Motor tract reorganization after acute central nervous system injury: a translational perspective

Acute central nervous system injuries are among the most common causes of disability worldwide, with widespread social and economic implications. Motor tract injury accounts for the majority of this disability; therefore, there is impetus to understand mechanisms underlying the pathophysiology of in...

Full description

Bibliographic Details
Main Authors: Hajime Takase, Robert W Regenhardt
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:Neural Regeneration Research
Subjects:
Online Access:http://www.nrronline.org/article.asp?issn=1673-5374;year=2021;volume=16;issue=6;spage=1144;epage=1149;aulast=
id doaj-1e5167bc2d2948859727d3c9d4866616
record_format Article
spelling doaj-1e5167bc2d2948859727d3c9d48666162020-12-02T13:12:34ZengWolters Kluwer Medknow PublicationsNeural Regeneration Research1673-53742021-01-011661144114910.4103/1673-5374.300330Motor tract reorganization after acute central nervous system injury: a translational perspectiveHajime TakaseRobert W RegenhardtAcute central nervous system injuries are among the most common causes of disability worldwide, with widespread social and economic implications. Motor tract injury accounts for the majority of this disability; therefore, there is impetus to understand mechanisms underlying the pathophysiology of injury and subsequent reorganization of the motor tract that may lead to recovery. After acute central nervous system injury, there are changes in the microenvironment and structure of the motor tract. For example, ischemic stroke involves decreased local blood flow and tissue death from lack of oxygen and nutrients. Traumatic injury, in contrast, causes stretching and shearing injury to microstructures, including myelinated axons and their surrounding vessels. Both involve blood-brain barrier dysfunction, which is an important initial event. After acute central nervous system injury, motor tract reorganization occurs in the form of cortical remapping in the gray matter and axonal regeneration and rewiring in the white matter. Cortical remapping involves one cortical region taking on the role of another. cAMP-response-element binding protein is a key transcription factor that can enhance plasticity in the peri-infarct cortex. Axonal regeneration and rewiring depend on complex cell-cell interactions between axons, oligodendrocytes, and other cells. The RhoA/Rho-associated coiled-coil containing kinase signaling pathway plays a central role in axon growth/regeneration through interactions with myelin-derived axonal growth inhibitors and regulation of actin cytoskeletal dynamics. Oligodendrocytes and their precursors play a role in myelination, and neurons are involved through their voltage-gated calcium channels. Understanding the pathophysiology of injury and the biology of motor tract reorganization may allow the development of therapies to enhance recovery after acute central nervous system injury. These include targeted rehabilitation, novel pharmacotherapies, such as growth factors and axonal growth inhibitor blockade, and the implementation of neurotechnologies, such as central nervous system stimulators and robotics. The translation of these advances depends on careful alignment of preclinical studies and human clinical trials. As experimental data mount, the future is one of optimism.http://www.nrronline.org/article.asp?issn=1673-5374;year=2021;volume=16;issue=6;spage=1144;epage=1149;aulast=corticospinal tract; myelin-axon interaction; recovery; remapping; reorganization; rhoa/rock; translation
collection DOAJ
language English
format Article
sources DOAJ
author Hajime Takase
Robert W Regenhardt
spellingShingle Hajime Takase
Robert W Regenhardt
Motor tract reorganization after acute central nervous system injury: a translational perspective
Neural Regeneration Research
corticospinal tract; myelin-axon interaction; recovery; remapping; reorganization; rhoa/rock; translation
author_facet Hajime Takase
Robert W Regenhardt
author_sort Hajime Takase
title Motor tract reorganization after acute central nervous system injury: a translational perspective
title_short Motor tract reorganization after acute central nervous system injury: a translational perspective
title_full Motor tract reorganization after acute central nervous system injury: a translational perspective
title_fullStr Motor tract reorganization after acute central nervous system injury: a translational perspective
title_full_unstemmed Motor tract reorganization after acute central nervous system injury: a translational perspective
title_sort motor tract reorganization after acute central nervous system injury: a translational perspective
publisher Wolters Kluwer Medknow Publications
series Neural Regeneration Research
issn 1673-5374
publishDate 2021-01-01
description Acute central nervous system injuries are among the most common causes of disability worldwide, with widespread social and economic implications. Motor tract injury accounts for the majority of this disability; therefore, there is impetus to understand mechanisms underlying the pathophysiology of injury and subsequent reorganization of the motor tract that may lead to recovery. After acute central nervous system injury, there are changes in the microenvironment and structure of the motor tract. For example, ischemic stroke involves decreased local blood flow and tissue death from lack of oxygen and nutrients. Traumatic injury, in contrast, causes stretching and shearing injury to microstructures, including myelinated axons and their surrounding vessels. Both involve blood-brain barrier dysfunction, which is an important initial event. After acute central nervous system injury, motor tract reorganization occurs in the form of cortical remapping in the gray matter and axonal regeneration and rewiring in the white matter. Cortical remapping involves one cortical region taking on the role of another. cAMP-response-element binding protein is a key transcription factor that can enhance plasticity in the peri-infarct cortex. Axonal regeneration and rewiring depend on complex cell-cell interactions between axons, oligodendrocytes, and other cells. The RhoA/Rho-associated coiled-coil containing kinase signaling pathway plays a central role in axon growth/regeneration through interactions with myelin-derived axonal growth inhibitors and regulation of actin cytoskeletal dynamics. Oligodendrocytes and their precursors play a role in myelination, and neurons are involved through their voltage-gated calcium channels. Understanding the pathophysiology of injury and the biology of motor tract reorganization may allow the development of therapies to enhance recovery after acute central nervous system injury. These include targeted rehabilitation, novel pharmacotherapies, such as growth factors and axonal growth inhibitor blockade, and the implementation of neurotechnologies, such as central nervous system stimulators and robotics. The translation of these advances depends on careful alignment of preclinical studies and human clinical trials. As experimental data mount, the future is one of optimism.
topic corticospinal tract; myelin-axon interaction; recovery; remapping; reorganization; rhoa/rock; translation
url http://www.nrronline.org/article.asp?issn=1673-5374;year=2021;volume=16;issue=6;spage=1144;epage=1149;aulast=
work_keys_str_mv AT hajimetakase motortractreorganizationafteracutecentralnervoussysteminjuryatranslationalperspective
AT robertwregenhardt motortractreorganizationafteracutecentralnervoussysteminjuryatranslationalperspective
_version_ 1724406275601596416