Karim Fouad, University of Alberta, Edmonton, Canada

Reopening the window of opportunity for rehabilitative training after chronic spinal cord injury

Funded in: 2015, 2016, 2017, 2018

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Problem: The effectiveness of rehabilitation training is limited in the chronic stage after SCI

Target: Inducing an artificial inflammation in the chronic stage might facilitate restructuring of the nervous system (plasticity)

Goal: Enhanced plasticity in combination with rehabilitation training could lead to improved functional recovery.

Unfortunately, there are still no effective treatments to repair the injured spinal cord. However, depending on the severity and time after injury, rehabilitative training has been demonstrated to be an effective therapy to promote recovery. Training augments recovery likely through various mechanisms. This includes the remodeling of nervous tissue spared by the trauma, a process termed neuroplasticity. It is commonly acknowledged that initiating training in the early stages after injury is much more effective in promoting recovery than starting in a delayed fashion. Considering that spinal cord injury is often accompanied by other medical complications such as broken bones, and that following injury individuals have to relearn various essential tasks of daily living, intensive training of motor functions in the acute phase is often not an option.     

In this proposal, the team around Karim Fouad will investigate a possible cause for the decline in training efficacy by analyzing a reaching task over time after injury in an animal model of cervical spinal cord injury. Ultimately, this project will enable effective training beyond the critical period. For this, the team will follow the lead of studies that have suggested the importance of inflammation in the repair of the spinal cord through neuroplasticity. Karim Fouad and his team propose that a decline of the inflammatory process over the weeks following SCI is the reason for the reduced efficacy of rehabilitative training. To test this they will artificially re-introduce inflammation in order to rekindle training efficacy.

If their hypothesis is confirmed, these experiments will open the door for investigations on safe and clinically feasible approaches to boost the effect of rehabilitative training on functional recovery following injuries of the spinal cord and even the brain.