Technology-driven combinatorial therapy to rewire the spinal cord after injury (ReWire)

ReWIRE将结合创新的转化神经技术和康复干预措施，用于脊髓损伤后神经功能的修复和恢复。拟议中的研究项目将为下一代科学家提供独特的技能，为瘫痪患者开发破坏性的治疗方案。最近的技术突破引发了旨在恢复脊髓损伤（SCI）后功能的治疗概念的范式转变。新型药物输送系统和生物材料桥被设计用于减少继发性损伤和瘢痕形成，刺激和引导神经纤维在病变部位再生，并促进与完整组织的功能重新连接。此外，神经调节疗法可以重新激活脊髓损伤下方的脊髓回路，使慢性瘫痪患者重新获得自主行走的控制能力。与康复治疗相结合，在没有神经调节的情况下，神经恢复得到了持续的促进，这表明在临床前模型中证实了SC的重新布线。为了绕过损伤，神经调节已经与大脑信号联系起来，通过使用神经电刺激和机器人系统来重建对脊髓回路的皮层控制。机器人技术的进步通过诱导新的自然“有线”连接，显著增强了神经康复的影响。ReWIRE的目标是在多个博士项目的框架内利用所有这些技术和治疗上的突破，这些突破将不断相互作用，朝着有效的SCI组合治疗方向汇聚。ReWIRE将专注于三个相互交织的目标：1)建立一个国际、跨学科和跨部门的教育网络；2)建立一个SCI临床数据平台；3)使欧洲处于SCI治疗的前沿。

ReWIRE will combine innovative translational neurotechnologies and rehabilitation interventions for the repair and restoration of neurological functions following injury of the spinal cord (SC). The proposed research program will equip next-generation scientists with unique skills to develop disruptive therapeutic solutions for patients with paralysis. Recent technological breakthroughs have triggered a paradigm shift in the conception of therapies aimed to restore function after spinal cord injury (SCI). Novel drug delivery systems and biomaterial bridges have been engineered to reduce secondary injury and scarring, to stimulate and guide regenerating nerve fibres across the lesion site, and to promote functional reconnection with intact tissue. Additionally, neuromodulation therapies can reactivate spinal circuits below a SCI, allowing people with chronic paralysis to regain voluntary control of walking. In conjunction with rehabilitation, neurological recovery was promoted that persisted without neuromodulation, suggesting a rewiring of the SC as demonstrated in preclinical models. To bypass an injury, neuromodulation has been linked to brain signals to re-establish corticalcontrol over spinal circuits by employing electrical nerve stimulation and robotic systems. Advances in robotics are significantly augmenting the impact of neurorehabilitation by inducing new natural "wired" connections. The aim of ReWIRE is to leverage all these technical and therapeutic breakthroughs in the framework of multiple PhD projects that will continuously interact to converge toward effective combinatorial treatments for SCI. ReWIRE will focus on three inter-woven objectives: i) establish an international, interdisciplinary, and intersectoral educational network, ii) build an SCI clinical data platform, and, iii) position Europe at the forefront of therapy for SCI.