LAUSR

Cervical spinal cord injury (CSCI) can induce life-long disabilities, including spasticity and gait impairments. The objective of this preclinical study was to evaluate the therapeutic effects of simultaneous and combined early locomotor treadmill training (Tm) and injury site magnetic stimulation (TMSsc) on spasticity and gait impairments in a rat model of C6/7 moderate contusion SCI. Tm training was initiated at post-injury (PI) day 8, whereas TMS treatment was added to Tm 14 days PI, and then the combined therapy (TMSTm) was continued for 6 weeks. Untreated CSCI animals revealed significant and enduring hindlimb spasticity (measured as velocity-dependent ankle torques and time-locked triceps surae EMGs), significant alterations in limb coordination, and significant reductions in forelimb grip strength. The TMSTm showed significantly lower spasticity, significantly more normal limb coordination (quantitated using 3D-kinematics and Catwalk gait analyses), and significantly greater forelimb grip strength compared to the CSCI untreated controls. In addition, 3D gradient echo and diffusion tensor MRI imaging showed that TMSTm treated animals had smaller cavity volumes and better preservation of the white matter. In addition, compared to the CSCI untreated animals, the lumbar spinal cord (SC) of the treatment group revealed significant up-regulation of dopamine beta-hydroxylase (DβH), glutamic acid decarboxylase (GAD), gamma-aminobutyric acid receptor B (GABAb), and brain-derived neurotrophic factor (BDNF). The treatment-induced up-regulation of these molecules may have enhanced the activity-induced adaptive plasticity in the SC and contributed to normalization of pre- and post-synaptic reflex regulatory processes. In addition, the TMSTm therapy may have decreased injury-induced progressive maladaptive segmental and descending plasticity. Our data are the first to suggest that an early simultaneous combination of Tm and injury-site TMSsc application can be an effective therapy for CSCI-induced spasticity and gait impairments. These preclinical data demonstrated the feasibility and efficacy of a novel therapeutic strategy for SCI-induced spasticity and gait impairments.