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Su H, Luo H, Wang Y, Zhao Q, Zhang Q, Zhu Y, Pan L, Liu Y, Yang C, Yin Y, Tan B. Myelin repair of spinal cord injury in adult mice induced by treadmill training upregulated peroxisome proliferator-activated receptor gamma coactivator 1 alpha. Glia 2024; 72:607-624. [PMID: 38031815 DOI: 10.1002/glia.24493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
Growing evidence has proven the efficacy of physical exercise in remyelination and motor function performance after spinal cord injury (SCI). However, the molecular mechanisms of treadmill training on myelin repair and functional recovery after SCI have not yet been fully studied. Here, we explored the effect of treadmill training on upregulating peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC1α)-mediated myelin repair and functional recovery in a mouse model of thoracic T10 contusion injury. A 4-week treadmill training scheme was conducted on mice with SCI. The expression levels of oligodendrogenesis-related protein and PGC1α were detected by immunofluorescence, RNA fluorescence in situ hybridization and western blotting. Transmission electron microscopy (TEM) was used to observe myelin structure. The Basso Mouse Scale (BMS) and CatWalk automated gait analysis system were used for motor function recovery evaluation. Motor evoked potentials (MEPs) were also identified. In addition, adeno-associated virus (AAV)-mediated PGC1α knockdown in OLs was used to further unravel the role of PGC1α in exercise-induced remyelination. We found that treadmill training boosts oligodendrocyte precursor cells (OPCs) proliferation, potentiates oligodendrocytes (OLs) maturation, and increases myelin-related protein and myelin sheath thickness, thus impelling myelin repair and hindlimb functional performance as well as the speed and amplitude of nerve conduction after SCI. Additionally, downregulating PGC1α through AAV attenuated these positive effects of treadmill training. Collectively, our results suggest that treadmill training enhances remyelination and functional recovery by upregulating PGC1α, which should provide a step forward in the understanding of the effects of physical exercise on myelin repair.
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Affiliation(s)
- Hong Su
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haodong Luo
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunhang Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qin Zhao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Zhu
- State Key Laboratory of Trauma, Burns and Combined Injuries, Department of Special Environment War Wound Prevention and Treatment, Institute of Surgery Research, Army Medical Center of PLA, Chongqing, China
| | - Lu Pan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuan Liu
- State Key Laboratory of Trauma, Burns and Combined Injuries, Department of Special Environment War Wound Prevention and Treatment, Institute of Surgery Research, Army Medical Center of PLA, Chongqing, China
| | - Ce Yang
- State Key Laboratory of Trauma, Burns and Combined Injuries, Department of Special Environment War Wound Prevention and Treatment, Institute of Surgery Research, Army Medical Center of PLA, Chongqing, China
| | - Ying Yin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Botao Tan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Feng F, Xu DQ, Yue SJ, Chen YY, Tang YP. Neuroprotection by tetramethylpyrazine and its synthesized analogues for central nervous system diseases: a review. Mol Biol Rep 2024; 51:159. [PMID: 38252346 DOI: 10.1007/s11033-023-09068-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/24/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Due to the global increase in aging populations and changes in modern lifestyles, the prevalence of neurodegenerative diseases, cerebrovascular disorders, neuropsychiatrcic conditions, and related ailments is rising, placing an increasing burden on the global public health system. MATERIALS AND METHODS All studies on tetramethylpyrazine (TMP) and its derivatives were obtained from reputable sources such as PubMed, Elsevier, Library Genesis, and Google Scholar. Comprehensive data on TMP and its derivatives was meticulously compiled. RESULTS This comprehensive analysis explains the neuroprotective effects demonstrated by TMP and its derivatives in diseases of the central nervous system. These compounds exert their influence on various targets and signaling pathways, playing crucial roles in the development of various central nervous system diseases. Their multifaceted mechanisms include inhibiting oxidative damage, inflammation, cell apoptosis, calcium overload, glutamate excitotoxicity, and acetylcholinesterase activity. CONCLUSION This review provides a brief summary of the most recent advancements in research on TMP and its derivatives in the context of central nervous system diseases. It involves synthesizing analogs of TMP and evaluating their effectiveness in models of central nervous system diseases. The ultimate goal is to facilitate the practical application of TMP and its derivatives in the future treatment of central nervous system diseases.
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Affiliation(s)
- Fan Feng
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, State Key Laboratory of Research & Development of Characteristic Qin Medicine Resources (Cultivation), Shaanxi Key Laboratory of Chinese Medicine Fundamentals and New Drugs Research, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Ding-Qiao Xu
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, State Key Laboratory of Research & Development of Characteristic Qin Medicine Resources (Cultivation), Shaanxi Key Laboratory of Chinese Medicine Fundamentals and New Drugs Research, Shaanxi University of Chinese Medicine, Xi'an, China.
| | - Shi-Jun Yue
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, State Key Laboratory of Research & Development of Characteristic Qin Medicine Resources (Cultivation), Shaanxi Key Laboratory of Chinese Medicine Fundamentals and New Drugs Research, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Yan-Yan Chen
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, State Key Laboratory of Research & Development of Characteristic Qin Medicine Resources (Cultivation), Shaanxi Key Laboratory of Chinese Medicine Fundamentals and New Drugs Research, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Yu-Ping Tang
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, State Key Laboratory of Research & Development of Characteristic Qin Medicine Resources (Cultivation), Shaanxi Key Laboratory of Chinese Medicine Fundamentals and New Drugs Research, Shaanxi University of Chinese Medicine, Xi'an, China.
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Moro V, Beccherle M, Scandola M, Aglioti SM. Massive body-brain disconnection consequent to spinal cord injuries drives profound changes in higher-order cognitive and emotional functions: A PRISMA scoping review. Neurosci Biobehav Rev 2023; 154:105395. [PMID: 37734697 DOI: 10.1016/j.neubiorev.2023.105395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 09/23/2023]
Abstract
Spinal cord injury (SCI) leads to a massive disconnection between the brain and the body parts below the lesion level representing a unique opportunity to explore how the body influences a person's mental life. We performed a systematic scoping review of 59 studies on higher-order cognitive and emotional changes after SCI. The results suggest that fluid abilities (e.g. attention, executive functions) and emotional regulation (e.g. emotional reactivity and discrimination) are impaired in people with SCI, with progressive deterioration over time. Although not systematically explored, the factors that are directly (e.g. the severity and level of the lesion) and indirectly associated (e.g. blood pressure, sleeping disorders, medication) with the damage may play a role in these deficits. The inconsistency which was found in the results may derive from the various methods used and the heterogeneity of samples (i.e. the lesion completeness, the time interval since lesion onset). Future studies which are specifically controlled for methods, clinical and socio-cultural dimensions are needed to better understand the role of the body in cognition.
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Affiliation(s)
- Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy.
| | - Maddalena Beccherle
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy; Department of Psychology, Sapienza University of Rome and cln2s@sapienza Istituto Italiano di Tecnologia, Italy.
| | - Michele Scandola
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy
| | - Salvatore Maria Aglioti
- Department of Psychology, Sapienza University of Rome and cln2s@sapienza Istituto Italiano di Tecnologia, Italy; Fondazione Santa Lucia IRCCS, Roma, Italy
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Sinovas-Alonso I, Herrera-Valenzuela D, de-Los-Reyes-Guzmán A, Cano-de-la-Cuerda R, Del-Ama AJ, Gil-Agudo Á. Construct Validity of the Gait Deviation Index for People With Incomplete Spinal Cord Injury (GDI-SCI). Neurorehabil Neural Repair 2023; 37:705-715. [PMID: 37864467 DOI: 10.1177/15459683231206747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
BACKGROUND The Gait Deviation Index for Spinal Cord Injury (SCI-GDI) was recently proposed as a dimensionless multivariate kinematic measure based on 21 gait features derived from 3-dimensional kinematic data which quantifies gait impairment of adult population with incomplete spinal cord injury (iSCI) relative to the normative gait of a healthy group. Nevertheless, no validity studies of the SCI-GDI have been published to date. OBJECTIVE To assess the construct validity of the SCI-GDI in adult population following iSCI. Methods. SCI-GDI data were obtained from a sample of 50 healthy volunteers and 35 adults with iSCI. iSCI group was also assessed with the following measures: 10-Meter Walk Test (10MWT) at both self-selected (SS) and maximum speeds, Timed Up and Go Test (TUGT), SS and maximum levels of the Walking Index for Spinal Cord Injury (WISCI) II, mobility items of the Spinal Cord Independence Measure III (SCIM IIIIOMob), Lower Extremity Motor Score (LEMS), and Modified Ashworth Scale (MAS). Spearman's correlation coefficient was used to investigate the relationship with the SCI-GDI. RESULTS SCI-GDI shows strong correlation with the 10MWT (r ≥ -.716) and good correlation with LEMS (r = .638), TUGT (r = -.582), SS WISCI II levels (r = .521), and SCIM IIIIOMob (r = .501). No significant correlations were found with maximum WISCI II levels and MAS (P > .006). CONCLUSIONS Construct validity of the SCI-GDI was demonstrated with the 10MWT, TUGT, LEMS, SCIM IIIIOMob, and SS WISCI II levels for independently walking adults with iSCI. Future work will include assessing the psychometric characteristics with a more heterogeneous sample, also considering the pediatric population.
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Affiliation(s)
- Isabel Sinovas-Alonso
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics (SESCAM), Toledo, Spain
- International Doctoral School, Rey Juan Carlos University, Madrid, Spain
| | - Diana Herrera-Valenzuela
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics (SESCAM), Toledo, Spain
- International Doctoral School, Rey Juan Carlos University, Madrid, Spain
| | - Ana de-Los-Reyes-Guzmán
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics (SESCAM), Toledo, Spain
- Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), RDI Associated Unit of the CSIC, Toledo, Spain
| | - Roberto Cano-de-la-Cuerda
- Movement Analysis, Biomechanics, Ergonomics and Motor Control Laboratory (LAMBECOM), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Antonio J Del-Ama
- Department of Applied Mathematics, Materials Science and Engineering, and Electronic Technology, School of Science and Technology, Rey Juan Carlos University, Madrid, Spain
| | - Ángel Gil-Agudo
- Biomechanics and Technical Aids Unit, National Hospital for Paraplegics (SESCAM), Toledo, Spain
- Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), RDI Associated Unit of the CSIC, Toledo, Spain
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Hamad I, Van Broeckhoven J, Cardilli A, Hellings N, Strowig T, Lemmens S, Hendrix S, Kleinewietfeld M. Effects of Recombinant IL-13 Treatment on Gut Microbiota Composition and Functional Recovery after Hemisection Spinal Cord Injury in Mice. Nutrients 2023; 15:4184. [PMID: 37836468 PMCID: PMC10574124 DOI: 10.3390/nu15194184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 10/15/2023] Open
Abstract
In recent years, the gut-central nervous system axis has emerged as a key factor in the pathophysiology of spinal cord injury (SCI). Interleukin-13 (IL-13) has been shown to have anti-inflammatory and neuroprotective effects in SCI. The aim of this study was to investigate the changes in microbiota composition after hemisection injury and to determine whether systemic recombinant (r)IL-13 treatment could alter the gut microbiome, indirectly promoting functional recovery. The gut microbiota composition was determined by 16S rRNA gene sequencing, and correlations between gut microbiota alterations and functional recovery were assessed. Our results showed that there were no changes in alpha diversity between the groups before and after SCI, while PERMANOVA analysis for beta diversity showed significant differences in fecal microbial communities. Phylogenetic classification of bacterial families revealed a lower abundance of the Bacteroidales S24-7 group and a higher abundance of Lachnospiraceae and Lactobacillaceae in the post-SCI group. Systemic rIL-13 treatment improved functional recovery 28 days post-injury and microbiota analysis revealed increased relative abundance of Clostridiales vadin BB60 and Acetitomaculum and decreased Anaeroplasma, Ruminiclostridium_6, and Ruminococcus compared to controls. Functional assessment with PICRUSt showed that genes related to glyoxylate cycle and palmitoleate biosynthesis-I were the predominant signatures in the rIL-13-treated group, whereas sulfolactate degradation super pathway and formaldehyde assimilation-I were enriched in controls. In conclusion, our results indicate that rIL-13 treatment promotes changes in gut microbial communities and may thereby contribute indirectly to the improvement of functional recovery in mice, possibly having important implications for the development of novel treatment options for SCI.
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Affiliation(s)
- Ibrahim Hamad
- VIB Laboratory of Translational Immunomodulation, Center for Inflammation Research (IRC), Hasselt University, 3590 Diepenbeek, Belgium (A.C.)
- Department of Immunology and Infection, Biomedical Research Institute (BIOMED), Hasselt University, 3590 Diepenbeek, Belgium; (J.V.B.); (N.H.)
| | - Jana Van Broeckhoven
- Department of Immunology and Infection, Biomedical Research Institute (BIOMED), Hasselt University, 3590 Diepenbeek, Belgium; (J.V.B.); (N.H.)
| | - Alessio Cardilli
- VIB Laboratory of Translational Immunomodulation, Center for Inflammation Research (IRC), Hasselt University, 3590 Diepenbeek, Belgium (A.C.)
- Department of Immunology and Infection, Biomedical Research Institute (BIOMED), Hasselt University, 3590 Diepenbeek, Belgium; (J.V.B.); (N.H.)
| | - Niels Hellings
- Department of Immunology and Infection, Biomedical Research Institute (BIOMED), Hasselt University, 3590 Diepenbeek, Belgium; (J.V.B.); (N.H.)
| | - Till Strowig
- Department of Microbial Immune Regulation, Helmholtz Center for Infection Research, 38124 Braunschweig, Germany
| | - Stefanie Lemmens
- Department of Immunology and Infection, Biomedical Research Institute (BIOMED), Hasselt University, 3590 Diepenbeek, Belgium; (J.V.B.); (N.H.)
| | - Sven Hendrix
- Institute for Translational Medicine, Medical School Hamburg, 20457 Hamburg, Germany
| | - Markus Kleinewietfeld
- VIB Laboratory of Translational Immunomodulation, Center for Inflammation Research (IRC), Hasselt University, 3590 Diepenbeek, Belgium (A.C.)
- Department of Immunology and Infection, Biomedical Research Institute (BIOMED), Hasselt University, 3590 Diepenbeek, Belgium; (J.V.B.); (N.H.)
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de Sire A, Moggio L, Marotta N, Curci C, Lippi L, Invernizzi M, Mezian K, Ammendolia A. Impact of rehabilitation on volumetric muscle loss in subjects with traumatic spinal cord injury: A systematic review. NeuroRehabilitation 2023; 52:365-386. [PMID: 36806523 DOI: 10.3233/nre-220277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Spinal cord injury (SCI) leads to spinal nerve fiber tract damage resulting in functional impairments. Volumetric muscle loss (VML), a skeletal muscle volume abnormal reduction, is represented by atrophy below the injury level. The strategies for VML management included personalized approaches, and no definite indications are available. OBJECTIVE To identify the rehabilitation effects of VML in subjects with SCI (humans and animals). METHODS PubMed, Scopus, and Web of Science databases were systematically searched to identify longitudinal observational studies with individuals affected by traumatic SCI as participants; rehabilitation treatment as intervention; no control, sham treatment, and electrical stimulation programs as control; total lean body and lower limb lean mass, cross-sectional area, functional gait recovery, muscle thickness, and ultrasound intensity, as outcome. RESULTS Twenty-four longitudinal observational studies were included, evaluating different rehabilitation approaches' effects on the VML reduction in subjects affected by SCI. The data showed that electrical stimulation and treadmill training are effective in reducing the VML in this population. CONCLUSION This systematic review underlines the need to treat subjects with traumatic SCI (humans and animals) with different rehabilitation approaches to prevent VML in the subacute and chronic phases. Further clinical observations are needed to overcome the bias and to define the intervention's timing and modalities.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy.,Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Lucrezia Moggio
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy.,Rehabilitation Unit, Ospedale degliInfermi, Biella, Italy
| | - Nicola Marotta
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy
| | - Claudio Curci
- Department of Neurosciences, Physical Medicine and Rehabilitation Unit, ASST CarloPoma, Mantova, Italy
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, DipartimentoAttività Integrate Ricerca e Innovazione (DAIRI), AziendaOspedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, DipartimentoAttività Integrate Ricerca e Innovazione (DAIRI), AziendaOspedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General UniversityHospital in Prague, Prague, Czech Republic
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, Physical Medicine and Rehabilitation Unit, University of CatanzaroMagna Graecia, Catanzaro, Italy
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Arienti C, Patrini M, Negrini S, Kiekens C. Overview of Cochrane Systematic Reviews for Rehabilitation Interventions in Persons With Spinal Cord Injury: A Mapping Synthesis. Arch Phys Med Rehabil 2023; 104:143-150. [PMID: 35905770 DOI: 10.1016/j.apmr.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This article aims to describe the evidence on rehabilitation interventions for persons with spinal cord injury (SCI) identified in Cochrane Systematic Reviews (CSRs) selected for inclusion in the World Health Organization Rehabilitation Programme-Package of Interventions for Rehabilitation. DATA SOURCES The CSRs search was led by the Cochrane Rehabilitation team, using the tagging process, using the terms "spinal cord injury" and "rehabilitation" in the Cochrane Library. STUDY SELECTION We performed an overview of all the CSRs according to the inclusion criteria defined with the World Health Organization: rehabilitation interventions in persons with SCI. DATA EXTRACTION The CSRs identified after the screening process were summarized using an evidence map, grouping outcomes, and comparisons of included CSRs indicating the effect and the quality of evidence to provide a comprehensive view of what is known. DATA SYNTHESIS Out of 248 CSRs from the past 10 years tagged in the Cochrane Rehabilitation database, 3 were related to SCI. They provide data on 13 outcomes analyzed within 11 comparisons for a total of 64 primary studies, including 2024 participants with SCI. Of these, 7 outcomes and 1 comparison focused on people with cervical SCI. Rehabilitation interventions might improve respiratory outcomes and pain relief in people with SCI. There is uncertainty whether bodyweight-supported treadmill training, robotic-assisted training, and functional electrostimulation affect walking speed and capacity. CONCLUSIONS The current evidence needs to be confirmed by better quality research. Therefore, future priorities are the improvement of methodological quality of the studies in people with SCI, particularly considering the complexity of this health condition. Further, there is a need for more CSRs in the field.
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Affiliation(s)
| | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan; IRCCS Istituto Ortopedico Galeazzi, Milan.
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Pecchinenda A, Gonzalez Pizzio AP, Salera C, Pazzaglia M. The role of arousal and motivation in emotional conflict resolution: Implications for spinal cord injury. Front Hum Neurosci 2022; 16:927622. [PMID: 36277056 PMCID: PMC9579344 DOI: 10.3389/fnhum.2022.927622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/20/2022] [Indexed: 12/28/2022] Open
Abstract
Under many conditions, emotional information is processed with priority and it may lead to cognitive conflict when it competes with task-relevant information. Accordingly, being able to ignore emotional information relies on cognitive control. The present perspective offers an integrative account of the mechanism that may underlie emotional conflict resolution in tasks involving response activation. We point to the contribution of emotional arousal and primed approach or avoidance motivation in accounting for emotional conflict resolution. We discuss the role of arousal in individuals with impairments in visceral pathways to the brain due to spinal cord lesions, as it may offer important insights into the “typical” mechanisms of emotional conflict control. We argue that a better understanding of emotional conflict control could be critical for adaptive and flexible behavior and has potential implications for the selection of appropriate therapeutic interventions.
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Affiliation(s)
- Anna Pecchinenda
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
- *Correspondence: Anna Pecchinenda,
| | - Adriana Patrizia Gonzalez Pizzio
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Ph.D. Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Claudia Salera
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Ph.D. Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Mariella Pazzaglia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
- Mariella Pazzaglia,
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9
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Rahimi B, Aliaghaei A, Ramezani F, Behroozi Z, Nasirinezhad F. Sertoli cell transplantation attenuates microglial activation and inhibits TRPC6 expression in neuropathic pain induced by spinal cord injury. Physiol Behav 2022; 251:113807. [PMID: 35427673 DOI: 10.1016/j.physbeh.2022.113807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/10/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cell therapy is a promising treatment method for relieving neuropathic pain caused by spinal cord injuries (SCI). Sertoli cells (SCs) are an attractive choice given their demonstrated secretion of growth factors and immunosuppressant effect. This study mechanistically characterizes the analgesic effect of SCs transplantation. METHODS The clip compression SCI model was carried out on the T12-T13 level in male Wistar rats. One-week post-SCI, SCs were transplanted into the site of injury. Animals underwent Basso, Beattie, and Bresnahan locomotor scoring, mechanical allodynia, and thermal hyperalgesia on a weekly basis for a duration of six weeks. Histological examination of the spinal cord and molecular evaluation of Iba-1, P2Y4, TRPC6, and P-mTOR were performed. SCs survival, measured by anti-Müllerian hormone expression in the spinal cord. RESULTS Animals that received SCs transplantation showed improvement in motor function recovery and pain relief. Furthermore, a cavity was significantly decreased in the transplanted animals (p = 0.0024), the expression level of TRPC6 and caspase3 and the number of activated microglia decreased compared to the SCI animals, and p-mTOR and P2Y4R expression remarkably increased compared to the SCI group. CONCLUSION SCs transplantation produces an analgesic effect which may represent a promising treatment for SCI-induced chronic pain.
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Affiliation(s)
- Behnaz Rahimi
- Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Aliaghaei
- Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ramezani
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Behroozi
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Farinaz Nasirinezhad
- Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran; Center for experimental and comparative study, Iran university of medical sciences, Tehran, Iran.
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10
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Warmerdam E, Schumacher M, Beyer T, Nerdal PT, Schebesta L, Stürner KH, Zeuner KE, Hansen C, Maetzler W. Postural Sway in Parkinson's Disease and Multiple Sclerosis Patients During Tasks With Different Complexity. Front Neurol 2022; 13:857406. [PMID: 35422747 PMCID: PMC9001932 DOI: 10.3389/fneur.2022.857406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Neurological diseases are associated with static postural instability. Differences in postural sway between neurological diseases could include "conceptual" information about how certain symptoms affect static postural stability. This information might have the potential to become a helpful aid during the process of finding the most appropriate treatment and training program. Therefore, this study investigated static postural sway performance of Parkinson's disease (PD) and multiple sclerosis (MS) patients, as well as of a cohort of healthy adults. Three increasingly difficult static postural tasks were performed, in order to determine whether the postural strategies of the two disease groups differ in response to the increased complexity of the balance task. Participants had to perform three stance tasks (side-by-side, semi-tandem and tandem stance) and maintain these positions for 10 s. Seven static sway parameters were extracted from an inertial measurement unit that participants wore on the lower back. Data of 47 healthy adults, 14 PD patients and 8 MS patients were analyzed. Both healthy adults and MS patients showed a substantial increase in several static sway parameters with increasingly complex stance tasks, whereas PD patients did not. In the MS patients, the observed substantial change was driven by large increases from semi-tandem and tandem stance. This study revealed differences in static sway adaptations between PD and MS patients to increasingly complex stance tasks. Therefore, PD and MS patients might require different training programs to improve their static postural stability. Moreover, this study indicates, at least indirectly, that rigidity/bradykinesia and spasticity lead to different adaptive processes in static sway.
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Affiliation(s)
- Elke Warmerdam
- Department of Neurology, Kiel University, Kiel, Germany.,Innovative Implant Development (Fracture Healing), Division of Surgery, Saarland University, Homburg, Germany
| | | | - Thorben Beyer
- Department of Neurology, Kiel University, Kiel, Germany
| | | | | | | | | | - Clint Hansen
- Department of Neurology, Kiel University, Kiel, Germany
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11
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Sivakanthan S, Feroze A, Eaton J, Saigal R. Three Column Cervical Fracture-Dislocation in a 3-Year-Old Boy. Cureus 2022; 14:e23213. [PMID: 35449661 PMCID: PMC9012570 DOI: 10.7759/cureus.23213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/07/2022] Open
Abstract
Complete traumatic cervical fracture-dislocation with spinal cord transection in children is a rare entity with no evidence-based guidelines on management. The authors reviewed the literature for pediatric spinal cord injury and present the case of a 3-year-old with traumatic cervical fracture-dislocation and spinal cord transection who presented as a cervical-6 complete spinal cord injury (ASIA A). His other organ systems injured included liver, spleen, bowel, and abdominal aortic injury. The patient underwent halo placement for preoperative reduction followed by open reduction and internal fixation with posterior segmental instrumented fusion. Intraoperatively, the patient had motor evoked potential signals present below the level of his injury. Early postoperative follow-up demonstrated that, although his leg function did not improve, he did demonstrate improvement in upper extremities. This is a rare case of complete cervical spinal cord transection in a pediatric patient. We elected to manage this challenging case with initial external reduction and orthosis with a halo vest followed by acute posterior cervical fusion. Despite a cervical-6 injury level on clinical exam, there was electrographic evidence of function below that level on intraoperative neuromonitoring. Postoperatively the patient has recovered some lost function.
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12
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Müller-Putz GR, Kobler RJ, Pereira J, Lopes-Dias C, Hehenberger L, Mondini V, Martínez-Cagigal V, Srisrisawang N, Pulferer H, Batistić L, Sburlea AI. Feel Your Reach: An EEG-Based Framework to Continuously Detect Goal-Directed Movements and Error Processing to Gate Kinesthetic Feedback Informed Artificial Arm Control. Front Hum Neurosci 2022; 16:841312. [PMID: 35360289 PMCID: PMC8961864 DOI: 10.3389/fnhum.2022.841312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Establishing the basic knowledge, methodology, and technology for a framework for the continuous decoding of hand/arm movement intention was the aim of the ERC-funded project “Feel Your Reach”. In this work, we review the studies and methods we performed and implemented in the last 6 years, which build the basis for enabling severely paralyzed people to non-invasively control a robotic arm in real-time from electroencephalogram (EEG). In detail, we investigated goal-directed movement detection, decoding of executed and attempted movement trajectories, grasping correlates, error processing, and kinesthetic feedback. Although we have tested some of our approaches already with the target populations, we still need to transfer the “Feel Your Reach” framework to people with cervical spinal cord injury and evaluate the decoders’ performance while participants attempt to perform upper-limb movements. While on the one hand, we made major progress towards this ambitious goal, we also critically discuss current limitations.
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Affiliation(s)
- Gernot R. Müller-Putz
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
- BioTechMed, Graz, Austria
- *Correspondence: Gernot R. Müller-Putz
| | - Reinmar J. Kobler
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
- RIKEN Center for Advanced Intelligence Project, Kyoto, Japan
| | - Joana Pereira
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
- Brain-State Decoding Lab, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
- Stereotaxy and Functional Neurosurgery Department, Uniklinik Freiburg, Freiburg, Germany
| | - Catarina Lopes-Dias
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
| | - Lea Hehenberger
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
| | - Valeria Mondini
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
| | - Víctor Martínez-Cagigal
- Biomedical Engineering Group, E.T.S. Ingenieros de Telecomunicación, University of Valladolid, Valladolid, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | | | - Hannah Pulferer
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
| | - Luka Batistić
- Faculty of Engineering, Department of Computer Engineering, University of Rijeka, Rijeka, Croatia
| | - Andreea I. Sburlea
- Institute of Neural Engineering, Graz University of Technology, Graz, Austria
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13
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Dolci S, Mannino L, Bottani E, Campanelli A, Di Chio M, Zorzin S, D'Arrigo G, Amenta A, Segala A, Paglia G, Denti V, Fumagalli G, Nisoli E, Valerio A, Verderio C, Martano G, Bifari F, Decimo I. Therapeutic Induction of Energy Metabolism Reduces Neural Tissue Damage and Increases Microglia Activation in Severe Spinal Cord Injury. Pharmacol Res 2022; 178:106149. [PMID: 35240272 DOI: 10.1016/j.phrs.2022.106149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/16/2022] [Accepted: 02/26/2022] [Indexed: 01/11/2023]
Abstract
Neural tissue has high metabolic requirements. Following spinal cord injury (SCI), the damaged, tissue suffers from a severe metabolic impairment, which aggravates axonal degeneration and, neuronal loss. Impaired cellular energetic, tricarboxylic acid (TCA) cycle and oxidative, phosphorylation metabolism in neuronal cells has been demonstrated to be a major cause of neural tissue death and regeneration failure following SCI. Therefore, rewiring the spinal cord cell metabolism may be an innovative therapeutic strategy for the treatment of SCI. In this study, we evaluated the therapeutic effect of the recovery of oxidative metabolism in a mouse model of severe contusive SCI. Oral administration of TCA cycle intermediates, co-factors, essential amino acids, and branched-chain amino acids was started 3 days post-injury and continued until the end of the experimental procedures. Metabolomic, immunohistological, and biochemical analyses were performed on the injured spinal cord sections. Administration of metabolic precursors enhanced spinal cord oxidative metabolism. In line with this metabolic shift, we observed the activation of the mTORC1 anabolic pathway, the increase in mitochondrial mass, and ROS defense which effectively prevented the injury-induced neural cell apoptosis in treated animals. Consistently, we found more choline acetyltransferase (ChAT)-expressing motor neurons and increased neurofilament positive corticospinal axons in the spinal cord parenchyma of the treated mice. Interestingly, oral administration of the metabolic precursors increased the number of activated microglia expressing the CD206 marker suggestive of a, pro-resolutive, M2-like phenotype. These molecular and histological modifications observed in treated animals ultimately led to a significant, although partial, improvement of the motor functions. Our data demonstrate that rewiring the cellular metabolism can represent an effective strategy to treat SCI.
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Affiliation(s)
- Sissi Dolci
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | - Loris Mannino
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | - Emanuela Bottani
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | - Alessandra Campanelli
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | - Marzia Di Chio
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | - Stefania Zorzin
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | | | - Alessia Amenta
- Laboratory of Cell Metabolism and Regenerative Medicine, Department of Medical Biotechnology and Translational Medicine, University of Milan, 20133, Italy
| | - Agnese Segala
- Department of Molecular and Translational Medicine, University of Brescia, 25121, Italy
| | - Giuseppe Paglia
- School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, 20126, Italy
| | - Vanna Denti
- School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, 20126, Italy
| | - Guido Fumagalli
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy
| | - Enzo Nisoli
- Center for Study and Research on Obesity, Department of Medical Biotechnology and Translational Medicine, University of Milan, 20133, Italy
| | - Alessandra Valerio
- Department of Molecular and Translational Medicine, University of Brescia, 25121, Italy
| | | | | | - Francesco Bifari
- Laboratory of Cell Metabolism and Regenerative Medicine, Department of Medical Biotechnology and Translational Medicine, University of Milan, 20133, Italy.
| | - Ilaria Decimo
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, 37134, Italy.
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14
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Tang F, Tang J, Zhao Y, Zhang J, Xiao Z, Chen B, Han G, Yin N, Jiang X, Zhao C, Cheng S, Wang Z, Chen Y, Chen Q, Song K, Zhang Z, Niu J, Wang L, Shi Q, Chen L, Yang H, Hou S, Zhang S, Dai J. Long-term clinical observation of patients with acute and chronic complete spinal cord injury after transplantation of NeuroRegen scaffold. SCIENCE CHINA-LIFE SCIENCES 2021; 65:909-926. [PMID: 34406569 DOI: 10.1007/s11427-021-1985-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/08/2021] [Indexed: 02/05/2023]
Abstract
Spinal cord injury (SCI) often results in an inhibitory environment at the injury site. In our previous studies, transplantation of a scaffold combined with stem cells was proven to induce neural regeneration in animal models of complete SCI. Based on these preclinical studies, collagen scaffolds loaded with the patients' own bone marrow mononuclear cells or human umbilical cord mesenchymal stem cells were transplanted into SCI patients. Fifteen patients with acute complete SCI and 51 patients with chronic complete SCI were enrolled and followed up for 2 to 5 years. No serious adverse events related to functional scaffold transplantation were observed. Among the patients with acute SCI, five patients achieved expansion of their sensory positions and six patients recovered sensation in the bowel or bladder. Additionally, four patients regained voluntary walking ability accompanied by reconnection of neural signal transduction. Among patients with chronic SCI, 16 patients achieved expansion of their sensation level and 30 patients experienced enhanced reflexive defecation sensation or increased skin sweating below the injury site. Nearly half of the patients with chronic cervical SCI developed enhanced finger activity. These long-term follow-up results suggest that functional scaffold transplantation may represent a feasible treatment for patients with complete SCI.
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Affiliation(s)
- Fengwu Tang
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China
| | - Jiaguang Tang
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China.,Department of Orthopaedics, Beijing Tongren Hospital, Beijing, 100730, China
| | - Yannan Zhao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100190, China.,Beijing ZhongKeZaiKang Biotechnology Co., Ltd, Beijing, 101407, China
| | - Jiaojiao Zhang
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zhifeng Xiao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100190, China.,Beijing ZhongKeZaiKang Biotechnology Co., Ltd, Beijing, 101407, China
| | - Bing Chen
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100190, China
| | - Guang Han
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China
| | - Na Yin
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China.,Department of Rehabilitation, the 983rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Tianjin, 300141, China
| | - Xianfeng Jiang
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China
| | - Changyu Zhao
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China
| | - Shixiang Cheng
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China
| | - Ziqiang Wang
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China
| | - Yumei Chen
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China
| | - Qiaoling Chen
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China
| | - Keran Song
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China
| | - Zhiwei Zhang
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China
| | - Junjie Niu
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Lingjun Wang
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Qin Shi
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Liang Chen
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Huilin Yang
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Shuxun Hou
- Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China.
| | - Sai Zhang
- Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China.
| | - Jianwu Dai
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100190, China.
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15
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Takase H, Regenhardt RW. Motor tract reorganization after acute central nervous system injury: a translational perspective. Neural Regen Res 2021; 16:1144-1149. [PMID: 33269763 PMCID: PMC8224132 DOI: 10.4103/1673-5374.300330] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Acute central nervous system injuries are among the most common causes of disability worldwide, with widespread social and economic implications. Motor tract injury accounts for the majority of this disability; therefore, there is impetus to understand mechanisms underlying the pathophysiology of injury and subsequent reorganization of the motor tract that may lead to recovery. After acute central nervous system injury, there are changes in the microenvironment and structure of the motor tract. For example, ischemic stroke involves decreased local blood flow and tissue death from lack of oxygen and nutrients. Traumatic injury, in contrast, causes stretching and shearing injury to microstructures, including myelinated axons and their surrounding vessels. Both involve blood-brain barrier dysfunction, which is an important initial event. After acute central nervous system injury, motor tract reorganization occurs in the form of cortical remapping in the gray matter and axonal regeneration and rewiring in the white matter. Cortical remapping involves one cortical region taking on the role of another. cAMP-response-element binding protein is a key transcription factor that can enhance plasticity in the peri-infarct cortex. Axonal regeneration and rewiring depend on complex cell-cell interactions between axons, oligodendrocytes, and other cells. The RhoA/Rho-associated coiled-coil containing kinase signaling pathway plays a central role in axon growth/regeneration through interactions with myelin-derived axonal growth inhibitors and regulation of actin cytoskeletal dynamics. Oligodendrocytes and their precursors play a role in myelination, and neurons are involved through their voltage-gated calcium channels. Understanding the pathophysiology of injury and the biology of motor tract reorganization may allow the development of therapies to enhance recovery after acute central nervous system injury. These include targeted rehabilitation, novel pharmacotherapies, such as growth factors and axonal growth inhibitor blockade, and the implementation of neurotechnologies, such as central nervous system stimulators and robotics. The translation of these advances depends on careful alignment of preclinical studies and human clinical trials. As experimental data mount, the future is one of optimism.
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Affiliation(s)
- Hajime Takase
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Department of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Robert W Regenhardt
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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16
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Klein E. Ethics and the emergence of brain-computer interface medicine. HANDBOOK OF CLINICAL NEUROLOGY 2020; 168:329-339. [PMID: 32164863 DOI: 10.1016/b978-0-444-63934-9.00024-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Brain-computer interface (BCI) technology will usher in profound changes to the practice of medicine. BCI devices, broadly defined as those capable of reading brain activity and translating this into operation of a device, will offer patients and clinicians new ways to address impairments of communication, movement, sensation, and mental health. These new capabilities will bring new responsibilities and raise a diverse set of ethical challenges. One way to understand and begin to address these challenges is to view them in terms of the goals of medicine. In this chapter, different ways in which BCI technology may subserve the goals of medicine is explored. This is followed by articulation of additional goals particularly relevant to BCI technology: neural diversity, neural privacy, agency, and authenticity. The goals of medicine provide a useful ethical framework for the introduction of BCI devices into medicine.
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Affiliation(s)
- Eran Klein
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States; Department of Philosophy, University of Washington, Seattle, WA, United States.
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