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Tashiro S, Shibata S, Nagoshi N, Zhang L, Yamada S, Tsuji T, Nakamura M, Okano H. Do Pharmacological Treatments Act in Collaboration with Rehabilitation in Spinal Cord Injury Treatment? A Review of Preclinical Studies. Cells 2024; 13:412. [PMID: 38474376 DOI: 10.3390/cells13050412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/18/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
There is no choice other than rehabilitation as a practical medical treatment to restore impairments or improve activities after acute treatment in people with spinal cord injury (SCI); however, the effect is unremarkable. Therefore, researchers have been seeking effective pharmacological treatments. These will, hopefully, exert a greater effect when combined with rehabilitation. However, no review has specifically summarized the combinatorial effects of rehabilitation with various medical agents. In the current review, which included 43 articles, we summarized the combinatorial effects according to the properties of the medical agents, namely neuromodulation, neurotrophic factors, counteraction to inhibitory factors, and others. The recovery processes promoted by rehabilitation include the regeneration of tracts, neuroprotection, scar tissue reorganization, plasticity of spinal circuits, microenvironmental change in the spinal cord, and enforcement of the musculoskeletal system, which are additive, complementary, or even synergistic with medication in many cases. However, there are some cases that lack interaction or even demonstrate competition between medication and rehabilitation. A large fraction of the combinatorial mechanisms remains to be elucidated, and very few studies have investigated complex combinations of these agents or targeted chronically injured spinal cords.
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Affiliation(s)
- Syoichi Tashiro
- Department of Rehabilitation Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
- Department of Rehabilitation Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
| | - Shinsuke Shibata
- Division of Microscopic Anatomy, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Liang Zhang
- Department of Rehabilitation Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Faculty of Medicine, Kyorin University, Tokyo 181-8611, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Hideyuki Okano
- Department of Physiology, School of Medicine, Keio University, Tokyo 160-8582, Japan
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Bonnet M, Alluin O, Trimaille T, Gigmes D, Marqueste T, Decherchi P. Delayed Injection of a Physically Cross-Linked PNIPAAm- g-PEG Hydrogel in Rat Contused Spinal Cord Improves Functional Recovery. ACS OMEGA 2020; 5:10247-10259. [PMID: 32426581 PMCID: PMC7226861 DOI: 10.1021/acsomega.9b03611] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
Spinal cord injury is a main health issue, leading to multiple functional deficits with major consequences such as motor and sensitive impairment below the lesion. To date, all repair strategies remain ineffective. In line with the experiments showing that implanted hydrogels, immunologically inert biomaterials, from natural or synthetic origins, are promising tools and in order to reduce functional deficits, to increase locomotor recovery, and to reduce spasticity, we injected into the lesion area, 1 week after a severe T10 spinal cord contusion, a thermoresponsive physically cross-linked poly(N-isopropylacrylamide)-poly(ethylene glycol) copolymer hydrogel. The effect of postinjury intensive rehabilitation training was also studied. A group of male Sprague-Dawley rats receiving the hydrogel was enrolled in an 8 week program of physical activity (15 min/day, 5 days/week) in order to verify if the combination of a treadmill step-training and hydrogel could lead to better outcomes. The data obtained were compared to those obtained in animals with a spinal lesion alone receiving a saline injection with or without performing the same program of physical activity. Furthermore, in order to verify the biocompatibility of our designed biomaterial, an inflammatory reaction (interleukin-1β, interleukin-6, and tumor necrosis factor-α) was examined 15 days post-hydrogel injection. Functional recovery (postural and locomotor activities and sensorimotor coordination) was assessed from the day of injection, once a week, for 9 weeks. Finally, 9 weeks postinjection, the spinal reflexivity (rate-dependent depression of the H-reflex) was measured. The results indicate that the hydrogel did not induce an additional inflammation. Furthermore, we observed the same significant locomotor improvements in hydrogel-injected animals as in trained saline-injected animals. However, the combination of hydrogel with exercise did not show higher recovery compared to that evaluated by the two strategies independently. Finally, the H-reflex depression recovery was found to be induced by the hydrogel and, albeit to a lesser degree, exercise. However, no recovery was observed when the two strategies were combined. Our results highlight the effectiveness of our copolymer and its high therapeutic potential to preserve/repair the spinal cord after lesion.
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Affiliation(s)
- Maxime Bonnet
- Aix
Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement:
Etienne-Jules MAREY, Equipe, Plasticité des Systèmes
Nerveux et Musculaire, (PSNM), Parc Scientifique et Technologique
de Luminy, Faculté des Sciences du Sport de Marseille, CC910—163 Avenue de Luminy, F-13288 Marseille Cedex 09, France
| | - Olivier Alluin
- Aix
Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement:
Etienne-Jules MAREY, Equipe, Plasticité des Systèmes
Nerveux et Musculaire, (PSNM), Parc Scientifique et Technologique
de Luminy, Faculté des Sciences du Sport de Marseille, CC910—163 Avenue de Luminy, F-13288 Marseille Cedex 09, France
| | - Thomas Trimaille
- Aix
Marseille Univ, CNRS, ICR, UMR 7273, Institut de Chimie Radicalaire,
Equipe, Chimie Radicalaire Organique et Polymères de Spécialité,
(CROPS), Case 562—Avenue
Escadrille Normandie-Niemen, F-13397 Marseille Cedex 20, France
| | - Didier Gigmes
- Aix
Marseille Univ, CNRS, ICR, UMR 7273, Institut de Chimie Radicalaire,
Equipe, Chimie Radicalaire Organique et Polymères de Spécialité,
(CROPS), Case 562—Avenue
Escadrille Normandie-Niemen, F-13397 Marseille Cedex 20, France
| | - Tanguy Marqueste
- Aix
Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement:
Etienne-Jules MAREY, Equipe, Plasticité des Systèmes
Nerveux et Musculaire, (PSNM), Parc Scientifique et Technologique
de Luminy, Faculté des Sciences du Sport de Marseille, CC910—163 Avenue de Luminy, F-13288 Marseille Cedex 09, France
| | - Patrick Decherchi
- Aix
Marseille Univ, CNRS, ISM, UMR 7287, Institut des Sciences du Mouvement:
Etienne-Jules MAREY, Equipe, Plasticité des Systèmes
Nerveux et Musculaire, (PSNM), Parc Scientifique et Technologique
de Luminy, Faculté des Sciences du Sport de Marseille, CC910—163 Avenue de Luminy, F-13288 Marseille Cedex 09, France
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Lee-Kubli C, Marshall AG, Malik RA, Calcutt NA. The H-Reflex as a Biomarker for Spinal Disinhibition in Painful Diabetic Neuropathy. Curr Diab Rep 2018; 18:1. [PMID: 29362940 PMCID: PMC6876556 DOI: 10.1007/s11892-018-0969-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Neuropathic pain may arise from multiple mechanisms and locations. Efficacy of current treatments for painful diabetic neuropathy is limited to an unpredictable subset of patients, possibly reflecting diversity of pain generator mechanisms, and there is a lack of targeted treatments for individual patients. This review summarizes preclinical evidence supporting a role for spinal disinhibition in painful diabetic neuropathy, the physiology and pharmacology of rate-dependent depression (RDD) of the spinal H-reflex and the translational potential of using RDD as a biomarker of spinally mediated pain. RECENT FINDINGS Impaired RDD occurs in animal models of diabetes and was also detected in diabetic patients with painful vs painless neuropathy. RDD status can be determined using standard neurophysiological equipment. Loss of RDD may provide a clinical biomarker of spinal disinhibition, thereby enabling a personalized medicine approach to selection of current treatment options and enrichment of future clinical trial populations.
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Affiliation(s)
| | - Andrew G Marshall
- Faculty of Medical and Human Sciences, Institute of Cardiovascular Sciences, University of Manchester and National Institute for Healthy Research/Wellcome Trust Clinical Research Facility, Manchester, UK
- Department of Clinical Neurophysiology, Salford Royal Hospital, National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rayaz A Malik
- Faculty of Medical and Human Sciences, Institute of Cardiovascular Sciences, University of Manchester and National Institute for Healthy Research/Wellcome Trust Clinical Research Facility, Manchester, UK
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Nigel A Calcutt
- Department of Pathology, University of California San Diego, La Jolla, CA, USA.
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Liabeuf S, Stuhl-Gourmand L, Gackière F, Mancuso R, Sanchez Brualla I, Marino P, Brocard F, Vinay L. Prochlorperazine Increases KCC2 Function and Reduces Spasticity after Spinal Cord Injury. J Neurotrauma 2017; 34:3397-3406. [PMID: 28747093 DOI: 10.1089/neu.2017.5152] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In mature neurons, low intracellular chloride level required for inhibition is maintained by the potassium-chloride cotransporter, KCC2. Impairment of Cl- extrusion after KCC2 dysfunction has been involved in many central nervous system disorders, such as seizures, neuropathic pain, or spasticity, after a spinal cord injury (SCI). This makes KCC2 an appealing drug target for restoring Cl- homeostasis and inhibition in pathological conditions. In the present study, we screen the Prestwick Chemical Library® and identify conventional antipsychotics phenothiazine derivatives as enhancers of KCC2 activity. Among them, prochlorperazine hyperpolarizes the Cl- equilibrium potential in motoneurons of neonatal rats and restores the reciprocal inhibition post-SCI. The compound alleviates spasticity in chronic adult SCI rats with an efficacy equivalent to the antispastic agent, baclofen, and rescues the SCI-induced downregulation of KCC2 in motoneurons below the lesion. These pre-clinical data support prochlorperazine for a new therapeutic indication in the treatment of spasticity post-SCI and neurological disorders involving a KCC2 dysfunction.
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Affiliation(s)
- Sylvie Liabeuf
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Laetitia Stuhl-Gourmand
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Florian Gackière
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Renzo Mancuso
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Irene Sanchez Brualla
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Philippe Marino
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Frédéric Brocard
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
| | - Laurent Vinay
- Team P3M, Institut de Neurosciences de la Timone, UMR7289, Aix Marseille Université and Centre National de la Recherche Scientifique (CNRS) , Marseille, France
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Osuna-Carrasco LP, López-Ruiz JR, Mendizabal-Ruiz EG, De la Torre-Valdovinos B, Bañuelos-Pineda J, Jiménez-Estrada I, Dueñas-Jiménez SH. Quantitative analysis of hindlimbs locomotion kinematics in spinalized rats treated with Tamoxifen plus treadmill exercise. Neuroscience 2016; 333:151-61. [PMID: 27450566 DOI: 10.1016/j.neuroscience.2016.07.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/27/2016] [Accepted: 07/08/2016] [Indexed: 11/25/2022]
Abstract
Locomotion recovery after a spinal cord injury (SCI) includes axon regeneration, myelin preservation and increased plasticity in propriospinal and descending spinal circuitries. The combined effects of tamoxifen and exercise after a SCI were analyzed in this study to determine whether the combination of both treatments induces the best outcome in locomotion recovery. In this study, the penetrating injury was provoked by a sharp projectile that penetrates through right dorsal and ventral portions of the T13-L1 spinal segments, affecting propriospinal and descending/ascending tracts. Intraperitoneal application of Tamoxifen and a treadmill exercise protocol, as rehabilitation therapies, separately or combined, were used. To evaluate the functional recovery, angular patterns of the hip, knee and ankle joints as well as the leg pendulum-like movement (PLM) were measured during the unrestricted gait of treated and untreated (UT) animals, previously and after the traumatic injury (15 and 30days post-injury (dpi)). A pattern (curve) comparison analysis was made by using a locally designed Matlab script that determines the Frechet dissimilarity. The SCI magnitude was assessed by qualitative and quantitative histological analysis of the injury site 30days after SCI. Our results showed that all treated groups had an improvement in hindlimbs kinematics compared to the UT group, which showed a poor gait locomotion recovery throughout the rehabilitation period. The group with the combined treatment (tamoxifen+exercise (TE)) presented the best outcome. In conclusion, tamoxifen and treadmill exercise treatments are complementary therapies for the functional recovery of gait locomotion in hemi-spinalized rats.
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Affiliation(s)
- L P Osuna-Carrasco
- Department of Neuroscience, CUCS, Universidad de Guadalajara, Guadalajara, Mexico
| | - J R López-Ruiz
- Department of Neuroscience, CUCS, Universidad de Guadalajara, Guadalajara, Mexico
| | | | | | - J Bañuelos-Pineda
- Department of Veterinary Medicine, CUCBA, Universidad de Guadalajara, Mexico
| | - I Jiménez-Estrada
- Department of Physiology, Biophysics and Neurosciences, CINVESTAV, IPN, México City, Mexico
| | - S H Dueñas-Jiménez
- Department of Neuroscience, CUCS, Universidad de Guadalajara, Guadalajara, Mexico.
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Caron G, Marqueste T, Decherchi P. Restoration of post-activation depression of the H-reflex by treadmill exercise in aged rats. Neurobiol Aging 2016; 42:61-8. [DOI: 10.1016/j.neurobiolaging.2016.02.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 02/17/2016] [Accepted: 02/20/2016] [Indexed: 01/28/2023]
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Rossignol S, Martinez M, Escalona M, Kundu A, Delivet-Mongrain H, Alluin O, Gossard JP. The "beneficial" effects of locomotor training after various types of spinal lesions in cats and rats. PROGRESS IN BRAIN RESEARCH 2015; 218:173-98. [PMID: 25890137 DOI: 10.1016/bs.pbr.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This chapter reviews a number of experiments on the recovery of locomotion after various types of spinal lesions and locomotor training mainly in cats. We first recall the major evidence on the recovery of hindlimb locomotion in completely spinalized cats at the T13 level and the role played by the spinal locomotor network, also known as the central pattern generator, as well as the beneficial effects of locomotor training on this recovery. Having established that hindlimb locomotion can recover, we raise the issue as to whether spinal plastic changes could also contribute to the recovery after partial spinal lesions such as unilateral hemisections. We found that after such hemisection at T10, cats could recover quadrupedal locomotion and that deficits could be improved by training. We further showed that, after a complete spinalization a few segments below the first hemisection (at T13, i.e., the level of previous studies on spinalization), cats could readily walk with the hindlimbs within hours of completely severing the remaining spinal tracts and not days as is usually the case with only a single complete spinalization. This suggests that neuroplastic changes occurred below the first hemisection so that the cat was already primed to walk after the spinalization subsequent to the hemispinalization 3 weeks before. Of interest is the fact that some characteristic kinematic features in trained or untrained hemispinalized cats could remain after complete spinalization, suggesting that spinal changes induced by training could also be durable. Other studies on reflexes and on the pattern of "fictive" locomotion recorded after curarization corroborate this view. More recent work deals with training cats in more demanding situations such as ladder treadmill (vs. flat treadmill) to evaluate how the locomotor training regimen can influence the spinal cord. Finally, we report our recent studies in rats using compressive lesions or surgical complete spinalization and find that some principles of locomotor recovery in cats also apply to rats when adequate locomotor training is provided.
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Affiliation(s)
- Serge Rossignol
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada; SensoriMotor Rehabilitation Research Team of the Canadian Institute of Health Research, Montreal, Quebec, Canada.
| | - Marina Martinez
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada; SensoriMotor Rehabilitation Research Team of the Canadian Institute of Health Research, Montreal, Quebec, Canada
| | - Manuel Escalona
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada
| | - Aritra Kundu
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada
| | - Hugo Delivet-Mongrain
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada
| | - Olivier Alluin
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada; SensoriMotor Rehabilitation Research Team of the Canadian Institute of Health Research, Montreal, Quebec, Canada
| | - Jean-Pierre Gossard
- Department of Neuroscience and Groupe de Recherche sur le Système Nerveux Central (GRSNC), Faculty of Medicine, Université de Montréal, P.O. Box 6128, Montreal, Quebec, Canada; SensoriMotor Rehabilitation Research Team of the Canadian Institute of Health Research, Montreal, Quebec, Canada
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Effects of activity-dependent strategies on regeneration and plasticity after peripheral nerve injuries. Ann Anat 2011; 193:347-53. [DOI: 10.1016/j.aanat.2011.02.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 02/14/2011] [Accepted: 02/24/2011] [Indexed: 12/27/2022]
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Yates C, Garrison K. Translational Research on Spinal Cord Injury. Transl Neurosci 2011. [DOI: 10.1002/9781118260470.ch7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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