Building of New Motoneurons in the Human Spinal Cord upon Coordination Dynamics Therapy to Improve Finger Functions in Motoric Complete Cervical Spinal Cord Injury, pp. 231-264
Authors: G. Schalow
Abstract: Cervical spinal cord injury (SCI) can partly be cured (including movement, bladder, sexual, and blood circulation functions) upon administering a long lasting movementbased learning therapy called ‘Coordination Dynamics Therapy’ (CDT). In incomplete cervical SCI a repair is mainly achieved by a functional reorganization including an improvement of the impaired phase and frequency coordination for the self-organization of the neuronal networks of the central nervous system. But in motoric complete SCI at C5/6 levels (sensoric incomplete), a repair has to include a functional and a structural repair. Limited regeneration of the cord, which started approximately 1 year after the accident, could be achieved in a patient upon 3 years of optimal CDT. But a further problem in SCI at C5/6 levels is that also the motoneurons in the grey matter are destroyed at the injured site, with the consequence that the fingers cannot be moved any more. There is indication that upon 3.5 years of optimal CDT the fingers start to function again in motoric complete cervical SCI. From brachial plexus and cauda equina injuries it is known that hand and leg functions, respectively, start to re-appear 2 years after the accident. The growing of motoneuron axons, after injury, along the Bügners bands in peripheral nerves to reinnervate hand and foot muscles therefore needs at least 2 years. The starting of finger functions in the patient with the cervical SCI upon 3.5 years of optimal CDT is interpreted in the way that the building of new motoneurons in the human spinal cord needed 1.5 years upon therapy (endogenous stem cell therapy) and the growing of the axons down to the muscles and the building of functioning new synapses needed at least 2 years. The believe that motor functions can re-occur after a few days till to a few months in patients with SCI upon exogenous stem cell therapy is in contradiction to the delay times for repair.