Peripheral nerve injury induced changes in the spinal cord and strategies to counteract/enhance the changes to promote nerve regeneration

Peripheral nerve injuries (PNI) cause partial or complete motor, sensory and autonomic function disabilities in patients and impose enormous socioeconomic burden. The incidence of PNI is steadily growing over the last few decades, accounting for several hundred thousand cases each year around the world. Despite the development and advances in treatment modalities, the functional clinical outcomes often remain unsatisfactory. Given that cell bodies of the peripheral nerves reside in the spinal cord and dorsal root ganglia (DRG), and the integral relationship between the peripheral nerves and the spinal cord, more emphasis should be given to research in this direction. This article reviews recent findings related to studying PNI induced changes in the spinal cord. Of major interest is the possibility of therapeutically influencing the changes in spinal cord to promote peripheral nerve regeneration and improve functional outcomes.

• 1
  Peripheral nerve injury leads to morphological, molecular and gene expression changes in the spinal cord and dorsal root ganglia, some of which have positive impact on the survival of neurons and nerve regeneration, while the effect of others is the opposite.
• 2
  Early nerve repair, exogenous supply of neurotrophic factors and Schwann cells can sustain the regeneration inductive environment and enhance the positive changes in neurons.
• 3
  Administration of neurotrophic factors, acetyl-L-carnitine, N-acetyl-cysteine, and N-methyl-D-aspartate receptor antagonist MK-801 can help counteract axotomy-induced neuronal loss and promote regeneration, which are all time-dependent.