Brain stimulation aids walking after spinal injury

Nature Reviews Neurology, Journal Year: 2025, Volume and Issue: 21(2), P. 66 - 66

Published: Jan. 17, 2025

Language: Английский

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In Small Pilot Study, Deep Brain Stimulation Facilitates Walking in People With Incomplete Spinal Cord Injury

Neurology Today, Journal Year: 2025, Volume and Issue: 25(3), P. 14 - 15

Published: Feb. 6, 2025

Language: Английский

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Scientific Advances in Neural Regeneration After Spinal Cord Injury

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 6, 2025

Spinal cord injury (SCI) is a devastating condition that results in loss of motor and sensory function, morbidity, severe dependence. Neural regeneration, which refers to the regrowth or repair nerve tissue cells, holds promise as therapeutic approach for SCI. This narrative review explores current state neural regeneration SCI treatment, including endogenous neuroprotection, neuroplasticity, neuroremediation, cell-based therapies. The based on search literature from past 20 years, conducted via databases PubMed Google Scholar. While many studies show promising results, majority are preclinical, highlighting need randomized clinical trials (RCTs) evaluate effectiveness these therapies humans. Among different approaches, therapies, particularly use stem have shown most promoting functional recovery animal models human trials. Therefore, cell transplantation considered useful treatment method However, further research needed optimize procedure, improve survival, enhance outcomes patients with

Language: Английский

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Editorial: Rehabilitation to guide functional plasticity and regeneration with novel cellular, pharmacological and neuromodulation therapies

Frontiers in Rehabilitation Sciences, Journal Year: 2025, Volume and Issue: 6

Published: Feb. 13, 2025

Editorial on the research topic: Rehabilitation to Guide Functional Plasticity and Regeneration with Novel Cellular, Pharmacological Neuromodulation Therapies While we, as a field, strive improve outcomes for people neurological conditions, we understand that no single therapy or intervention can work in isolation.Combining methods represents future of optimizing rehabilitation.Research combinatorial treatments remains limited. some studies have explored combination exercise-or activity-based therapies neuromodulation, little has been done investigate integration neuromodulation cellular pharmacologic treatments. Given stablished safety broad range neuromodulton techniques, there is an interesting opportunity further potential benefits combining approaches neuromodulation.The quest restore function following injuries continues drive innovation field rehabilitation. Despite complexity central nervous system limited capacity regeneration, promising avenues are emerging. By integrating rehabilitation cutting-edge therapies, pharmacological interventions, strategies, researchers aim harness body's inherent plasticity facilitate recovery functional regeneration.Spinal cord injury (SCI) offers compelling example these advancements. Cervical SCI disrupts critical neural circuits controlling upper limb function. endogenous repair mechanisms promote reorganization adaptive sparred circuits, maladaptive rewiring hinder (Bareyre et al., 2004;Cohen 1991;Green 1999Green , 1998;;von Euler 2002;Zai Wrathall, 2005). Therefore, strategies targeting motor pathways essential enhance meaningful recovery. Multiple preclinical (de Leon 1998;Leon 1998) clinical (Behrman andHarkema, 2007, 2000) demonstrated improves after by training spared networks providing activity-dependent feedback locomotor pathways. For instance, Gregoire Courtine's humans highlights epidural (Wagner 2018) transcutaneous spinal stimulation (Moritz 2024), brain-spine interfaces (Hachem 2023;Lorach 2023), hypothalamic deep brain (Cho 2024). Importantly, neuroplastic changes induced dependent type adopted paradigm (Adkins 2006). Strength primarily modulates network excitability increases number synapses, whereas skilled elicits broader mechanisms, including synapse formation, enhanced synaptic strength, In stroke, anti-NOGO demonstrate its efficacy optimized when combined sequentially appropriate regimen (Wahl 2014). These examples underscore need targeted paradigms.Building concepts, this topic examines perspectives advanced stem cell applications (Balbinot, Hebbian-type (Haakana personalized pediatric cerebral palsy (Behboodi 2023;Raess 2022), sex-specific effects acrobatic cognitive decline hypoperfusion (Martini 2024).Balbinot, 2024 emphasizes synergy between cellbased particularly improving extremity cervical SCI.Preclinical highlight necessity regenerative protocols mirror practices, notably using activate below level. Techniques such corticospinal tract represent frontier enchance cell-based therapies' severe paralysis. The convergence holds significant hope unlocking new setting.Adding depth, novel protocol paired associative (high PAS), combines high-intensity transcranial magnetic highfrequency peripheral nerve target (Bunday Perez, 2012;Haakana 2023;Jo 2020). Preliminary findings Haakana 2023 heart rate variability indicate approach safe, inducing short-term modulation parasympathetic activity without sustained cardiovascular effects. High PAS emphasizing continued exploration systemic impacts-specially other enhancing approaches.In parallel, adaptability therapeutic interventions extend conditions palsy. electrical mixed results gait kinematics 2023). This importance identifying neurotherapeutic responders optimize individualized tailored individual needs. Furthermore, robotic direct current shows promise outcomes. Raess 2022 show that, despite logistical challenges patient-specific barriers, feasibility tolerability, foundation elucidate optimal application.Finally challenge treating chronic addressed through innovative Martini mitigates astrocytic remodeling hippocampal subfields associated spatial memory impairments while uncovering response. males, appears increase astrocyte populations retention, females, it enhances viability, higlighting nuanced interplay plasticity.In conclusion, cellular, pharmacological, comprehensive heralds era possibilities conditions. remain, imperative rigorously assess biological plausibility technologies cornerstone their validation. Drawing from Bradford-Hill criteria (Hill, 1965), focus ensures driving regeneration both scientifically credible capable being translated into effective applications. Such framework harnessing maximize neuroplasticity advance sciences.

Language: Английский

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Harnessing spinal circuit reorganization for targeted functional recovery after spinal cord injury

Neurobiology of Disease, Journal Year: 2025, Volume and Issue: unknown, P. 106854 - 106854

Published: Feb. 1, 2025

Spinal cord injury (SCI) disrupts the communication between brain and spinal cord, resulting in loss of motor function below site. However, spontaneous structural functional plasticity occurs neural circuits after SCI, with unaffected synaptic inputs forming new connections detour pathways to support recovery. The review discusses various mechanisms circuit reorganization post-SCI, including supraspinal pathways, interneurons, central pattern generators. Functional recovery may rely on maintaining a balance excitatory inhibitory activity, as well enhancing proprioceptive input, which plays key role limb stability. emphasizes importance endogenous neuronal regeneration, neuromodulation therapies (such electrical stimulation) proprioception SCI treatment. Future research should integrate advanced technologies such gene targeting, imaging, single-cell mapping better understand underpinning recovery, aiming identify subpopulations for targeted reconstruction enhanced By harnessing reorganization, these efforts hold potential pave way more precise effective strategies SCI.

Language: Английский

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Deep Brain Stimulation and Brain–Spine Interface for Functional Restoration in Spinal Cord Injury

Biomedicines, Journal Year: 2025, Volume and Issue: 13(3), P. 631 - 631

Published: March 5, 2025

Background/Objectives: Spinal cord injury (SCI) presents significant challenges in restoring motor function, with limited therapeutic options available. Recent advancements neuromodulation technologies, such as brain-spine interface (BSI), epidural electrical stimulation (EES), and deep brain (DBS), offer promising solutions. This review article explores the integration of these approaches, focusing on their potential to restore function SCI patients. Findings: DBS has shown efficacy treatment several sites identified, including nucleus raphe magnus (NRM) periaqueductal gray (PAG). However, transitioning from animal human studies highlights challenges, technical risks targeting NRM humans instead rodent models. Additionally, other regions have for rehabilitation, midbrain locomotor region (MLR) pathways, cuneiform (CnF), pedunculopontine (PPN), lateral hypothalamic. EES further supports recovery SCI; however, this approach requires high-DBS amplitude, serotonergic pharmacotherapy, cortical activity decoding attenuate stress-associated locomotion. BSI combined recently emerged a novel therapy. Although are limited, models provided evidence supporting its potential. Despite advancements, effectiveness systems remains cases complete central denervation. Conclusions: The combination DBS, BSI, represent transformational treating patients SCI. While research is needed optimize strategies, hold immense improving quality life advancing field neuromodulation.

Language: Английский

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The diversity and plasticity of descending motor pathways rewired after stroke and trauma in rodents

Frontiers in Neural Circuits, Journal Year: 2025, Volume and Issue: 19

Published: March 21, 2025

Descending neural pathways to the spinal cord plays vital roles in motor control. They are often damaged by brain injuries such as stroke and trauma, which lead severe impairments. Due limited capacity for regeneration of circuits adult central nervous system, currently no essential treatments available complete recovery. Notably, accumulating evidence shows that residual descending dynamically reorganized after injury contribute Furthermore, recent technological advances cell-type classification manipulation have highlighted structural functional diversity these pathways. Here, we focus on three major pathways, namely, corticospinal tract from cerebral cortex, rubrospinal red nucleus, reticulospinal reticular formation, summarize current knowledge their structures functions, especially rodent models (mice rats). We then review discuss process patterns reorganization induced following injury, compensate lost connections Understanding basic properties each pathway principles induction outcome rewired will provide therapeutic insights enhance interactive rewiring multiple

Language: Английский

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Activation of hypothalamic-pontine-spinal pathway promotes locomotor initiation and functional recovery after spinal cord injury in mice

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: March 25, 2025

The hypothalamus is critical for regulating behaviors essential survival and locomotion, but how it integrates internal needs transmits locomotion commands to the spinal cord (SC) remains unclear. We found that glutamatergic neurons in lateral hypothalamic area (LHA) are motivated locomotor activity. Using single-neuron projectome analysis, trans-synaptic tracing, optogenetic manipulation, we showed LHA facilitates during food seeking via pontine oral part (PnO) projection neurons, rather than direct SC projections or indirect stress signaling medial septum diagonal band. Activating PnO-SC also initiated locomotion. Importantly, LHA-PnO were crucial recovery following mouse injury (SCI). Motor cortex signals gated deep brain stimulation treatment markedly promoted long-term restoration of hindlimb motor functions after severe SCI. Thus, have identified a hypothalamic-pontine-spinal pathway paradigm potential therapeutic intervention

Language: Английский

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