Regenerative and Repair Strategies for the Central Nervous System: Progress in Basic and Clinical Research on Spinal Cord Injury

The brain and spinal cord comprise the central nervous system (CNS), which generates motor commands that produce all bodily movements. Damage to these structures (e.g., from spinal cord injury) causes major neurological impairments, devastating patients quality of life. To date, no randomized clinical trial has shown definitive evidence of a repair strategy that improves functional recovery after spinal cord injury (SCI). Therefore, developing strategies to recover function after severe neurotrauma remains a major challenge for basic and clinical neuroscientists. In this chapter, we review fundamental principles and recent advances in our understanding of SCI biology through experimental readouts from animal models and observations from human SCI patients. Furthermore, we describe the current state of regenerative and repair strategies for restoring function after CNS trauma with an emphasis on spinal cord injuries. In summary, only by tailoring combinations of different strategies can we appropriately target multiple facets of spinal cord repair and mediate clinically meaningful functional improvements. These concepts may also apply to other CNS disorders.