, indicating that ESCS promotes oligodendrocyte survival and differentiation after SCI.