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REVIEW
Year : 2019  |  Volume : 14  |  Issue : 12  |  Page : 2054-2062

From cortex to cord: motor circuit plasticity after spinal cord injury


1 Département de Neurosciences, Faculté de Médecine, Université de Montréal; Hôpital du Sacré-Coeur de Montréal (CIUSS-NIM), Montréal, Québec, Canada
2 Département de Neurosciences, Faculté de Médecine, Université de Montréal; Hôpital du Sacré-Coeur de Montréal (CIUSS-NIM), Montréal; Groupe de Recherche sur le Système Nerveux Central, Université de Montréal, Montréal, Québec, Canada

Correspondence Address:
Marina Martinez
Département de Neurosciences, Faculté de Médecine, Université de Montréal; Hôpital du Sacré-Coeur de Montréal (CIUSS-NIM), Montréal; Groupe de Recherche sur le Système Nerveux Central, Université de Montréal, Montréal, Québec
Canada
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Source of Support: This work was partially supported by the Canadian Institutes for Health Research (CIHR; MOP-142288 to MM); MM was supported by a salary award from Fonds de Recherche Québec Santé (FRQS) and ARB was supported by a fellowship from FRQS, Conflict of Interest: None


DOI: 10.4103/1673-5374.262572

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Spinal cord injury is associated with chronic sensorimotor deficits due to the interruption of ascending and descending tracts between the brain and spinal cord. Functional recovery after anatomically complete spinal cord injury is limited due to the lack of long-distance axonal regeneration of severed fibers in the adult central nervous system. Most spinal cord injuries in humans, however, are anatomically incomplete. Although restorative treatment options for spinal cord injury remain currently limited, research from experimental models of spinal cord injury have revealed a tremendous capability for both spontaneous and treatment-induced plasticity of the corticospinal system that supports functional recovery. We review recent advances in the understanding of corticospinal circuit plasticity after spinal cord injury and concentrate mainly on the hindlimb motor cortex, its corticospinal projections, and the role of spinal mechanisms that support locomotor recovery. First, we discuss plasticity that occurs at the level of motor cortex and the reorganization of cortical movement representations. Next, we explore downstream plasticity in corticospinal projections. We then review the role of spinal mechanisms in locomotor recovery. We conclude with a perspective on harnessing neuroplasticity with therapeutic interventions to promote functional recovery.


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