Jed S. Shumsky, Ph.D.
Scientific Director, Behavior Core Facility
The Spinal Cord Research Center
Research Associate Professor
Dept of Neurobiology and Anatomy
Drexel University College of Medicine
Pharmacotherapy and Rehabilitation Promote Recovery of Function from Spinal Cord Injury
Since most individual treatments have demonstrated limited success, combination therapies are being investigated to improve recovery from spinal cord injury. We examined the combination of pharmacotherapy with drugs that stimulate the monoamine systems and rehabilitative exercise in several spinal cord injury models: from thoracic transection to unilateral cervical injury. Thoracic spinal cord transection disrupts spinal circuitry leading to a complete loss of voluntary motor function and muscle atrophy below the injury. The combination of pharmacotherapy to stimulate upregulated receptors and daily passive cycling exercise to stimulate spinal circuitry and prevent muscle atrophy is more beneficial than either treatment alone. Cervical spinal cord injury results in specific deficits in forelimb reaching function. Both functional and anatomical recovery has been promoted by monoamine pharmacotherapy, and task-oriented practice is used clinically to maximize recovery of function. Rehabilitative exercise consisted of daily training in a reaching trough apparatus that provided task-oriented practice by encouraging reaching by the impaired limb for food pellets. Behavioral recovery was significantly improved in the combination groups in both injury models, although not all combinations were successful. Thus combination treatments directed towards improving different aspects of spinal cord injury may elicit a greater degree of recovery, which could lead to clinical translation.