Neurology

From spinal cord injury to recovery



neurosciencestuff:

Spinal cord injury disconnects communication between the brain and
the spinal cord, disrupting control over part of the body. Studying the
mechanisms of recovery, Leuven researcher Aya Takeoka (NERF) found that a
specific type of neuronal feedback from sites below the injury plays a
crucial role during early recovery and for maintaining regained motor
functions. These new basic research findings implicate the importance of
continued use of affected body parts for rehabilitative success in
spinal cord injury patients.

“Following spinal cord injury, disrupted neuronal pathways can no
longer provide sufficiently strong signals to the spinal networks below
the injury, often leading to permanent and devastating motor
impairment,” explains prof. Aya Takeoka from NERF (NeuroElectronics
Research Flanders), an interdisciplinary research center empowered by
VIB, KU Leuven and imec. Her lab studies the mechanisms of motor
learning and control, including how motor functions recover after
injury.

“Incomplete injuries, where only part of the neuronal connections
are damaged, frequently recover spontaneously,” adds Takeoka. “We know
that activating a very specific type of sensory feedback pathway plays a
crucial role during rehabilitative training, promoting the formation of
detour circuits. Understanding this process in more detail can help us
design rehabilitation strategies with maximal benefit for spinal cord
injury patients.”

Early and maintained feedback for maximal success

One type of so-called somatosensory feedback is proprioception,
which entails the unconscious perception of self-movement and body
position through nerve cells that are located in close proximity of the
spinal cord and can detect muscle stretch.

To learn more about where and when proprioceptive feedback affects
locomotor recovery after injury, Takeoka devised a conditional genetic
approach to eliminate this type of feedback at different locations and
time points in mice. Using these models, she showed that proprioceptive
feedback below but not above the site of injury is critical for
naturally occurring circuit rearrangement and locomotor recovery.

“We found a central role for so-called proprioceptive afferents,
nerve fibers which signal proprioceptive information back to the spinal
cord,” says Takeoka. “Afferents below the lesion undergo specific
rearrangements soon after injury, and without them regained motor
function cannot be maintained, even if detour circuits have formed.”

In short, proprioceptive feedback is not only essential to initiate
locomotor recovery but it is also permanently required to maintain any
regained motor function. According to Takeoka, these findings can inform
rehabilitation practices for patients as well: “The fact that
proprioceptive feedback, specifically from below the site of injury, is
so important, suggests that task-specific rehabilitative training that
emphasizes such feedback is likely to maximize functional outcomes in
rehabilitation clinics.”

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