Spinal Cord Injury and CNS Regeneration

Neurological rehabilitation is expanding its scope to include restoration of function through regeneration. However, this complex task will require multi-stage interventions, some easier to achieve than others. Of repair strategies on the horizon, harnessing the potential of neural stem cells already present in the CNS and placed there by transplantation appears promising. In fact, using stem cells to remyelinate the damaged cord is an immediate clinical target. Demyelination is an important contributor to disability after spinal cord injury because it incapacitates axons that remain intact below level of injury. Thus, remyelinating bridging axons would likely improve important functions, such as, bladder and bowel control, limb movement, and respiration. I will describe our recent studies, and those of others, transplanting embryonic stem cells into the injured rodent spinal cord focusing on remyelination. In addition, I will also focus on a second strategy, to mobilize endogenous stem cells to repair the damaged spinal cord. I will put forth a hypothesis that the conditions necessary for optimal spontaneous regeneration are not present after spinal cord injury. A growing body of evidence indicates that at least one of these factors is optimization of pattern neural activity. I will discuss the role of optimized pattern neural activity in regeneration and recovery of function and suggest that recovery of function can occur many years following injury. Although, it is impossible to predict what final strategies will be used to ultimately repair the damaged spinal cord, it is possible to discuss step-wise strategies towards partial repair. 0 47 PLASTICITY AND REPAIR AFTER SPINAL CORD INJURY JC. Bresnahan (Columbus, USA)