Why New Spinal Cord Plasticity Does Not Disrupt Old Motor Behaviors

Chen, Yi; Chen, Lu; Wang, Yu; Chen, Xiang Yang; Wolpaw, Jonathan R.

doi:10.1523/jneurosci.0767-17.2017

Cited by 14 publications

(16 citation statements)

References 41 publications

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“…DA transection) largely abolished proprioceptive feedback to the brain from the lumbosacral spinal cord (Chen et al . 2017). The lesion alone did not impair locomotor right–left symmetry in step timing or hip height.…”

Section: Evidence Supporting the Modelmentioning

confidence: 99%

“…This prediction was recently tested in rats in which mid-thoracic transection of the spinal dorsal ascending tracts (i.e. DA transection) largely abolished proprioceptive feedback to the brain from the lumbosacral spinal cord (Chen et al 2017). The lesion alone did not impair locomotor right-left symmetry in step timing or hip height.…”

Section: Negotiation Among the Behavioursmentioning

confidence: 99%

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The negotiated equilibrium model of spinal cord function

Wolpaw

2018

The Journal of Physiology

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The belief that the spinal cord is hardwired is no longer tenable. Like the rest of the CNS, the spinal cord changes during growth and ageing, when new motor behaviours are acquired, and in response to trauma and disease. This paper describes a new model of spinal cord function that reconciles its recently appreciated plasticity with its long‐recognized reliability as the final common pathway for behaviour. According to this model, the substrate of each motor behaviour comprises brain and spinal plasticity: the plasticity in the brain induces and maintains the plasticity in the spinal cord. Each time a behaviour occurs, the spinal cord provides the brain with performance information that guides changes in the substrate of the behaviour. All the behaviours in the repertoire undergo this process concurrently; each repeatedly induces plasticity to preserve its key features despite the plasticity induced by other behaviours. The aggregate process is a negotiation among the behaviours: they negotiate the properties of the spinal neurons and synapses that they all use. The ongoing negotiation maintains the spinal cord in an equilibrium – a negotiated equilibrium – that serves all the behaviours. This new model of spinal cord function is supported by laboratory and clinical data, makes predictions borne out by experiment, and underlies a new approach to restoring function to people with neuromuscular disorders. Further studies are needed to test its generality, to determine whether it may apply to other CNS areas such as the cerebral cortex, and to develop its therapeutic implications.

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Section: Evidence Supporting the Modelmentioning

confidence: 99%

Section: Negotiation Among the Behavioursmentioning

confidence: 99%

The negotiated equilibrium model of spinal cord function

Wolpaw

2018

The Journal of Physiology

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“…A new model is needed that reconciles the recently appreciated plasticity of the spinal cord with its long-recognized role as the final common pathway for motor behaviors. This need has provided the impetus for the negotiated equilibrium model of spinal cord function [3,12,13,37,38].…”

Section: The Negotiated Equilibrium Model Of Spinal Cord Functionmentioning

confidence: 99%

“…For example, when the new behavior of a larger or smaller H-reflex changes the spinal pathway of the reflex, it affects the kinematic and EMG details of locomotion [17,39]. At the same time, compensatory changes in other pathways preserve the key features of locomotion (e.g., right/left symmetry in step-cycle timing and hip height) [37,40]. This compensation is guided by the feedback the brain receives on the locomotor impact of the plasticity underlying the new behavior [37].…”

Section: The Negotiated Equilibrium Model Of Spinal Cord Functionmentioning

confidence: 99%

“…At the same time, compensatory changes in other pathways preserve the key features of locomotion (e.g., right/left symmetry in step-cycle timing and hip height) [37,40]. This compensation is guided by the feedback the brain receives on the locomotor impact of the plasticity underlying the new behavior [37].…”

Section: The Negotiated Equilibrium Model Of Spinal Cord Functionmentioning

confidence: 99%

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Acquisition, maintenance, and therapeutic use of a simple motor skill

Norton

Wolpaw

2018

Current Opinion in Behavioral Sciences

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Operant conditioning of the spinal stretch reflex (SSR) or its electrical analog, the H-reflex, is a valuable experimental paradigm for studying the acquisition and maintenance of a simple motor skill. The CNS substrate of this skill consists of brain and spinal cord plasticity that operates as a hierarchy—the learning experience induces plasticity in the brain that guides and maintains plasticity in the spinal cord. This is apparent in the two components of the skill acquisition: task-dependent adaptation, reflecting brain plasticity; and long-term change, reflecting gradual development of spinal plasticity. The inferior olive, cerebellum, sensorimotor cortex, and corticospinal tract (CST) are essential components of this hierarchy. The neuronal and synaptic mechanisms of the spinal plasticity are under study. Because acquisition of this skill changes the spinal cord, it can affect other skills, such as locomotion. Thus, it enables investigation of how the highly plastic spinal cord supports the acquisition and maintenance of a broad repertoire of motor skills throughout life. These studies have resulted in the negotiated equilibrium model of spinal cord function, which reconciles the spinal cord’s long-recognized reliability as the final common pathway for behaviors with its recently recognized ongoing plasticity. In accord with this model, appropriate H-reflex conditioning in a person with spasticity due to an incomplete spinal cord injury can trigger wider beneficial plasticity that markedly improves walking. H-reflex operant conditioning appears to provide a valuable new method for enhancing functional recovery in people with spinal cord injury and possibly other disorders as well.

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Effect of mental rehearsal on team performance and non-technical skills in surgical teams: systematic review

2020

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Background: Simulation-based training in medical education has become a common method to develop both technical and non-technical skills in teams. Mental rehearsal (MR) is the cognitive act of simulating a task in our heads to pre-experience tasks imaginatively. It has been used widely to improve individual and collective performance in fields outside healthcare, and offers potential for more efficient training in time-pressured surgical and medical team contexts. This study aimed to review the available literature to determine the impact of MR on team performance and non-technical skills in healthcare. Methods: MEDLINE, Embase, British Educational Index, CINAHL, Web of Science, PsycInfo and Cochrane databases were searched for the period 1994-2018. The primary outcome measure was improvement in team performance and non-technical skills. Study quality of RCTs was assessed using the Medical Education Research Quality Instrument. The reported impacts of MR in all included studies were mapped on to the Kirkpatrick framework for evaluation of educational interventions. Results: Eight studies with 268 participants were identified that met the inclusion criteria, of which there were six randomized trials, one prospective pragmatic trial and one qualitative study. Three studies found MR to be effective in improving team non-technical skills. MR practices were varied and often poorly defined. MR benefited team non-technical skills when it was specifically designed to do so, but was not an automatic consequence of technical MR alone. The majority of studies demonstrated benefits of MR for technical performance, but only three showed positive impacts on teamwork. Overall the studies were of low quality and lacked sufficient discriminatory focus to examine impacts on teamwork dynamics. Conclusion: MR can improve technical performance, but the benefits on non-technical skills are less clear. Future research should look at longitudinal mixed-method evaluation designs and focus on real clinical teams.

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Why New Spinal Cord Plasticity Does Not Disrupt Old Motor Behaviors

Cited by 14 publications

References 41 publications

The negotiated equilibrium model of spinal cord function

The negotiated equilibrium model of spinal cord function

Acquisition, maintenance, and therapeutic use of a simple motor skill

Effect of mental rehearsal on team performance and non-technical skills in surgical teams: systematic review

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