Sequential therapy of anti-Nogo-A antibody treatment and treadmill training leads to cumulative improvements after spinal cord injury in rats

Intense training is the most clinically successful treatment modality following incomplete spinal cord injuries (SCIs). With the advent of plasticity enhancing treatments, understanding how treatments might interact when delivered in combination becomes critical. Here, we investigated a rational approach to sequentially combine treadmill locomotor training with antibody mediated suppression of the fiber growth inhibitory protein Nogo-A. Following a large but incomplete thoracic lesion, rats were immediately treated with either anti-Nogo-A or control antibody (2 weeks) and then either left untrained or step-trained starting 3 weeks after injury for 8 weeks. It was found that sequentially combined therapy improved step consistency and reduced toe dragging and climbing errors, as seen with training and anti-Nogo-A individually. Animals with sequential therapy also adopted a more parallel paw position during bipedal walking and showed greater overall quadrupedal locomotor recovery than individual treatments. Histologically, sequential therapy induced the greatest corticospinal tract sprouting caudally into the lumbar region and increased the number of serotonergic synapses onto lumbar motoneurons. Increased primary afferent sprouting and synapse formation onto lumbar motoneurons observed with anti-Nogo-A antibody were reduced by training. Animals with sequential therapy also showed the highest reduction of lumbar interneuronal activity associated with walking (c-fos expression). No treatment effects for thermal nociception, mechanical allodynia, or lesion volume were observed. The results demonstrate that sequential administration of anti-Nogo-A antibody followed in time with intensive locomotor training leads to superior recovery of lost locomotor functions, which is probably mediated by changes in the interaction between descending sprouting and local segmental networks after SCI

Effects of treadmill training on microvascular remodeling in the rat after spinal cord injury

Introduction : The morphological characteristics of skeletal muscles innervated caudal to a spinal cord injury (SCI) undergo dramatic phenotypic and microvascular changes. Method : Female Sprague–Dawley rats received a severe contusion at thoracic level 9/10 and were randomly assigned to locomotor training, epidural stimulation, or a combination of the treatment groups (CB). Fiber type composition and capillary distribution were assessed in phenotypically distinct compartments of the tibialis anterior. Results : Spinal cord injury induced a shift in type II fiber phenotype from oxidative to glycolytic (P  < 0.05) as well as capillary loss within the oxidative core and glycolytic cortex; the CB treatment best maintained capillary supply within both compartments. Discussion : The angiogenic response of CB training improved capillary distribution across the muscle; capillary distribution became spatially more homogeneous and mean capillary supply area decreased, potentially improving oxygenation. There is an important role for weight‐bearing training in maintaining the oxidative phenotype of muscle after SCI. Muscle Nerve 59 :370–379, 201