Understanding Spinal Cord Injury and Repair: From Molecules to Neurocircuits and Multimodal Prostheses

A special issue of Cells (ISSN 2073-4409).

Deadline for manuscript submissions: 30 June 2024 | Viewed by 3717

Special Issue Editor


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Guest Editor
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
Interests: spinal cord injury; stem cell biology; regenerative medicine; neuroscience; traumatic brain injury; neural oncology; neurodegeneration

Special Issue Information

Dear Colleagues,

Each year, there are ~250,000 to ~500,000 clinical encounters of spinal cord injury (SCI) worldwide. Among them, the majority are traumatic, and more frequently affect young adults and the elderly. The rest of the cases consist of non-traumatic SCI. SCI often results in severe and lifelong disabilities such as sensorimotor deficits, autonomic abnormalities including cardiorespiratory disorders, and other serious complications (e.g., lower urinary tract malfunction, neuropathic pain, gastrointestinal dysfunction, osteoporosis, sexuality and reproduction health issues, and depression). A young age at injury and a large degree of functional loss produce a long-term high fiscal burden that is placed on the individual, their family, and society. Moreover, the daily life challenges for people living with SCI can never be assigned a monetary value. The need for a cure is obvious, but effective therapy for SCI has, to date, remained an unmet medical demand.

Encouragingly, impactful progress has been made since the 1990s in basic science research, translational studies, and clinical investigations of SCI. These endeavors aim to identify molecules and cell organelles as key players of post-SCI pathophysiology, neuroprotection, neurite regrowth, neuroplasticity, and neuroimmune modulation; attain stem cell biology insights to empower regenerative and recovery therapy development; unlock spinal cord neurocircuits for functional reinstatement; and establish the next generation of prostheses for functional rehabilitation. Further, a newly established cross-disciplinary research approach has enabled the field to decipher novel therapeutic targets, develop innovative theoretical frameworks, and formulate multimodal regiments to augment clinical efficacy.

In this Special Issue, we invite laboratory researchers, physician scientists, and academic physicians with expertise in SCI-related molecular and cellular biology, neurobiology, pathophysiology, bioengineering, biomechanics, the brain–computer–spinal cord interface, multiple assistive and robotic devices, pathology, neurology, neurosurgery, pain management, rehabilitation, and neuro-oncology to contribute original research articles, reviews, and communication articles on the aforementioned aspects concerning the current advancements in understanding SCI and neural repair. We particularly welcome papers that will shed mechanistic light at the molecular, cellular, neurocircuit, neuromusculoskeletal, or system biology level with strong translational potentials.

Dr. Yang D. Teng
Guest Editor

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Published Papers (3 papers)

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Research

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30 pages, 7178 KiB  
Article
T12-L3 Nerve Transfer-Induced Locomotor Recovery in Rats with Thoracolumbar Contusion: Essential Roles of Sensory Input Rerouting and Central Neuroplasticity
by Dou Yu, Xiang Zeng, Zaid S. Aljuboori, Rachel Dennison, Liquan Wu, Jamie A. Anderson and Yang D. Teng
Cells 2023, 12(24), 2804; https://doi.org/10.3390/cells12242804 - 08 Dec 2023
Viewed by 1178
Abstract
Locomotor recovery after spinal cord injury (SCI) remains an unmet challenge. Nerve transfer (NT), the connection of a functional/expendable peripheral nerve to a paralyzed nerve root, has long been clinically applied, aiming to restore motor control. However, outcomes have been inconsistent, suggesting that [...] Read more.
Locomotor recovery after spinal cord injury (SCI) remains an unmet challenge. Nerve transfer (NT), the connection of a functional/expendable peripheral nerve to a paralyzed nerve root, has long been clinically applied, aiming to restore motor control. However, outcomes have been inconsistent, suggesting that NT-induced neurological reinstatement may require activation of mechanisms beyond motor axon reinnervation (our hypothesis). We previously reported that to enhance rat locomotion following T13-L1 hemisection, T12-L3 NT must be performed within timeframes optimal for sensory nerve regrowth. Here, T12-L3 NT was performed for adult female rats with subacute (7–9 days) or chronic (8 weeks) mild (SCImi: 10 g × 12.5 mm) or moderate (SCImo: 10 g × 25 mm) T13-L1 thoracolumbar contusion. For chronic injuries, T11-12 implantation of adult hMSCs (1-week before NT), post-NT intramuscular delivery of FGF2, and environmentally enriched/enlarged (EEE) housing were provided. NT, not control procedures, qualitatively improved locomotion in both SCImi groups and animals with subacute SCImo. However, delayed NT did not produce neurological scale upgrading conversion for SCImo rats. Ablation of the T12 ventral/motor or dorsal/sensory root determined that the T12-L3 sensory input played a key role in hindlimb reanimation. Pharmacological, electrophysiological, and trans-synaptic tracing assays revealed that NT strengthened integrity of the propriospinal network, serotonergic neuromodulation, and the neuromuscular junction. Besides key outcomes of thoracolumbar contusion modeling, the data provides the first evidence that mixed NT-induced locomotor efficacy may rely pivotally on sensory rerouting and pro-repair neuroplasticity to reactivate neurocircuits/central pattern generators. The finding describes a novel neurobiology mechanism underlying NT, which can be targeted for development of innovative neurotization therapies. Full article
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Review

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16 pages, 351 KiB  
Review
The Translation of Nanomedicines in the Contexts of Spinal Cord Injury and Repair
by Wenqian Wang, Joel Yong, Paul Marciano, Ryan O’Hare Doig, Guangzhao Mao and Jillian Clark
Cells 2024, 13(7), 569; https://doi.org/10.3390/cells13070569 - 24 Mar 2024
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Abstract
Purpose of this review: Manipulating or re-engineering the damaged human spinal cord to achieve neuro-recovery is one of the foremost challenges of modern science. Addressing the restricted permission of neural cells and topographically organised neural tissue for self-renewal and spontaneous regeneration, respectively, is [...] Read more.
Purpose of this review: Manipulating or re-engineering the damaged human spinal cord to achieve neuro-recovery is one of the foremost challenges of modern science. Addressing the restricted permission of neural cells and topographically organised neural tissue for self-renewal and spontaneous regeneration, respectively, is not straightforward, as exemplified by rare instances of translational success. This review assembles an understanding of advances in nanomedicine for spinal cord injury (SCI) and related clinical indications of relevance to attempts to design, engineer, and target nanotechnologies to multiple molecular networks. Recent findings: Recent research provides a new understanding of the health benefits and regulatory landscape of nanomedicines based on a background of advances in mRNA-based nanocarrier vaccines and quantum dot-based optical imaging. In relation to spinal cord pathology, the extant literature details promising advances in nanoneuropharmacology and regenerative medicine that inform the present understanding of the nanoparticle (NP) biocompatibility–neurotoxicity relationship. In this review, the conceptual bases of nanotechnology and nanomaterial chemistry covering organic and inorganic particles of sizes generally less than 100 nm in diameter will be addressed. Regarding the centrally active nanotechnologies selected for this review, attention is paid to NP physico-chemistry, functionalisation, delivery, biocompatibility, biodistribution, toxicology, and key molecular targets and biological effects intrinsic to and beyond the spinal cord parenchyma. Summary: The advance of nanotechnologies for the treatment of refractory spinal cord pathologies requires an in-depth understanding of neurobiological and topographical principles and a consideration of additional complexities involving the research’s translational and regulatory landscapes. Full article
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28 pages, 1030 KiB  
Review
Do Pharmacological Treatments Act in Collaboration with Rehabilitation in Spinal Cord Injury Treatment? A Review of Preclinical Studies
by Syoichi Tashiro, Shinsuke Shibata, Narihito Nagoshi, Liang Zhang, Shin Yamada, Tetsuya Tsuji, Masaya Nakamura and Hideyuki Okano
Cells 2024, 13(5), 412; https://doi.org/10.3390/cells13050412 - 27 Feb 2024
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Abstract
There is no choice other than rehabilitation as a practical medical treatment to restore impairments or improve activities after acute treatment in people with spinal cord injury (SCI); however, the effect is unremarkable. Therefore, researchers have been seeking effective pharmacological treatments. These will, [...] Read more.
There is no choice other than rehabilitation as a practical medical treatment to restore impairments or improve activities after acute treatment in people with spinal cord injury (SCI); however, the effect is unremarkable. Therefore, researchers have been seeking effective pharmacological treatments. These will, hopefully, exert a greater effect when combined with rehabilitation. However, no review has specifically summarized the combinatorial effects of rehabilitation with various medical agents. In the current review, which included 43 articles, we summarized the combinatorial effects according to the properties of the medical agents, namely neuromodulation, neurotrophic factors, counteraction to inhibitory factors, and others. The recovery processes promoted by rehabilitation include the regeneration of tracts, neuroprotection, scar tissue reorganization, plasticity of spinal circuits, microenvironmental change in the spinal cord, and enforcement of the musculoskeletal system, which are additive, complementary, or even synergistic with medication in many cases. However, there are some cases that lack interaction or even demonstrate competition between medication and rehabilitation. A large fraction of the combinatorial mechanisms remains to be elucidated, and very few studies have investigated complex combinations of these agents or targeted chronically injured spinal cords. Full article
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