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research article

Multi-system neurorehabilitative strategies to restore motor functions following severe spinal cord injury

Musienko, Pavel  
•
Heutschi, Janine  
•
Friedli, Lucia
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2012
Experimental neurology

Severe spinal cord injury (SCI) permanently abolishes motor functions caudal to the lesion. However, the neuronal machinery sufficient to produce standing and stepping is located below most SCI, and can be reactivated with training. Therefore, why do rats and humans fail to regain significant levels of motor control after a severe SCI? In this review, we argue that the lack of sustainable excitability in locomotor circuitries after SCI prevents the emergence of functional motor states during training, thus limiting the occurrence of activity-dependent plasticity in paralyzed subjects. In turn, we show that spinal rats trained with combinations of epidural electrical stimulation and monoamine agonists, which promote locomotor permissive states during rehabilitation, can regain coordinated stepping with full weight bearing capacities in the total absence of supraspinal influences. This impressive recovery of function relies on the ability of spinal circuitries to utilize multisensory information as a source of control and learning after the loss of brain input. We finally discuss the implication of these findings for the design of multi-system neurorehabilitative interventions capable of restoring some degree of function in humans with severe SCI.

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Type
research article
DOI
10.1016/j.expneurol.2011.08.025
Author(s)
Musienko, Pavel  
Heutschi, Janine  
Friedli, Lucia
van den Brand, Rubia  
Courtine, Grégoire  
Date Issued

2012

Published in
Experimental neurology
Volume

235

Issue

1

Start page

100

End page

109

Editorial or Peer reviewed

REVIEWED

Written at

OTHER

EPFL units
UPCOURTINE  
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/77869
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