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Nat Neurosci. 2018 Apr;21(4):576-588. doi: 10.1038/s41593-018-0093-5. Epub 2018 Mar 19.

Cortico-reticulo-spinal circuit reorganization enables functional recovery after severe spinal cord contusion.

Author information

1
Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.
2
Pavlov Institute of Physiology RAS, St. Petersburg, Russia.
3
Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland.
4
Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
5
Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland. gregoire.courtine@epfl.ch.
6
Department of Neurosurgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. gregoire.courtine@epfl.ch.

Abstract

Severe spinal cord contusions interrupt nearly all brain projections to lumbar circuits producing leg movement. Failure of these projections to reorganize leads to permanent paralysis. Here we modeled these injuries in rodents. A severe contusion abolished all motor cortex projections below injury. However, the motor cortex immediately regained adaptive control over the paralyzed legs during electrochemical neuromodulation of lumbar circuits. Glutamatergic reticulospinal neurons with residual projections below the injury relayed the cortical command downstream. Gravity-assisted rehabilitation enabled by the neuromodulation therapy reinforced these reticulospinal projections, rerouting cortical information through this pathway. This circuit reorganization mediated a motor cortex-dependent recovery of natural walking and swimming without requiring neuromodulation. Cortico-reticulo-spinal circuit reorganization may also improve recovery in humans.

PMID:
29556028
DOI:
10.1038/s41593-018-0093-5
[Indexed for MEDLINE]

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