Zentrale Lokomotionsgeneratoren im Rückenmark der Katze und ihre Bedeutung bei der Rehabilitation nach spinalen Läsionen

Zusammenfassung

Die Fähigkeit des Rückenmarks, sich nach partiellen oder vollständigen Schädigungen wieder zu erholen und sogar die Gehfähigkeit wiederherzustellen, ist Gegenstand vieler Untersuchungen an Katzen. Wesentliche Erkenntnis dieser Versuche ist, dass selbst nach einer vollständigen Durchtrennung des Rückenmarks auf der Ebene des 12./13. thorakalen Rückenmarksabschnittes eine gute Chance auf Wiederherstellung der Bewegung in den Hintergliedmaßen besteht. Eine wichtige Rolle spielen dabei die im Rückenmark gelegenen zentralen Lokomotionsgeneratoren („central pattern generators“, CPGs). Die CPGs alleine bewirken allerdings keine Reinitiierung der Motorik, sondern ein gezieltes und konsequentes Bewegungstraining, kombiniert unter Umständen mit einer sensorischen Stimulation der Hintergliedmaßen, ist dafür essenziell. Beide Maßnahmen führen zu einer Neuorganisation der CPGs sowie der neuronalen Netzwerke im Rückenmark. Grundsätzlich sind dabei das Alter der Tiere zum Zeitpunkt der Verletzung sowie Ausmaß und Lokalisation der Läsionen von großer Bedeutung. Einen neuen Ansatzpunkt liefert der Einfluss von Neurotransmittern/Neuromodulatoren auf die Regeneration des Rückenmarks. Inwieweit diese das Bewegungstraining unterstützen können, bedarf allerdings noch weiterführender klinischer Untersuchungen.

Summary

The ability of the spinal cord to recover after partial or complete transection, and even reinitiate motor function, was investigated in several studies in cats. It has been shown that even after a complete spinalisation at the level of T12/T13, the possibility of restoration of hindlimb function is good. Central pattern generators (CPGs), located in the spinal cord, play an important role in this situation. Although CPGs alone are unable to restore function, the combination of CPGs with targeted and consistent mobility training and, in some cases, hindlimb sensory stimulation is essential to improve function. These result in a reorganisation of the CPGs and neuronal networks in the spinal cord. The age of the animal at the time of injury and the extent and localisation of lesions, play a crucial role in recovery. A new focus of research is the influence of neurotransmitters/neuromodulators on spinal- cord regeneration. How and to what extent these factors support locomotor training remains for further clinical investigation.

Schlüsselwörter

Neurologie - Rückenmarksläsion - pharmakologische Unterstützung - Gehfähigkeit - Laufbandtraining

Keywords

Neurology - spinal cord lesion - pharmacological support - treadmill training

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