Recovery of motor functions by using spinal interneuronal systems

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We investigated indirect cortico-motoneuronal (C-M) pathways intercalated by spinal interneurons in humans, to confirm if the pathways are useful for functional recovery in spinal patients. (1) We could observe indirect C-M excitations in upper limb muscles of normal subjects, which were difficult to be evoked when subjects contracted a muscle in isolation. (2) We could induce long-term potentiation in the indirect C-M excitations, by using repetitive combined stimulation of the motor cortex and a peripheral nerve. The potentiation lasted for ca. 1 hour. (3) We performed movement analyses in patients with cervical myelopathy, and revealed that dexterous hand functions were not impaired in parallel with proximal arm functions, which are known to use mainly the indirect pathways. But postoperative recovery of hand functions partly depended on arm functions. We will improve the methods for long-term potentiation in the indirect pathways, for clinical use.