Experimental neurorehabilitation training

  • M. Selzer
    Corresponding author.
    Lewis Katz School of Medicine-Temple University, Shriners Hospitals Pediatric Research Center and the Department of Neurology, Philadelphia, USA
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      Neurorehabilitation developed in several countries around 1990 through a conviction that optimal restoration of function to patients disabled by neurological disorders requires an understanding of the pathophysiology of those disorders. The field has matured by adopting, as an essential scientific underpinning, research on the mechanisms underlying functional recovery, including neural plasticity and regeneration of axons after injury. Increasingly, preparation for an academic career in neurorehabilitation will incorporate basic or clinical research training in the science of neural plasticity and repair. This lecture focuses on the challenges confronting researchers attempting to translate animal models of injury and repair into human application. Among the questions addressed are:
      • 1)
        What are the mechanisms of plasticity available to the CNS to mediate functional recovery?
      • 2)
        Does the small size of most experimental animals influence the validity of findings for human therapeutic application?
      • 3)
        In partial injury models, such as those commonly employed to study spinal cord injury, can we distinguish true regeneration of injured axons from collateral sprouting by spared axons, and why does it matter?
      • 4)
        Are mechanisms of regeneration in the mature CNS the same as the mechanisms of axon outgrowth in embryonic development in vivo or in cell cultures?
      • 5)
        What are the causes of regenerative failure in mammalian CNS axons? Since the known environmental inhibitory cues also are found in species whose axons regenerate, neuron-intrinsic differences must be important, such as the ability of injured axon tips to make their own protein.
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