A second chance for recovery


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To date, rehabilitation is the most effective way to promote functional recovery after spinal cord injury. According to common opinion, the greatest gain in function is expected when the rehab begins early after the injury. If it starts too late, a recovery is still possible, but the success rather low. There seems to be a limited “window of opportunity” in which the plasticity of the nervous tissue is greatest and rehabilitation is maximal.
Unfortunately, spinal cord injuries often go hand in hand with further physical damage. Medical complications can be the reason why patients are immobilized and may miss this tight window of opportunity.

Inflammation can open a "second window"
On an injury or infection, the body reacts with inflammation. This activates the Immune and initiates the repair of the tissue. Damage is then eliminated. A team headed by Karim Fouad from the University of Alberta, Canada, discovered that triggering mild inflammation can open a “second window” for nervous system adjustments. This helps to improve regeneration in later stages. In a preclinical model, a low dose of lipopolysaccharide (LPS) was injected into the circulatory system, producing a mild inflammatory response in the body.
In the study, the experimental group received an injection of LPS two months after the injury (chronic stage) and began intensive rehabilitation training. The control group did not receive LPS, only training.
The results were remarkable: The experimental group with LPS and intensive training showed a significantly improved production of the functions compared to the control group.


Karim Fouad, the author of the study, argues that inflammation opens a second, new window of time for plastic changes in the nervous system. The exact underlying mechanisms and the role of the immune system still need to be clarified. However, this work opens up a completely new approach in the rehabilitation of chronically injured patients.

Wings for Life was supporting this important research. The prestigious journal "Brain" published these results.

Source: “Eliciting inflammation enables successful rehabilitative training in chronic spinal cord injury”. Torres-Espín A, Forero J, Fenrich KK, Lucas-Osma AM, Krajacic A, Schmidt E, Vavrek R, Raposo P, Bennett DJ, Popovich PG, Fouad K. Brain, June 2018.