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Neurological recovery following spinal cord injury

Neurons are cells that transmit messages between your brain and all parts of your body. When your spinal cord suffers a trauma neurons are damaged, resulting in changes in some of your body's functions. However, some neurons do recover.

What are neurons?

Neurons are the basic building blocks of your nervous system. These cells are in your brain, spinal cord and all nerves throughout your body. They are responsible for receiving and transmitting information

A neuron consists of a nerve cell body (soma), an elongated projection (axon), and short branching fibers (dendrites). Neurons receive nerve signals (action potentials), act on these 'action potentials', and transmit these signals to other neurons or organs such as muscles and glands.

How are neurons damaged following spinal cord injury?

Your spinal cord can be damaged in a number of ways:

  • by compression or impinged upon by fractured bones or ruptured discs following falls or accidents (e.g. vehicle or diving)
  • by direct injury from a foreign object such as a knife
  • by inflammation from disease as tumors and cancers
  • by infections and from vascular or blood vessel diseases

Trauma and other damage results in neuron destruction at the level of your injury. This particularly affects the cell bodies but can also affect the axons.

However, most of the damage to your spinal cord is due to secondary effects of the initial injury.

This includes:

  • ischaemia (loss or lack of blood supply)
  • oedema (swelling)
  • demyelination of axons (loss of the special myelin sheath surrounding many axons)
  • necrosis (death) of the spinal cord and the neurons within it.
How do neurons recover following spinal cord injury?

Some neurons within your injured spinal cord can recover, but the reasons for this are often not clear.
Possible causes of recovery include:

  • resolution of haemorrhage
  • resolution of ischaemia
  • resolution of oedema
  • resolution of inflammation and ion derangement
  • relief of compression on the spinal cord
  • regeneration and regrowth of neurons and glial cells
  • remyelination of axons
  • sprouting of intact axons
  • activation of previously inactive neurons
  • increased sensitivity of receptors to neurotransmitters
  • increased density of receptors in post-synaptic neurons
  • altered responsiveness of neurons below the lesion.

Many of these mechanisms of recovery have been demonstrated in animals.

In experiments it has been shown that the proportion of nerve fibres that regenerate in humans is always small, and the distance regrown is modest in the context of your overall spinal cord anatomy.

Interventions that may support neuronal recovery following spinal cord injury

Your specialist can discuss with you whether any of these interventions may have success in your individual spinal cord injury:

  • Cellular therapeutic interventions
    • transplantation of Schwann cells
    • ttransplantation of peripheral nerve
    • transplantation of embryonic central nervous system tissue
    • transplantation of embryonic stem/progenitor cells
    • transplantation of adult stem/progenitor cells
    • transplantation of engineered stem/progenitor cells
    • transplantation of activated macrophages
    • transplantation of olfactory nervous system cells  

  • Molecular therapeutic interventions
    • neuroprotective therapies
    • delivery of antibodies against a cell adhesion molecule present on neutrophils and monocytes/macrophages
    • intravenous steroids
    • enhancing conduction
    • potassium channel blocker
    • delivery of growth factors
    • delivery of cAMP or small GTPases
    • modulation of interactions with myelin inhibitors
    • extracellular matrix modifiers
  • Rehabilitative training 

References

*http://psychology.about.com/od/biopsychology/ss/neuronanat.htm
*http://science.jrank.org/pages/4612/Neuron.html
*Spinal Cord Injury Patient Information Manual, Caulfield Hospital; Spinal Rehabilitation Unit, Caulfield, Victoria, Australia 2008.
*Somers, Martha Freeman. Spinal Cord Injury: Functional Rehabilitation. Prentice-Hall, New Jersey 2001
*Lindsay KW and Bone I. Neurology and Neurosurgery Illustrated 4th Edition. Churchill Livingstone 2004
*Sandrine T et al. Therapeutic interventions after spinal cord injury. Nature Reviews Neuroscience 2006; 628-643

Further information

For further, up to date information about research and spinal cord injury you can go to the website of the Spinal Cord Injury Network.

Information about Australian research into stem cells and travelling overseas for treatment can be found at The Australian Stem Cell Centre website.