Exercise therapy guides cortical reorganization after midthoracic spinal contusion to enhance control of lower thoracic muscles, supporting functional recovery

Nandakumar, Bharadwaj; Blumenthal, Gary H.; Disse, Gregory D.; Desmond, Pierce C.; Ebinu, Julius O.; Ricard, Jacques; Bethea, John R.; Moxon, Karen A.

doi:10.1016/j.expneurol.2023.114394

Cited by 4 publications

(2 citation statements)

References 125 publications

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“…Freund et al [101] also confirmed the presence of structural atrophy of the sensory and motor cortex in patients with chronic cervical SCI, and this condition is closely related to the degree of dysfunction and recovery. The deterioration of cortical structural integrity reduces the processing speed and functional integration of the brain, leading to the deterioration of walking function and neuropathic pain after SCI [6,102].…”

Section: Effect Of Rehabilitation Training On the Structural Remodeli...mentioning

confidence: 99%

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Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods

He,

Guo,

Zhao

et al. 2023

Biomedicines

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Spinal cord injury (SCI) is a serious neurological insult that disrupts the ascending and descending neural pathways between the peripheral nerves and the brain, leading to not only functional deficits in the injured area and below the level of the lesion but also morphological, structural, and functional reorganization of the brain. These changes introduce new challenges and uncertainties into the treatment of SCI. Rehabilitation training, a clinical intervention designed to promote functional recovery after spinal cord and brain injuries, has been reported to promote activation and functional reorganization of the cerebral cortex through multiple physiological mechanisms. In this review, we evaluate the potential mechanisms of exercise that affect the brain structure and function, as well as the rehabilitation training process for the brain after SCI. Additionally, we compare and discuss the principles, effects, and future directions of several rehabilitation training methods that facilitate cerebral cortex activation and recovery after SCI. Understanding the regulatory role of rehabilitation training at the supraspinal center is of great significance for clinicians to develop SCI treatment strategies and optimize rehabilitation plans.

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Section: Effect Of Rehabilitation Training On the Structural Remodeli...mentioning

confidence: 99%

“…Rehabilitation training, a type of physical therapy that utilizes physical factors to stimulate adaptive changes in local neural circuits, is used widely in the clinical treatment of SCI to improve the dysfunction caused by SCI [6]. Previous research has shown that and humans.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods

He,

Guo,

Zhao

et al. 2023

Biomedicines

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show abstract

Increased excitability and reduced GABAergic levels in somatosensory cortex under chronic spinal cord injury

Alonso-Calviño,

Fernández-López,

Zaforas

et al. 2023

Experimental Neurology

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State dependent vagus nerve stimulation for targeted plasticity therapy: challenges and considerations

Nandakumar,

Mylavarapu,

Harris

et al. 2024

Front. Control Eng.

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Targeted plasticity therapy (TPT) utilizes vagus nerve stimulation (VNS) to promote improvements in function following neurological injury and disease. During TPT, a brief burst of VNS induces neuromodulator release, which when paired with relevant behavioral events can influence functionally relevant neuroplasticity. Functional improvements following TPT are therefore in part mediated by neuromodulator signaling. Unfortunately, comorbidities associated with neurological disease often result in altered cognitive states that can influence neuromodulator signaling, potentially impeding neuroplasticity induced by TPT. Aside from altered cognitive states, cardiorespiratory rhythms also affect neuromodulator signaling, due to the vagus nerve’s role in relaying visceral sensory information from the cardiovascular and respiratory systems. Moreover, precise VNS delivery during specific periods of the cardiorespiratory rhythms may further improve TPT. Ultimately, understanding the impact of patient-specific states on neuromodulator signaling may likely facilitate optimized VNS delivery, paving the way for personalized neuromodulation during TPT. Overall, this review explores challenges and considerations for developing advanced TPT paradigms, focusing on altered cognitive states and cardiorespiratory rhythms. We specifically discuss the possible impact of these cognitive states and autonomic rhythms on neuromodulator signaling and subsequent neuroplasticity. Altered cognitive states (arousal deficits or pain) could affect VNS intensity, while cardiorespiratory rhythms may further inform optimized timing of VNS. We propose that understanding these interactions will lead to the development of personalized state dependent VNS paradigms for TPT.

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Exercise therapy guides cortical reorganization after midthoracic spinal contusion to enhance control of lower thoracic muscles, supporting functional recovery

Cited by 4 publications

References 125 publications

Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods

Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods

Increased excitability and reduced GABAergic levels in somatosensory cortex under chronic spinal cord injury

State dependent vagus nerve stimulation for targeted plasticity therapy: challenges and considerations

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