Spinal Cord Injury and Neuroplasticity

Background and Aim: Spinal cord injury (SCI) leads to sensory, motor, and autonomic dysfunctions and changes in different nerve fibers that can greatly impact the quality of life of many people. Neuroplasticity is a spontaneous mechanism of the nervous system to adapt to different molecular, physiological, and anatomical changes after SCI. Methods and Materials/Patients: A literature search of relevant articles was made with a focus on recent publications. Results: This narrative review first discusses the definition of neuroplasticity in the nervous system and cellular processes of neuroplasticity in the synapses and their effects on synaptogenesis and neuroplasticity. We describe some of the important central and spinal neuronal pathways and their role in voluntary movements and the regenerative capacity in neuroplasticity and functional recovery. Then this review focuses on the effects of exercise and training programs and different neuromodulation techniques using electrical stimulation (ES) on the development of neuroplasticity. These rehabilitation and neuromodulation techniques accelerate the release of some neurotrophic factors to enhance neuroplasticity and functional sensorimotor recovery. Conclusion: This narrative review emphasizes the importance and capability of neuroplasticity in improving functional recovery and quality of life of the people following SCI. It identifies that different physical rehabilitation and neuromodulation strategies induce significant improvements in sensorimotor recovery and underlines that the combination of rehabilitation and neuromodulation techniques provides greater functional outcomes. There is a need for further investigation using preclinical and clinical studies in the future that should concentrate on the basic molecular and cellular processes of neuroplasticity and investment in enhancing the rehabilitation and neuromodulation techniques and finding new techniques.