Restoring After Central Nervous System Injuries: Neural Mechanisms and Translational Applications of Motor Recovery
Zhengrun Gao1,2 · Zhen Pang1 · Yiming Chen1 · Gaowei Lei1 · Shuai Zhu1 · Guotao Li7 · Yundong Shen1,2,3 · Wendong Xu1,2,3,4,5,8,91 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
2 The National Clinical Research Center for Aging and Medicine, Fudan University, Shanghai 200040, China
3 Department of Hand and Upper Extremity Surgery, Jing’an District Central Hospital, Fudan University, Shanghai 200040, China
4 Institutes of Brain Science, Fudan University, Shanghai 200040, China
5 State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200040, China
7 Institute of Automation, State Key Laboratory of Management and Control for Complex Systems, Chinese Academy of Sciences, Beijing 100190, China
8 Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226000, China
9 Research Unit of Synergistic Reconstruction of Upper and Lower Limbs after Brain Injury, Chinese Academy of Medical Sciences, Shanghai 200400, China
Abstract
Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are leading causes of long-term disability. It is estimated that more than half of the survivors of severe unilateral injury are unable to use the denervated limb. Previous studies have focused on neuroprotective interventions in the affected hemisphere to limit brain lesions and neurorepair measures to promote recovery. However, the ability to increase plasticity in the injured brain is restricted and difficult to improve. Therefore, over several decades, researchers have been prompted to enhance the compensation by the unaffected hemisphere. Animal experiments have revealed that regrowth of ipsilateral descending fibers from the unaffected hemisphere to denervated motor neurons plays a significant role in the restoration of motor function. In addition, several clinical treatments have been designed to restore ipsilateral motor control, including brain stimulation, nerve transfer surgery, and brain–computer interface systems. Here, we comprehensively review the neural mechanisms as well as translational applications of ipsilateral motor control upon rehabilitation after CNS injuries.
Keywords
Stroke; Traumatic brain injury; Spinal cord injury; Brain–computer interface system; Neuroplasticity; Ipsilateral motor control; Axon regrowth
