Neural plasticity and functional recovery of human central nervous system with special reference to spinal cord injury.

摘要

STUDY DESIGN: Literature review. OBJECTIVE: To study the progress that has been made in neural plasticity for the past few decades. SETTING: United Kingdom/China. METHODS: An electronic search of relevant publications through PubMed was conducted using two key words: 'axonal regeneration' and 'neural plasticity'. The search included publications of the past three decades of all languages and of both animal and human studies. After confirmation of immense increase of publications on neural plasticity, reviewing of neural plasticity alone was conducted. The review covered only the most important and clinically relevant publications. For convenience of reading by busy clinicians, discussions focused on cellular and functional levels, and only the most investigated molecules were mentioned. The size of references is also planned to be concise rather than comprehensive into three digits. RESULTS: Neural plasticity is about memory and learning. The entire process of neural plasticity is presented in the sequence of (1) lesion-induced plasticity, (2) clearance of debris, (3) collateral sprouting (4) potentiation. The recent discovery and understanding of the important role of Chondroitinase in clearance of debris is discussed in detail. CONCLUSION: Neural plasticity has enormous potentials in facilitating functional recovery. It is a realistic target than structural axonal regeneration at current level of neuroscience.