Ryk controls remapping of motor cortex during functional recovery after spinal cord injury

Limited functional recovery can be achieved with rehabilitation after incomplete spinal cord injury. Eliminating the function of a repulsive Wnt receptor, Ryk, by either conditional knockout in the motor cortex or monoclonal antibody infusion, resulted in increased corticospinal axon collateral branches with pre-synaptic puncta in the spinal cord and enhanced recovery of forelimb reaching and grasping function following a cervical dorsal column lesion. Using optical stimulation, we observed that motor cortical output maps underwent massive changes after injury and the hindlimb cortical areas were recruited to control the forelimb over time. Furthermore, a greater cortical area was dedicated to control the forelimb in Ryk cKO. In the absence of weekly task-specific training, recruitment of ectopic cortical areas was greatly reduced without significant functional recovery even in Ryk cKO. Our study provides evidence that maximal circuit reorganization and functional recovery can be achieved by combining molecular manipulation and task-specific training.