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Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity
The state of areflexia and muscle weakness that immediately follows a spinal cord injury (SCI) is gradually replaced by the recovery of neuronal and network excitability, leading to both improvements in residual motor function and the development of spasticity. In this review we summarize recent ani...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026713/ https://www.ncbi.nlm.nih.gov/pubmed/24860447 http://dx.doi.org/10.3389/fnint.2014.00036 |
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author | D'Amico, Jessica M. Condliffe, Elizabeth G. Martins, Karen J. B. Bennett, David J. Gorassini, Monica A. |
author_facet | D'Amico, Jessica M. Condliffe, Elizabeth G. Martins, Karen J. B. Bennett, David J. Gorassini, Monica A. |
author_sort | D'Amico, Jessica M. |
collection | PubMed |
description | The state of areflexia and muscle weakness that immediately follows a spinal cord injury (SCI) is gradually replaced by the recovery of neuronal and network excitability, leading to both improvements in residual motor function and the development of spasticity. In this review we summarize recent animal and human studies that describe how motoneurons and their activation by sensory pathways become hyperexcitable to compensate for the reduction of functional activation of the spinal cord and the eventual impact on the muscle. Specifically, decreases in the inhibitory control of sensory transmission and increases in intrinsic motoneuron excitability are described. We present the idea that replacing lost patterned activation of the spinal cord by activating synaptic inputs via assisted movements, pharmacology or electrical stimulation may help to recover lost spinal inhibition. This may lead to a reduction of uncontrolled activation of the spinal cord and thus, improve its controlled activation by synaptic inputs to ultimately normalize circuit function. Increasing the excitation of the spinal cord with spared descending and/or peripheral inputs by facilitating movement, instead of suppressing it pharmacologically, may provide the best avenue to improve residual motor function and manage spasticity after SCI. |
format | Online Article Text |
id | pubmed-4026713 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-40267132014-05-23 Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity D'Amico, Jessica M. Condliffe, Elizabeth G. Martins, Karen J. B. Bennett, David J. Gorassini, Monica A. Front Integr Neurosci Neuroscience The state of areflexia and muscle weakness that immediately follows a spinal cord injury (SCI) is gradually replaced by the recovery of neuronal and network excitability, leading to both improvements in residual motor function and the development of spasticity. In this review we summarize recent animal and human studies that describe how motoneurons and their activation by sensory pathways become hyperexcitable to compensate for the reduction of functional activation of the spinal cord and the eventual impact on the muscle. Specifically, decreases in the inhibitory control of sensory transmission and increases in intrinsic motoneuron excitability are described. We present the idea that replacing lost patterned activation of the spinal cord by activating synaptic inputs via assisted movements, pharmacology or electrical stimulation may help to recover lost spinal inhibition. This may lead to a reduction of uncontrolled activation of the spinal cord and thus, improve its controlled activation by synaptic inputs to ultimately normalize circuit function. Increasing the excitation of the spinal cord with spared descending and/or peripheral inputs by facilitating movement, instead of suppressing it pharmacologically, may provide the best avenue to improve residual motor function and manage spasticity after SCI. Frontiers Media S.A. 2014-05-12 /pmc/articles/PMC4026713/ /pubmed/24860447 http://dx.doi.org/10.3389/fnint.2014.00036 Text en Copyright © 2014 D'Amico, Condliffe, Martins, Bennett and Gorassini. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience D'Amico, Jessica M. Condliffe, Elizabeth G. Martins, Karen J. B. Bennett, David J. Gorassini, Monica A. Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
title | Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
title_full | Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
title_fullStr | Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
title_full_unstemmed | Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
title_short | Recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
title_sort | recovery of neuronal and network excitability after spinal cord injury and implications for spasticity |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026713/ https://www.ncbi.nlm.nih.gov/pubmed/24860447 http://dx.doi.org/10.3389/fnint.2014.00036 |
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