Importance of brain alterations in spinal cord injury

Science Progress, 2021 · DOI: 10.1177/00368504211031117 · Published: July 1, 2021

Spinal Cord Injury Neurology Regenerative Medicine & Stem Cells

Simple Explanation

Spinal cord injury (SCI) disrupts communication between the brain and body, affecting movement and autonomic functions. Studies show the brain changes after SCI, demonstrating its ability to adapt. Therapies aim to reconnect the brain to the limbs, and while research is ongoing, early findings suggest these reconnections can alter brain structure and function. The integration of brain function is the basis for the human body to exercise complex/fine movements and is intricately and widely regulated by information flow. Hence, its changes after SCI and treatments should be considered. This review summarizes the changes in brain structure and function after SCI from single cell (micro-level) to brain regions (macro-level) and discussed future research directions. Broadening the knowledge on the role of brain plasticity in functional restoration after SCI may support the development of effective repair strategies.

Study Duration

Not specified

Participants

Animal models (rats, monkeys, lampreys) and human patients

Evidence Level

Review Article

Key Findings

1
SCI causes neuronal death/atrophy in the brain, which might be attributed to a series of biochemical processes.
2
SCI modulates cortical neuronal response amplitude and changes the number and spike frequency of active neurons in cortical representation.
3
SCI induces extensive reorganization of neuronal circuits in the cerebral cortex and alters functional connections. The reorganization of brain function is one of the key factors for spontaneous functional recovery after SCI.

Research Summary

Spinal cord injury (SCI) disrupts the sensorimotor pathway, leading to autonomic function loss. Research indicates that SCI impacts brain structure and function, highlighting the brain's plasticity. Studies using brain-computer interfaces (BMI) show increased functional connectivity in the brain after training, suggesting the potential for limb function improvement through brain network reorganization. The review concludes that further research is needed to understand the regulatory mechanisms of brain functional reorganization after SCI and to develop precise therapeutic strategies.

Practical Implications

Therapeutic interventions

Targeting sensorimotor cortical activity through external interventions (e.g., transcranial direct current stimulation, exoskeleton training) can restore normal neural electrical activity and alleviate pain syndromes after SCI.

Brain-Computer Interfaces

The increasing application of brain-computer interfaces (BMI) in CNS injury provides evidence that establishing a connection between the peripheral nerve and the brain for SCI subjects can improve limb functions through visual feedback.

Rehabilitation Strategies

Understanding brain function alterations induced by therapies after SCI can reveal the underlying neural mechanisms of large-scale brain functional reorganization and its role in restoring physical functions.

Study Limitations

1
The regulatory mechanism of SCI on brain functional reorganization remains unclear.
2
Longitudinal progress of brain functional reorganization in neural regeneration has never been reported.
3
The relationship between the change in brain functions and the recovery of limb functions has not been established.

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