Cortical reorganization after spinal cord injury: always for good?
Cortical reorganization after spinal cord injury: always for good?
复制标题
DOI：
10.1016/j.neuroscience.2014.06.056
复制
发表时间：
2014-12-26
期刊：
影响因子：
3.3
通讯作者：
Foffani G
中科院分区：
文献类型：
--
作者：
Moxon KA;Oliviero A;Aguilar J;Foffani G
可塑性构成了作为经验结果的行为变化的基础。它是指在学习或记忆编码期间，或由于急性或慢性病理状况，在全局水平上的神经网络成形和再成形以及在局部水平上的突触接触重塑。中枢神经系统损伤后的“可塑性”脑重组在感觉和运动功能障碍的恢复和康复中具有关键作用，但也可能是“适应不良”的。此外，很明显，大脑重组不是一个“静态”现象，而是一个非常动态的过程。脊髓损伤立即引起大脑状态的改变并开始皮质重组。从长远来看，损伤对大脑的影响-无论是否伴随治疗-都是脊髓上重组和脊髓恢复之间的复杂平衡。脊髓损伤后皮质重组的程度是高度可变的，并且可以从无重组（即“沉默”）到大量皮质重映射。这种变异性主要取决于物种、损伤发生时动物的年龄、损伤发生后的时间以及损伤后的行为活动和可能的治疗方案。我们将简要讨论这些依赖关系，试图突出它们的翻译价值。总的来说，不仅需要更好地了解损伤后大脑如何在治疗或不治疗的情况下进行重组，还需要澄清何时以及为什么大脑重组在临床后果方面可以是“好”或“坏”的。这些信息对于开发和优化具有成本效益的治疗方法以最大限度地恢复功能，同时最大限度地减少脊髓损伤后的适应不良状态至关重要。
Plasticity constitutes the basis of behavioral changes as a result of experience. It refers to neural network shaping and re-shaping at the global level and to synaptic contacts remodeling at the local level, either during learning or memory encoding, or as a result of acute or chronic pathological conditions. ‘Plastic’ brain reorganization after central nervous system lesions has a pivotal role in the recovery and rehabilitation of sensory and motor dysfunction, but can also be “maladaptive”. Moreover, it is clear that brain reorganization it is not a “static” phenomenon but rather a very dynamic process. Spinal cord injury immediately initiates a change in brain state and starts cortical reorganization. In the long term, the impact of injury – with or without accompanying therapy – on the brain is a complex balance between supraspinal reorganization and spinal recovery. The degree of cortical reorganization after spinal cord injury is highly variable, and can range from no reorganization (i.e. “silencing”) to massive cortical remapping. This variability critically depends on the species, the age of the animal when the injury occurs, the time after the injury has occurred, and the behavioral activity and possible therapy regimes after the injury. We will briefly discuss these dependencies, trying to highlight their translational value. Overall, it is not only necessary to better understand how the brain can reorganize after injury with or without therapy, it is also necessary to clarify when and why brain reorganization can be either “good” or “bad” in terms of its clinical consequences. This information is critical in order to develop and optimize cost-effective therapies to maximize functional recovery while minimizing maladaptive states after spinal cord injury.