TARGETED NEUROPLASTICITY FOR REHABILITATION

Prog Brain Res, 2015 · DOI: 10.1016/bs.pbr.2015.02.002 · Published: January 1, 2015

Spinal Cord Injury Neuroplasticity Rehabilitation

Simple Explanation

Operant conditioning can be used to modify specific neural pathways in the central nervous system by rewarding specific EMG responses. This method has been shown to alter spinal reflexes, leading to broader changes in the spinal cord and brain, which can positively affect various behaviors, including locomotion. In individuals with spinal cord injuries, targeted reflex conditioning can initiate widespread beneficial plasticity, potentially improving multiple behaviors by adjusting the properties of spinal neurons and synapses.

Study Duration

8-10 weeks for human studies

Participants

Humans with and without spinal cord injury, monkeys, rats, and mice

Evidence Level

Not specified

Key Findings

1
Operant conditioning protocols can induce specific changes (up- or down-regulation) in targeted spinal reflexes, as demonstrated in various animal models and humans.
2
Conditioning-induced changes in spinal reflexes are associated with plasticity not only in the targeted pathway but also in other areas of the spinal cord and brain, including motoneuron properties and sensorimotor cortex.
3
In individuals with SCI, H-reflex down-conditioning can lead to improved locomotion, while in rats with SCI, H-reflex up-conditioning improved stance phase.

Research Summary

Operant conditioning protocols can modify specific CNS pathways by rewarding specific EMG responses, leading to changes in spinal reflexes and broader plasticity in the spinal cord and brain. The time course of reflex change in humans can be dissected into a rapid task-dependent adaptation component and a slow component reflecting long-term spinal cord plasticity. Operant conditioning of spinal reflexes has shown promise in improving gait recovery after chronic incomplete SCI, with the functional impact extending beyond the targeted pathway due to the spinal cord being a multi-user system.

Practical Implications

Therapeutic Potential

Operant conditioning protocols provide a promising therapeutic approach that can complement other rehabilitation methods and enhance functional recovery in individuals with spinal cord injuries.

Personalized Interventions

Targeted neuroplasticity induced by operant conditioning can address the specific functional deficits of individuals with spinal cord injuries or other CNS disorders, offering personalized interventions.

Understanding Plasticity

Researching the mechanisms of reflex conditioning can provide insights into the brain's capacity for plasticity and adaptation, leading to more effective rehabilitation strategies.

Study Limitations

1
Successful use requires strict adherence to appropriately designed procedures.
2
Close attention to accommodating and engaging the individual subject in the conditioning process is needed.
3
Consistency across sessions is essential for effective operant conditioning.

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