Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation
After an initial period of recovery, human neurological injury has long been thought to be static. In order to improve quality of life for those suffering from stroke, spinal cord injury, or traumatic brain injury, researchers have been working to restore the nervous system and reduce neurological d...
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Published in | Frontiers in neuroscience Vol. 10; p. 584 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Switzerland
Frontiers Research Foundation
27.12.2016
Frontiers Media S.A |
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Abstract | After an initial period of recovery, human neurological injury has long been thought to be static. In order to improve quality of life for those suffering from stroke, spinal cord injury, or traumatic brain injury, researchers have been working to restore the nervous system and reduce neurological deficits through a number of mechanisms. For example, neurobiologists have been identifying and manipulating components of the intra- and extracellular milieu to alter the regenerative potential of neurons, neuro-engineers have been producing brain-machine and neural interfaces that circumvent lesions to restore functionality, and neurorehabilitation experts have been developing new ways to revitalize the nervous system even in chronic disease. While each of these areas holds promise, their individual paths to clinical relevance remain difficult. Nonetheless, these methods are now able to synergistically enhance recovery of native motor function to levels which were previously believed to be impossible. Furthermore, such recovery can even persist after training, and for the first time there is evidence of functional axonal regrowth and rewiring in the central nervous system of animal models. To attain this type of regeneration, rehabilitation paradigms that pair cortically-based intent with activation of affected circuits and positive neurofeedback appear to be required-a phenomenon which raises new and far reaching questions about the underlying relationship between conscious action and neural repair. For this reason, we argue that multi-modal therapy will be necessary to facilitate a truly robust recovery, and that the success of investigational microscopic techniques may depend on their integration into macroscopic frameworks that include task-based neurorehabilitation. We further identify critical components of future neural repair strategies and explore the most updated knowledge, progress, and challenges in the fields of cellular neuronal repair, neural interfacing, and neurorehabilitation, all with the goal of better understanding neurological injury and how to improve recovery. |
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AbstractList | After an initial period of recovery, human neurological injury has long been thought to be static. In order to improve quality of life for those suffering from stroke, spinal cord injury, or traumatic brain injury, researchers have been working to restore the nervous system and reduce neurological deficits through a number of mechanisms. For example, neurobiologists have been identifying and manipulating components of the intra- and extracellular milieu to alter the regenerative potential of neurons, neuro-engineers have been producing brain-machine and neural interfaces that circumvent lesions to restore functionality, and neurorehabilitation experts have been developing new ways to revitalize the nervous system even in chronic disease. While each of these areas holds promise, their individual paths to clinical relevance remain difficult. Nonetheless, these methods are now able to synergistically enhance recovery of native motor function to levels which were previously believed to be impossible. Furthermore, such recovery can even persist after training, and for the first time there is evidence of functional axonal regrowth and rewiring in the central nervous system of animal models. To attain this type of regeneration, rehabilitation paradigms that pair cortically-based intent with activation of affected circuits and positive neurofeedback appear to be required-a phenomenon which raises new and far reaching questions about the underlying relationship between conscious action and neural repair. For this reason, we argue that multi-modal therapy will be necessary to facilitate a truly robust recovery, and that the success of investigational microscopic techniques may depend on their integration into macroscopic frameworks that include task-based neurorehabilitation. We further identify critical components of future neural repair strategies and explore the most updated knowledge, progress, and challenges in the fields of cellular neuronal repair, neural interfacing, and neurorehabilitation, all with the goal of better understanding neurological injury and how to improve recovery. After an initial period of recovery, human neurological injury has long been thought to be static. In order to improve quality of life for those suffering from stroke, spinal cord injury, or traumatic brain injury, researchers have been working to restore the nervous system and reduce neurological deficits through a number of mechanisms. For example, neurobiologists have been identifying and manipulating components of the intra- and extracellular milieu to alter the regenerative potential of neurons, neuro-engineers have been producing brain-machine and neural interfaces that circumvent lesions to restore functionality, and neurorehabilitation experts have been developing new ways to revitalize the nervous system even in chronic disease. While each of these areas holds promise, their individual paths to clinical relevance remain difficult. Nonetheless, these methods are now able to synergistically enhance recovery of native motor function to levels which were previously believed to be impossible. Furthermore, such recovery can even persist after training, and for the first time there is evidence of functional axonal regrowth and rewiring in the central nervous system of animal models. To attain this type of regeneration, rehabilitation paradigms that pair cortically-based intent with activation of affected circuits and positive neurofeedback appear to be required – a phenomenon which raises new and far reaching questions about the underlying relationship between conscious action and neural repair. For this reason, we argue that multi-modal therapy across disciplines will be necessary to facilitate a truly robust recovery, and that the success of investigational microscopic techniques may depend on their integration into macroscopic frameworks that include task-based neurorehabilitation. We further identify critical components of future neural repair strategies and explore the most updated knowledge, progress, and challenges in the fields of cellular neuronal repair, neural interfacing, and neurorehabilitation, all with the goal of better understanding neurological injury and how to improve recovery. |
Author | Turner, Dennis A Rahimpour, Shervin Slutzky, Marc W Edgerton, V Reggie Krucoff, Max O |
AuthorAffiliation | 3 Department of Neurology, Feinberg School of Medicine, Northwestern University Chicago, IL, USA 2 Department of Physiology, Feinberg School of Medicine, Northwestern University Chicago, IL, USA 5 Department of Neurobiology, Duke University Medical Center Durham, NC, USA 6 Research and Surgery Services, Durham Veterans Affairs Medical Center Durham, NC, USA 1 Department of Neurosurgery, Duke University Medical Center Durham, NC, USA 4 Department of Integrative Biology and Physiology, University of California, Los Angeles Los Angeles, CA, USA |
AuthorAffiliation_xml | – name: 6 Research and Surgery Services, Durham Veterans Affairs Medical Center Durham, NC, USA – name: 1 Department of Neurosurgery, Duke University Medical Center Durham, NC, USA – name: 4 Department of Integrative Biology and Physiology, University of California, Los Angeles Los Angeles, CA, USA – name: 5 Department of Neurobiology, Duke University Medical Center Durham, NC, USA – name: 2 Department of Physiology, Feinberg School of Medicine, Northwestern University Chicago, IL, USA – name: 3 Department of Neurology, Feinberg School of Medicine, Northwestern University Chicago, IL, USA |
Author_xml | – sequence: 1 givenname: Max O surname: Krucoff fullname: Krucoff, Max O organization: Department of Neurosurgery, Duke University Medical Center Durham, NC, USA – sequence: 2 givenname: Shervin surname: Rahimpour fullname: Rahimpour, Shervin organization: Department of Neurosurgery, Duke University Medical Center Durham, NC, USA – sequence: 3 givenname: Marc W surname: Slutzky fullname: Slutzky, Marc W organization: Department of Physiology, Feinberg School of Medicine, Northwestern UniversityChicago, IL, USA; Department of Neurology, Feinberg School of Medicine, Northwestern UniversityChicago, IL, USA – sequence: 4 givenname: V Reggie surname: Edgerton fullname: Edgerton, V Reggie organization: Department of Integrative Biology and Physiology, University of California, Los Angeles Los Angeles, CA, USA – sequence: 5 givenname: Dennis A surname: Turner fullname: Turner, Dennis A organization: Department of Neurosurgery, Duke University Medical CenterDurham, NC, USA; Department of Neurobiology, Duke University Medical CenterDurham, NC, USA; Research and Surgery Services, Durham Veterans Affairs Medical CenterDurham, NC, USA |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28082858$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | 2016. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2016 Krucoff, Rahimpour, Slutzky, Edgerton and Turner. 2016 Krucoff, Rahimpour, Slutzky, Edgerton and Turner |
Copyright_xml | – notice: 2016. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Copyright © 2016 Krucoff, Rahimpour, Slutzky, Edgerton and Turner. 2016 Krucoff, Rahimpour, Slutzky, Edgerton and Turner |
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DOI | 10.3389/fnins.2016.00584 |
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Keywords | brain-machine interface (BMI) neural regeneration neural repair neural stimulation neural interface spinal cord stimulation neurorehabilitation neuroplasticity |
Language | English |
License | This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 This article was submitted to Neuroprosthetics, a section of the journal Frontiers in Neuroscience Reviewed by: Yoshio Sakurai, Doshisha University, Japan; Brian R. Noga, University of Miami, USA Edited by: Ioan Opris, University of Miami, USA |
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SubjectTerms | Animal models Central nervous system Computer applications Feedback Implants Interfaces Motor task performance Nervous system Neurological diseases Neurology Neuroscience Quality of life Regeneration Rehabilitation Spinal cord injuries Traumatic brain injury |
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