Impact of treatment duration and lesion size on effectiveness of chondroitinase treatment post-SCI

Exp Neurol, 2015 · DOI: 10.1016/j.expneurol.2015.02.028 · Published: May 1, 2015

Spinal Cord Injury Neurology Neuroplasticity

Simple Explanation

After a spinal cord injury, substances called chondroitin sulfate proteoglycans (CSPGs) increase at the injury site, inhibiting axon growth and preventing the plasticity needed for functional recovery. The study examines how intralesional chondroitinase abc (ch'abc) treatment duration affects anatomical plasticity and behavioral recovery in adult cats following tightly controlled lateral hemisection injuries. The cat model is beneficial for assessing a range of locomotor tasks and motor precision on challenging tasks.

Study Duration

5 Months

Participants

35 adult female cats

Evidence Level

Not specified

Key Findings

1
Both 2 and 4 weeks of ch'abc treatment significantly increased the number of rubrospinal tract (RuST) neurons with axons below the lesion.
2
Four weeks of treatment promoted greater accuracy of movement compared to two weeks, especially for tasks requiring precise hindlimb placement.
3
Four weeks of ch'abc treatment lessened the dependence of recovery on the amount of spared tissue.

Research Summary

This study investigates the impact of chondroitinase abc (ch'abc) treatment duration (2 vs. 4 weeks) and lesion size on anatomical plasticity and functional recovery in cats with spinal cord injury. Results showed that both 2 and 4 weeks of ch'abc treatment increased the number of rubrospinal tract (RuST) neurons with axons extending below the lesion site, but only 4 weeks of treatment significantly improved accuracy in challenging motor tasks. The study concludes that ch'abc treatment can enhance functional recovery after spinal hemisection, but the effectiveness is closely linked to the timing and duration of treatment, particularly for tasks requiring adaptive behaviors.

Practical Implications

Optimizing Treatment Duration

The duration of ch'abc treatment should be carefully considered, as shorter durations may not provide the same benefits as longer durations, particularly for complex motor tasks.

Targeting Specific Neural Pathways

The study suggests that ch'abc primarily affects the rubrospinal tract (RuST) and that future therapies should consider targeting other neural pathways, such as the corticospinal tract (CST), to enhance overall recovery.

Combination Therapies

Ch'abc treatment is emerging as a treatment of choice in combination therapies.

Study Limitations

1
The adult CST shows relatively little axonal growth following axotomy even in the presence of added growth factors
2
Premature halting of ch'abc delivery may lock unrefined, possibly abhorrent circuits, into place
3
The neuronal counts used here definitively distinguish if there is an increase in the number of neurons contributing to growth below the lesion.

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