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Table 2 Rehabilitative potential for different areas of the nervous system damaged by blast or gunshot injuries

From: Neuroregeneration and plasticity: a review of the physiological mechanisms for achieving functional recovery postinjury

Areas for rehabilitation improvement Affected area Methods that can be used with observed impacts
Movement disorders in Parkinson’s Disease Basal ganglia [144] • Long-term deep brain stimulation of the subthalamic nuclei
• Restorative effects of global structural and functional connectivity as a result of plasticity and neuroregeneration [145]
• Stimulation of mesencephalic locomotor region [146] [analogous to the pedunculopontine nucleus in humans [147]
Motor recovery after stroke Unilateral cervical contusion [148] • Vagal nerve stimulation
• Release of monoamines within cerebral cortex
• Promotes plasticity of neural circuits and enhances motor learning [148, 149].
• Activity-dependent plasticity also occurs [150].
Allodynia Mid-thoracic contusion SCI [151] • Induces plasticity via stimulation to the nucleus raphe magnus to augment serotonin release [151].
Speech Left fronto-temporo-parietal region (15708219) • Intensive speech therapy [152, 153]
• Combined with pharmacological therapies [154,155,156,157]
• Combined with noninvasive brain stimulation [158,159,160,161].
• Results are promising, but sample sizes have been small [162].
Eating and swallowing Motor cortex • Sensory input essential as it drive changes in cortical circuitry [163].
• Neuromuscular stimulation induces plasticity changes [164].
Visual field and recognition Visual cortex • Restitutive capacity is limited [165]
• Compensatory mechanism are effective – shifting the visual field border towards the hemianopic side in hemianopia to improve spatial orientation and mobility [165].
• New visual functions – enhancement of the resolution to make it greater than that of the retina [165].
• Plasticity level in higher visual functions is unknown [166].
• Plasticity through cross-mode sharing of visual pathways with tactile or auditory pathways through extensive training and practice [167].
Optic Nerve • Optic nerve with appropriate deletions of physiological “brakes” or additions of “facilitators” can regenerate centrally from the retinal ganglion cells [47].
Cognitive (thinking, reasoning, judgment and memory) Frontal cortex • NF training can lead to positive memory function and normalization of pathological brain activation patterns [168].
• Enriched environment promotes synaptic plasticity [169].
• Selective serotonin reuptake inhibitors administered acutely after brain injury may induce plasticity similar to that seen in the critical period [170].
• Normal plasticity becomes dysfunctional postinjury, failing to confer neuroprotection and to prevent further cell death. Therapies should target aspects of normal plasticity that are altered postinjury [171].
Bowel and bladder control SCI above the sacrum • Early sacral neuromodulation following SCI reduces the extent of secondary injury and maladaptive neural restricting [172].
• Further evidence needed to support this theory.
• EGFR inhibition promotes nerve regeneration in vitro and in vivo, with bladder function restored in rodents [173].
Emotional control Fear memories • Inhibition of NgR1 can help with the recovery of emotional control postinjury [174, 175].
  1. NF Neurofeedback, SCI Spinal Cord Injury, EGFR epidermal growth factor receptor, NgR1 Neuronal Nogo-66 receptor 1