Plasticity in Cervical Motor Circuits following Spinal Cord Injury and Rehabilitation

Spinal cord injury results in a decreased quality of life and impacts hundreds of thousands of people in the US alone. This review discusses the underlying cellular mechanisms of injury and the concurrent therapeutic hurdles that impede recovery. The neural plasticity that occurs without intervention is discussed, which shows new connections growing around the injury site and the involvement of compensatory movements. Rehabilitation-driven neural plasticity is shown to have the ability to guide connections to create more normal functions. Overall, this review seeks to delineate the historical and contemporary research into neural plasticity following injury and rehabilitation to guide future studies.

• 1
  Spontaneous plasticity of the spared components of the CST is a compensatory mechanism underlying forelimb motor recovery, as opposed to the restoration and/or regeneration of the damaged motor tract.
• 2
  After experimental SCI, nociceptive primary afferent fibers display a robust and maladaptive increase in their terminal arborizations in the dorsal horn and display hyperexcitability and increased spontaneous activity.
• 3
  Combinatorial therapies yield the greatest results, in particular rehabilitative strategies capitalize on the ability of the primary afferent to adapt and change in order to improve function after an injury.