Emerging treatments

Neuroplasticity modulating strategies

Nervous system stimulation (central, peripheral, and mixed) utilising transcutaneous, epidural, or magnetic approaches allows for motor and non-motor neuronal activation to be used in the context of therapeutic interventions.[115][116][117]

Acute hypoxia

Acute intermittent hypoxia has been consistently shown to improve function in patients with incomplete motor injuries.[118]

Transplantation strategies

The transplantation of several cell types has been investigated as potential therapy for spinal cord injury (SCI); these include Schwann cells, neural stem cells or progenitor cells, olfactory ensheathing cells, oligodendrocyte precursor cells, and mesenchymal stem cells. Strategies are focused on neuroprotection, immunomodulation, and neural reconstruction.[119][120] However, despite demonstration of safety and effectiveness in animal models, sufficient evidence of efficacy in a clinical setting is still lacking.[120]

Chondroitinase ABC

Studies in animals revealed that chondroitinase-induced plasticity improved the dexterity associated with trained skills, but had adverse effects on non-trained motor activities.[121][122] There are no studies in humans at this time.

Electrical stimulation

Simultaneous chemical and electrical stimulation of receptors has a synergistic effect. This has led to the development of combined electrical and pharmacological strategies for improving locomotor function.[123][124] Preliminary results from a trial of combined locomotor treadmill training, weight support, and epidural electrical stimulation showed an increase in voluntary movement among participants.[125] One systematic review concluded that functional electrical stimulation cycling exercise improves lower-body muscle health in adults with SCI, and may increase power output and aerobic fitness.[126] Cranial electrotherapy stimulation improved pain intensity and pain interference with daily life, with few side effects, in patients with SCI.[127]

Botulinum toxin

Preliminary evidence indicates that botulinum toxin type A (known as onabotulinumtoxinA, incabotulinumtoxinA, or abobotulinumtoxinA in the US) may reduce intractable chronic neuropathic pain in patients with SCI. Further study is warranted, given the difficulty of treating neuropathic pain.[128][129][130]

Use of this content is subject to our disclaimer