Combined Approaches Leading to Synergistic Therapeutic Effects in Spinal Cord Injury: State of the Art.

Abstract

Cell-based regenerative medicine approaches and motor rehabilitation are currently being used to overcome the consequences of spinal cord injury (SCI). However, their success in preclinical studies does not always translate into successful implementation in clinical practice. Recent work suggests that modern neuromodulation approaches hold great therapeutic promise. Despite these advances, the complete resolution of functional deficits caused by SCI is impossible, especially in cases of severe injury. Therefore, combined approaches based on cell transplantation and neuromodulation are needed to enhance the neuroregenerative effect. The additional inclusion of a dosed locomotor load in the overall therapeutic plan and against a background of combined approaches can have a significant supportive effect. The aim of this review is to evaluate studies that use combinations of different approaches, thereby advancing our current understanding of the mechanisms that underlie their therapeutic effect. This review will consider mostly the effects and limitations of regenerative approaches, as well as the effects of locomotor load and neuromodulation on molecular and cellular changes in the spinal cord.