Study about Neuroplasticity and Spinal Cord Injury: Pathophysiology and Epidemiology

Abstract

Neuroplasticity is a phenomenon present from the intrauterine period to old age, exhibiting distinct characteristics during the course of life. Neuroplasticity can be understood in three different ways, namely Morphological Neuroplasticity, Functional Neuroplasticity and Synaptic Plasticity. However, in the embryonic and postnatal period, there are some phenomena that occur during the development of the nervous system, which are ontogenetic plasticity, critical period and impriting. The dysfunctions found throughout life are linked to the neuroplasticity mechanism, be it morphological, functional or synaptic. This work explores the mechanism of neuroplasticity involving spinal cord trauma, where the objective is to reestablish the lost circuit that will culminate in a neuroregenerative process, that is, functional recovery. Many organic barriers, such as gliosis or the release of neurotoxic molecules, and other dysfunctions were found during and after the trauma mechanism, that is, there is a primary injury, triggered by the trauma itself, and a secondary injury, characterized by a chemical injury caused by trauma. molecules, inflammatory reaction, among others. Based on these previous findings, pharmacological and non-pharmacological treatments have been developed to optimize the neuroplasticity process and try to eliminate or attenuate the chemical injury process. The objective of the work was to define and show other forms of the term neuroplasticity, talk about some pathological and non-pathological conditions and, finally, show neuroplasticity and some of its treatments in the spinal cord injury process. A narrative review of the literature from 2000 to 2020 of the PubMed, UpToDate platform and analysis of three books were carried out for the elaboration of this work. Animal/human studies addressing pathologies, forms of treatment for spinal cord injury were included. Articles prior to 2000 were excluded. An exception was made for the Bracken studies of the 1990s. As a result, pharmacological studies were found that consisted of parenteral drug administration with the aim of promoting adequate neuroplasticity in the lesion and attenuating both the chemical lesion and other dysfunctions found at the site, however many side effects were reported after administration, like overdose. Therefore, non-pharmacological strategies were developed involving nanotechnology, stem cells, spinal supports, among others. Nanotechnology showed promise in the treatment, as well as the other forms, but some materials used did not suit the treatment. It can be concluded that the combination of pharmacological and non-pharmacological treatment is the best way to treat spinal cord injury as it promotes neuroplasticity overcoming organic barriers and other dysfunctions and if other forthcoming studies show positive and well-founded results, the treatment should be registered and patented for patients with spinal cord injury.