Experimental Neurology

Spinal cord injury (SCI) can result in temporary or permanent alterations in sensory, motor, and autonomic functions as a result of primary mechanical damage to the spinal cord. Functional recovery is often limited due to persistent secondary injury mechanisms like inflammation, vascular breakdown, and cellular damage. Mitochondrial dysfunction is a key driver of secondary injury pathology, and while mitochondrial-targeted therapies have shown promise in rodent models of injury, functional improvements fail to translate to humans. Pigs are excellent models for understanding both the behavioral and molecular consequences of SCI because of their physiological similarity to humans, which could bridge the translational gap between rodent research and clinical implementation. To develop effective, mechanistic-based therapies, we must understand the molecular underpinnings of SCI using both male and female animal models with high translational fidelity at multiple time points after injury. To date, research on mitochondrial dysfunction following SCI has been limited to female rodent models measured acutely (6h-7d) after injury. Here, we studied mitochondrial dysfunction at three different time points in male pigs to establish a relative time course of mitochondrial impairment following SCI that may be therapeutically targeted to treat secondary complications of injury. We measured mitochondrial bioenergetic function and electron transport chain (ETC) complex activities, as well as qualified mitochondrial dynamics and oxidative damage acutely (2h), sub-acutely (24h), and chronically (9wk) after SCI in adult male pigs. The results show distinct patterns of mitochondrial dysfunction between time points with functional deficits occurring 2h post-SCI, increased mitochondrial fragmentation at 24h post-SCI, and mitochondrial recovery by 9wks post-SCI. These studies offer insight into mitochondrial changes across time in a clinically relevant animal model of SCI in hopes of bridging the translational research gap.

Spinal cord injury (SCI) pathology is highly difficult to treat due to substantial heterogeneity in injury presentation and spread, along with unclear mechanisms linking damage to pathology. Damages from injury forces (primary injury) are exacerbated by a series of biochemical events that follow the initial damage and injure additional tissue, known as secondary injury. Reactive aldehydes, such as acrolein, play a key role in propagating secondary injury cascades following SCI. Targeting acrolein after SCI has demonstrated therapeutic potential in limiting injury spread and pathology. However, injury mechanisms linking reactive aldehydes to SCI outcome have not been fully characterized. To gain a more comprehensive understanding of the cellular and molecular mechanisms underlying SCI, we generated proteomic profiles of rat spinal cords 24 h (acute phase) after subjection to SCI, sham injury, saline injection, or acrolein injection. We performed gene set enrichment analysis (GSEA) to characterize proteins and pathways significantly enriched after SCI and acrolein-injection. We then used Translatable Components Regression (TransComp-R), a framework for translating biological signatures across systems, to assess whether acrolein-associated spinal cord signatures can stratify SCI from sham outcomes. Our proteomics analysis revealed 467 differentially expressed proteins (DEPs) between the sham and SCI groups and 7 DEPs between saline and acrolein injection groups. Notably, the complement and coagulation cascades were upregulated in spinal cords subjected to SCI and acrolein injection. Our TransComp-R analysis further demonstrated that acrolein-associated signatures could distinguish SCI from sham conditions. Taken together, our findings suggest that acrolein induces proteomic alterations during the acute phase of SCI and is associated with complement and coagulation cascade activation, among other pathways. Therefore, this study reinforces the notion that understanding the role of acrolein in the acute phase of secondary SCI may be beneficial.

Acute spinal cord injury triggers a complex secondary injury cascade characterized by lesion expansion, neuroinflammation, glial reactivity, and oligodendrocyte degeneration, which together limit endogenous repair. Identifying neuroprotective interventions capable of targeting distinct components of this cascade remains a major challenge. In this study, we compared the neuroprotective profiles of minocycline, a tetracycline derivative with anti-inflammatory and antioxidant properties, and bone marrow mononuclear cells (BMMCs), which exert paracrine immunomodulatory and trophic effects, using a model of complete thoracic spinal cord transection in adult rats. Animals received either BMMCs (5 x 106 cells, intravenously, 24 h post-injury) or minocycline (50 mg/kg twice daily for 48 h, followed by 25 mg/kg for five days). Histological and immunohistochemical analyses revealed that both treatments attenuated secondary damage, reducing lesion area, microglial/macrophage activation (ED1+ cells), and oligodendrocyte pathology (Tau-1+ cells). However, the magnitude and pattern of protection differed between interventions: minocycline produced a stronger reduction in lesion area, whereas BMMCs exerted greater suppression of microglial/macrophage activation and superior preservation of oligodendrocytes. Astrocyte counts (GFAP+ cells) did not differ quantitatively among groups, despite qualitative differences in astrocytic morphology. Integrated effect size analysis further highlighted these complementary neuroprotective profiles across outcomes. Collectively, these findings indicate that minocycline and BMMCs target distinct components of secondary injury after severe spinal cord injury, providing a mechanistic rationale for future studies exploring multi-targeted or combinatorial therapeutic strategies.

Preclinical traumatic brain injury (TBI) research relies on experimental models that vary by mechanism, parameters, surgical procedures, species, strains, and ages, to name a few. While these models are crucial for understanding injury mechanisms and testing therapies, the progress in translating this knowledge to the clinic has been limited. This is in part due to fragmented resources and inconsistent reporting of critical variables. Here, we introduce the PRECISE-TBI model catalog, a centralized, queryable resource that consolidates metadata from published studies. The catalog integrates curated annotations from more than 450 papers, including details such as age, sex, strain, model type, device, and injury parameters. Where available, entries are also linked to protocols and datasets to enhance transparency and reproducibility. The Model Catalog serves as a living resource that enables cross-study comparison, identifies gaps in reporting, and connects the literature to datasets, protocols, device information, and other relevant resources. Analysis of the initial catalog entries revealed gaps in the reporting of device, age, and weight. In contrast, the reporting of sex improved over time, with over 90% of recent studies within the catalog papers reporting sex. Strain was also reported in most studies, with consistent reporting of specificity, especially for the C57 mice substrain. We expect the Model Catalog to serve as a valuable tool to enhance study design and reproducibility in preclinical TBI research while advancing FAIR data principles in the TBI field.

Cervical spinal cord injury (SCI) frequently leads to life-threatening respiratory insufficiency by disrupting descending phrenic pathways. There is growing interest in non-invasive neuromodulatory approaches to enhance plasticity of spared respiratory circuits. We investigated whether cervical repetitive magnetic stimulation (rMS) applied to the injured cervical spinal cord promotes ventilatory recovery in a preclinical mouse model. Adult mice received a unilateral C3 hemicontusion followed by either rMS or sham stimulation. We found that rMS-treated mice significantly improved recovery of tidal volume and minute ventilation at 21 days post injury(dpi) compared to sham controls under various breathing conditions (isoflurane anesthesia, poikilocapnic phase and hypercapnic challenge). Correspondingly, diaphragm EMG enhanced ipsilateral hemidiaphragm activity in ventral and medial regions, and even contralateral hemidiaphragm activity in its ventral part. This was associated with a marked attenuation of the inflammatory response at the cervical spinal cord level. Indeed, rMS lowered astroglial, fibrotic scarring, pro-inflammatory CD68-, Iba1- microglial/macrophage markers. Moreover, perineuronal net expression (WFA positive staining) is globally reduced in the ventral spinal horn, whereas at the lesion site it is markedly increased and tightly wrapped around motoneurons. Together, these findings demonstrate that rMS promotes functional respiratory recovery after cervical SCI through combined enhancement of diaphragmatic motor output and modulation of the inflammatory and extracellular environment. Together, these functional and cellular findings indicate that spinal rMS promotes a permissive, pro-regenerative environment supporting respiratory circuit plasticity. We conclude that rMS significantly enhances ventilatory recovery via reduced inflammatory response and improved intraspinal rewiring after high cervical SCI, suggesting it is a promising non-invasive strategy. The ability of rMS to engage spared respiratory networks and support neuroplasticity highlights its promise as a safe, non-invasive therapeutic strategy with translational potential for rehabilitation of breathing function after SCI. One Sentence SummaryNoninvasive cervical magnetic stimulation improves breathing after spinal cord injury by boosting diaphragm activity and reducing inflammation.

Matrix metalloproteinase (MMP) expression and function are highly context dependent, varying across physiological and pathological conditions. We previously documented the expression profiles of select MMPs in the ischemic brains of young male rodents. However, aging is a major risk factor for stroke in humans and is associated with vasculature alterations, increased oxidative stress, and elevated inflammation. In addition, sex differences have been reported in stroke incidence and severity. Despite this, the effects of age, sex, and species on brain MMP gene expression after cerebral ischemia/reperfusion (I/R) has not been systematically examined. Therefore, we investigated how age, sex, and species influence the mRNA expression of all known MMPs (22 total) in the brain following cerebral I/R. Moderate-to-severe neurological deficits were induced by transient middle cerebral artery occlusion (MCAO) followed by reperfusion in young and aged male and female C57BL/6 mice and in young male Sprague-Dawley rats. Brain tissue from the ipsilateral (ischemic) hemisphere was collected on post-MCAO day 1, and MMP mRNA levels were quantified by real-time PCR and expressed as fold change relative to the sham control group. Across species, MMP-3, MMP-8, MMP-12, MMP-13, MMP-19, MMP-20, and MMP-27 were upregulated in both rats and mice. Species-specific increases were also observed: MMP-1, MMP-7, MMP-9, MMP-14, MMP-21, and MMP-25 were upregulated only in rats, whereas MMP-10 was upregulated only in mice. The most strongly upregulated MMPs were MMP-12 in rats and MMP-3, MMP-10, and MMP-12 in mice. By contrast, MMP-15 and MMP-17 were downregulated in both species, whereas MMP-23 and MMP-24 were downregulated only in rats and mice, respectively. Within mice, MMP-3, MMP-10, MMP-12, MMP-19, MMP-20, and MMP-21 increased in both sexes and age groups, except for MMP-19 in aged males and MMP-21 in young males. MMP-14 increased only in females (young and aged), whereas MMP-27 increased only in males (young and aged). Notably, MMP-3, MMP-10, and MMP-12 were the three most highly upregulated MMPs in both male and female mice regardless of age. Overall MMP mRNA expression levels were higher in aged male mice and lower in aged female mice relative to sex-matched young mice. Among all MMPs examined, MMP-12 showed the most marked upregulation across species and, within mice, across age groups and sexes. Collectively, these findings demonstrate that brain MMP gene expression after cerebral I/R is modulated by age, sex, and species, underscoring the importance of incorporating these biological variables when targeting MMPs individually or in combination in preclinical rodent stroke models.

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability and the leading monogenic cause of autism, resulting from mutations in the Fmr1 gene. While extensive research points to widespread circuit hyperexcitability across cortical and subcortical circuits, the contribution of the spinal cord circuits in the motor phenotypes associated with FXS remains largely unexplored. Given that Fmr1 is expressed in both dorsal and ventral spinal cord, including motoneurons, the possibility exists that loss of its protein product, FMRP, disrupts locomotor circuitry. Here, we investigate whether Fmr1 deletion alters the function of the spinal central pattern generator (CPG) networks and gait-related motor output. Using isolated neonatal spinal cord preparations from Fmr1 knockout (Fmr1 KO) mice, we assessed the ability of spinal circuits to generate coordinated fictive locomotor activity in vitro. In parallel, we quantified the gait parameters and motor performance in freely moving adult mice during unskilled and skill-demanding tasks. Our findings indicate that, despite the absence of FMRP in spinal neurons, neonatal Fmr1 KO spinal cords generated robust and coordinated locomotor rhythms compared to controls. Consistently, adult Fmr1 KO mice exhibited normal gait metrics under baseline conditions. However, these mice displayed hyperactivity and performance deficits during more challenging motor tasks demanding higher coordination. These findings suggest that the fundamental locomotor circuitry is preserved in FXS, likely through compensatory mechanisms. Consequently, motor impairments in FXS may arise primarily from supraspinal or integrative circuit dysfunction, rather than intrinsic deficits in spinal CPG function. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=148 SRC="FIGDIR/small/704392v1_ufig1.gif" ALT="Figure 1"> View larger version (32K): org.highwire.dtl.DTLVardef@19a64cborg.highwire.dtl.DTLVardef@14f8ad2org.highwire.dtl.DTLVardef@1230cbforg.highwire.dtl.DTLVardef@19fd51_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_LINeonatal Fmr1 KO spinal cords generated robust, coordinated locomotor rhythms similar to controls. C_LIO_LIAdult Fmr1 KO mice exhibited normal gait metrics during baseline, unskilled locomotion. C_LIO_LIFmr1 KO mice displayed hyperactivity and performance deficits during skill-demanding motor tasks. C_LIO_LIFXS motor impairments may arise primarily from supraspinal or integrative circuit dysfunction C_LIO_LISpinal cord circuitry appears to compensate for the fundamental loss of Fmr1 function. C_LI

BackgroundSpinal cord injury (SCI) triggers persistent neuroinflammation, gliosis, neuronal loss, and demyelination, leading to motor deficits and neuropathic pain. Botulinum neurotoxin type A (BoNT/A) has shown anti-inflammatory and neuroprotective effects in acute SCI, but its potential in the chronic phase remains unclear. This study investigates whether combining BoNT/A with electrical muscle stimulation (EMS) enhances recovery in chronic SCI. MethodsAdult mice with severe thoracic SCI (paraplegic) underwent EMS (30 min/day for 10 non-consecutive days starting 3 days post-injury) or no stimulation. Fifteen days after SCI, animals received a single intrathecal injection of BoNT/A (15 pg/5 L) or saline. Functional recovery was assessed up to 60 days as well as in moderate and mild SCI mice, neuropathic pain onset and maintenance were evaluated. Spinal cord tissue was analysed for astrocytic and microglial morphology, neuronal and oligodendroglia survival, myelin protein expression, and in vitro effects on oligodendrocyte precursor cells (OPCs). The phenotype of hindlimb muscles was evaluated through morphological and gene expression analyses. ResultsEMS was able to counteract muscle atrophy and fibrosis, and when combined with BoNT/A, also denervation. Moreover, the combination restored hindlimb motor function in chronic SCI, whereas BoNT/A or EMS alone were ineffective. Neuropathic pain, a common comorbidity associated with SCI, was mitigated by BoNT/A treatment even when administered in the chronic phase. BoNT/A reduced astrocytic hypertrophy and excitatory synapse association and was associated with a morphology-based redistribution of microglial profiles toward a resting-like classification, decreased apoptosis, and increased neuronal and oligodendroglia survival. Myelin basic protein expression was significantly elevated in vivo. In vitro, BoNT/A promoted OPC differentiation into myelinating oligodendrocytes, increased process complexity, and upregulated Myelin basic protein, galactocerebroside C, proteolipid protein, and myelin oligodendrocyte glycoprotein under both proliferative and differentiating conditions. Cleaved SNAP25 colocalization with OPC confirmed direct BoNT/A internalization and activity. ConclusionsBoNT/A exerts multi-cellular neuroprotective actions in chronic SCI, supporting neuronal and oligodendroglia survival, reducing neuroinflammation, enhancing remyelination and the combination with EMS promotes substantial recovery of muscle homeostasis within a permissive microenvironment shaped by early stimulation. Its efficacy depends on a permissive microenvironment achieved through EMS. These results provide strong rationale for the clinical evaluation of BoNT/A as a therapeutic strategy for chronic SCI.

Purpose: To determine whether spatial decomposition of longitudinal retinal nerve fiber layer (RNFL) change maps reveals distinct modes of glaucomatous progression masked by conventional averaging, and to validate these modes through structure function mapping and genetic association analysis. Methods: Pixel wise RNFL rates of change were computed from longitudinal optic disc OCT scans of 15,242 eyes (8,419 adults with primary open angle glaucoma [POAG]; Massachusetts Eye and Ear, 1998 to 2023). A loss only constraint zeroed all thickening values, reflecting the biological prior that adult RNFL does not regenerate. Nonnegative matrix factorization decomposed these maps into spatial progression components (80% training set). Components were evaluated in a heldout set (20%) for retinotopic structure function concordance, visual field (VF) progressor classification against global and quadrant RNFL rates, and enrichment of genetic association signals at established POAG loci. Results: Six anatomically distinct progression patterns emerged, including diffuse circumferential loss, focal peripapillary defects, and arcuate bundle degeneration. Pattern based models significantly outperformed global RNFL rate for classifying VF progressors (area under the curve, 0.750 [95% CI, 0.709 to 0.790] vs. 0.702; P = .0096) and explained additional variance in functional decline (Nagelkerke pseudoR2, 0.301 vs. 0.198; P = .0011). Structure function mapping confirmed retinotopic coherence. Spatial phenotypes recovered stronger genetic signals than global rates at 85.3% of established POAG loci, suggesting they capture more biologically homogeneous endophenotypes of progression. Conclusions: Glaucomatous structural progression occurs through spatially distinct modes with independent structure function and genetic signatures that conventional RNFL averaging obscures.

BackgroundAdult hippocampal neurogenesis is markedly altered after cerebral ischemia. Although stroke increases the production of newborn neurons, many of these cells display aberrant morphological and positional features that impair their functional integration and contribute to long-term cognitive decline. Given the clinical heterogeneity of ischemic stroke and the persistent translational failures of preclinical approaches relying on single-model studies it remains unknown whether post-stroke neurogenic alterations are conserved across different experimental paradigms. This study aimed to define common and model-specific features of hippocampal neurogenesis across complementary focal ischemia models. MethodsWe performed a multi-center, multimodel analysis within the STROKE-IMPaCT consortium using permanent and transient middle cerebral artery occlusion (MCAO) paradigms (MCAO via ligation or cauterization under normoxic (dMCAO) or hypoxic conditions (dMCAO+Hypoxia); and filament-based tMCAO across six international sites. Brains from adult C57BL/6J mice were collected 3 days, 7 days, or 2 months after ischemia, sham, or naive conditions. Hippocampal cell proliferation (Ki67) and neuroblast density (DCX) were quantified, and the morphological maturation of newborn neurons was evaluated using high-resolution analyses of dendritic architecture and somatodendritic polarity. All analyses were performed blind to experimental group. ResultsAcross all stroke models, ischemia induced a robust bilateral increase in hippocampal cell proliferation, most pronounced at 3 days and still elevated at 7 days, with levels returning to baseline by 2 months. Neuroblast density was similarly increased at 7 days, particularly in the ipsilateral hippocampus, but normalized by 2 months. Despite recovery in cell number, long-term morphological analysis revealed a consistent reduction in apical dendrite length and a higher proportion of neurons exhibiting aberrant features including ectopic localization, multipolar or inverted polarity, and abnormal lateral growth across all models. These abnormalities were observed both when pooling data across sites and when analyzing each model or center individually. ConclusionsIschemia induces an early, transient increase in hippocampal neurogenesis across diverse stroke paradigms, but the newborn neurons generated after stroke consistently display maladaptive morphological features. These cross-model, cross-site abnormalities indicate that aberrant hippocampal neurogenesis represents a robust hallmark of post-stroke pathology within the investigated species, independent of ischemia type or surgical approach, despite known differences in the spatial distribution of primary injury across experimental stroke models. Our findings support the concept that maladaptive neurogenesis may contribute to chronic post-stroke cognitive impairment and underscore the need to consider the quality not only the quantity of newborn neurons when developing therapeutic strategies.

The partial crush spinal cord injury (SCI) model enables preclinical testing of experimental therapies in mice, but substantial inter-animal variability in recovery outcomes confounds efficacy assessments. Here, we used open field behavioral data collected during the first 3 days post partial thoracic SCI to generate an Acute Functional Score (AFS) that defined three subgroups with divergent recovery trajectories. Applying latent class growth analysis and growth mixture modeling to open field and grid walk testing data, we demonstrated 83-92% prediction accuracy for AFS-defined recovery trajectories. The three subgroups differed significantly in treadmill kinematics and histological assessments of lesion size and astrocyte bridging. Applying the recovery trajectory framework to mice receiving saline or biomaterial vehicle injections at 3 days post-SCI revealed robust predictive accuracy while exposing disproportionate injury severity distributions between experimental groups. The approach enables individualized post-SCI recovery characterization that can neutralize procedural bias, minimize animal numbers, and provide a probabilistic basis for evaluating whether interventions enhance or suppress wound repair processes. Our findings establish a foundation for improving preclinical SCI study design and accelerating identification of effective therapies.

BackgroundTemporal lobe epilepsy (TLE) often originates from focal hippocampal injury but progressively evolves into a bilateral epileptic network engaging both hippocampi and distributed cortical regions. A mechanistic understanding of how this network emerges, and whether early perturbation of specific nodes can alter its trajectory, is essential for developing network-level therapeutic strategies. ObjectiveWe used a kainate-induced rodent model of TLE to (1) characterize the spatiotemporal emergence of epileptic discharges during the latent phase, (2) determine how bilaterally synchronized events develop, and (3) test whether transient chemogenetic silencing of either the ipsilateral epileptogenic focus (EF) or the contralateral hippocampus (CH) modifies large-scale epileptogenesis. MethodsFreely moving mice were implanted with multi-site electrodes spanning bilateral hippocampal subfields (dentate gyrus, CA1, subiculum) and cortical regions (M2, Cg1, PrL, V1, entorhinal cortex). Longitudinal LFP recordings were performed every other day during the latent and early chronic phases following KA or saline injection. DREADD-based chemogenetic inhibition of glutamatergic neurons was applied between days 2-7 post-KA. Epileptiform events were quantified via spike rates, waveform metrics, high-frequency oscillations (HFOs), and short-latency interregional co-spiking ResultsEarly after KA, epileptic spiking emerged locally in the ipsilateral dentate gyrus and progressively organized into HFO-coupled discharges. Contralateral hippocampal recruitment followed a distinctive biphasic time course, characterized by transient early activation, subsequent suppression, and later re-emergence with increasing bilateral coactivation. Cortical regions gradually developed higher spike rates and enhanced DG-related co-spiking, indicating large-scale network integration. Ipsilateral silencing modified local spike composition but did not prevent global network progression, whereas contralateral silencing accelerated ipsilateral epileptogenesis and strengthened pathological HFO expression. ConclusionEpileptogenesis in the KA model reflects a transition from a focal hippocampal insult to a resilient, bilateral cortico-hippocampal network. Targeting a single hippocampal node--even at early latent stages--is insufficient to halt this progression, highlighting the need for network-level therapeutic strategies. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=116 SRC="FIGDIR/small/701979v1_ufig1.gif" ALT="Figure 1"> View larger version (35K): org.highwire.dtl.DTLVardef@171797dorg.highwire.dtl.DTLVardef@df13d3org.highwire.dtl.DTLVardef@18e9594org.highwire.dtl.DTLVardef@1fe68f8_HPS_FORMAT_FIGEXP M_FIG C_FIG

Mature CNS neurons are incapable of sufficiently regenerating their axons following spinal cord injury (SCI). This is largely due to developmental changes in epigenetic control leading to suppression of axon growth transcriptomic profile, leading to a shift towards synapse function support. Recently, manipulating the PI3K/Akt/mTOR pathway through PI3K{delta} overexpression in cortical neurons enhanced axonal regeneration of corticospinal tract axons, which was accompanied by functional recovery monitored for up to 16 weeks. However, PI3K is more widely known for its role as an oncogene, and since overexpression is achieved by the use of AAVs, valid safety concerns are raised as it is unknown what the long-term consequences of sustained PI3K{delta} expression in the brain are, which may be necessary to achieve complete re-establishment of the motor pathway. In this study, AAV1-hSYN-PIK3CD was injected into the motor cortex of rats, which survived for 1 year. Comparison with uninjected control animals reveal stable PI3K{delta} expression and sustained pathway activation through increased pS6. PI3K{delta}-treated animals show absence of tumour formation, neural soma hypertrophy, glial cell activation, or haematological or biochemical abnormalities. Thus, long-term neuronal PI3K{delta} expression appears to be well tolerated and may provide a safe and durable strategy to promote functional repair following SCI.

Accumulating evidence supports sex differences in traumatic brain injury (TBI) outcomes, however the underlying processes that lead to sex differences are not well understood. TBI results in the initiation of molecular and cellular responses that facilitate the progression of neurodegeneration. Importantly, little is known about how the circulating hormone profile is altered in response to TBI, and whether sex differences in endocrine responses might shape secondary injury pathologies. Using intact male and female mice in a preclinical TBI model, we assessed changes in plasma hormone concentrations and cortical gene expression at 24 and 72 hours after TBI. We demonstrate that males and females exhibit sex-specific alterations in circulating levels of progesterone, testosterone, androstenedione, estradiol and dehydroepiandrosterone (DHEA) in response to TBI. We also identified sex differences in the expression of genes that are involved in immune responses and tissue remodeling after injury. Moreover, we report divergent circulating hormone and gene expression correlations between sexes.

Despite a long history of studying presynaptic inhibition of the Ia afferent synapse that produces the monosynaptic EPSP on motoneurons, recent evidence has upset the conventional idea that GABAA receptors mediate this inhibition and instead suggests that there are mainly GABAB receptors at this synapse. However, without targeted access to the GABAergic neurons that activate these receptors, quantifying their functional contribution to presynaptic inhibition has proven difficult. We demonstrate here that focal optogenetic activation of terminals of a subpopulation of GAD2+ GABAergic neurons that exclusively project ventrally to Ia afferent synapses produce long-lasting presynaptic inhibition that is entirely mediated by GABAB receptors and simultaneously produces a characteristic brief GABAA receptor-mediated IPSP on the motoneurons. These ventral GAD2 neurons are recurrently activated by Ia afferents, contributing to post-activation depression with repeated afferent reflex testing, with a similar long time-course to post-activation depression of the H-reflex induced in humans from either repetitive activation of the same Ia afferents or from antagonist nerve conditioning. In contrast, focal activation of dorsally projecting GAD2 neurons does not directly cause presynaptic inhibition or postsynaptic IPSPs but does produce primary afferent depolarization. Following chronic spinal cord injury (SCI), the expression of GABAB receptors on the Ia terminal is halved, and in mice and humans, is associated with a similar decrease of GABAB receptor-mediated post-activation depression of Ia-EPSPs transmission, which is reversed by the GABAB receptor agonist baclofen. In summary, GABAB receptors mediate presynaptic inhibition, but are down regulated with SCI, contributing to reflex hyperexcitability associated with spasticity. Key Points SummaryO_LIPresynaptic inhibition of Ia afferents is mediated by the recurrent activation of terminal GABAB receptors by a subpopulation of ventrally projecting GAD2+ interneurons. C_LIO_LIIn contrast, dorsally projecting GAD2+ interneurons activate GABAA receptors on Ia afferent nodes to facilitate action potential conduction through branchpoints. C_LIO_LIRepetitive activation of Ia afferents at rates of every 10 s or faster produces post-activation depression via neurotransmitter depletion and from activation of terminal GABAB receptors. C_LIO_LIThese ventrally projecting GAD2+ interneurons can also be activated by other afferents that then produce PAD-evoked spikes to produce post-activation depression from conditioning nerve stimulation. C_LIO_LIThe reduction of GABAB receptors on the Ia terminal in spinal cord injury results in reduced presynaptic inhibition and post-activation depression, contributing to reflex hyperexcitability. C_LI O_FIG O_LINKSMALLFIG WIDTH=189 HEIGHT=200 SRC="FIGDIR/small/700955v2_ufig1.gif" ALT="Figure 1"> View larger version (39K): org.highwire.dtl.DTLVardef@17abd51org.highwire.dtl.DTLVardef@12316baorg.highwire.dtl.DTLVardef@a92168org.highwire.dtl.DTLVardef@1d06ca0_HPS_FORMAT_FIGEXP M_FIG Abstract legend: Schematic of GABAergic circuit producing presynaptic inhibition and primary afferent depolarization (PAD) in proprioceptive Ia afferents. We propose two populations of GAD2+ GABAergic interneurons, one with dorsal projections (purple) that activate GABAA receptors on the nodes of Ia afferents to produce PAD and subsequent facilitation of Ia afferent conduction, and another ventrally projecting population (pink) that activates GABAB receptors on the Ia afferent terminal to produce presynaptic inhibition via inhibition of VCa2+ channels and reduction of neurotransmitter release and replenishment. Both are activated by first order interneurons (grey). Repetitive activation of Ia afferents (green extensor) recurrently activates twhe ventrally projecting GAD2+ neurons to activate terminal GABAB receptors and long-lasting post-activation depression of Ia EPSPs and reflexes as measured from ventral root recordings. Strong conditioning stimulation of other afferents (blue flexor) activates dorsal GAD2+ neurons that can produce PAD-evoked spikes in extensor afferents that orthodromically activate motoneurons to set up post-activation depression of subsequent extensor reflexes. Here, PAD is also evoked in other afferents (flexor) by dorsally projecting GAD2+ neurons (light pink branch) but without activation of the ventrally projecting GAD2+ neurons or presynaptic inhibition. C_FIG

While a history of TBI is associated with an increased risk of neurodegenerative disease, associated mechanisms remain largely unknown. Neuroinflammation is commonly implicated as playing a role in progressive neurodegeneration in general, yet little is known about the adaptive response of neuroinflammation in TBI or how it may contribute to progressive pathologies. To parse out components of the adaptive response, we assessed for intraparenchymal T-cell infiltration in two different translational large animal (swine) models of TBI, inertial injury and focal contusion. We characterized the extent and distribution of T cells post-injury and their association with blood-brain barrier disruption and axonal pathology. T-cell infiltration following focal TBI followed a spatiotemporal progression from gray matter at 72 hours to both gray and white matter at 6 months post-injury, consistent with recruitment into the parenchyma and then white matter. Inertial injury did not lead to substantial T-cell infiltration despite BBB breakdown and axonal pathology. We did not find a spatial correlation between blood-brain barrier breakdown or axonal pathology and T-cell infiltration in focal TBI. These data suggest that there is an active adaptive response to TBI, particularly in tissue proximal to contusions. A large animal model that reproducibly demonstrates chronic T-cell infiltration may allow for examination of the downstream effects of the adaptive response to TBI, and whether targeting this adaptive response may reduce chronic inflammation and improve recovery.

After cervical spinal cord injury (cSCI), swallowing dysfunction is common and increases mortality via aspiration pneumonia. While these deficits have often been attributed to secondary damage from complications of injury management, there has recently been a greater appreciation for the modulatory role of spinal populations in swallow generation that are disrupted by injury. Here, we illustrate in a rodent model of cSCI that epidural spinal stimulation (ESS) of the phrenic motor nucleus at spinal segment C4 alters motor output at the hypoglossal motor nucleus through activation of excitatory ascending spinal pathways and inhibitory peripheral sensory feedback mechanisms. These findings highlight the importance of spinal-brainstem communication in shaping the motor program of swallow-related musculature and offer the potential for stimulation of the cervical spinal cord to be a therapeutic target for restoring swallowing function after injury. NEW & NOTEWORTHYIn two varying severity models of spinal cord injury, we demonstrate the effects of spinal cord stimulation at C4 on the distal hypoglossal motor nucleus. We show that despite being anatomically distant, electrical stimulation of the phrenic motor nucleus increases hypoglossal motor output through ascending spinal pathways and dampens it through peripheral pathways. These findings highlight the importance of spinal-brainstem communication and illustrate the ability of spinal stimulation to restore this communication after injury.

Repeated exposure to hypoxia (oxygen levels below sea-level atmospheric conditions, [~]21%) alternated with regular voluntary exercise, known colloquially as Living High, Training Low, or simply High-Low, is used by elite athletes to boost exercise benefits and athletic performance. While paradigms of High-Low training have been utilized by Olympic athletes for decades, the therapeutic potential of a High-Low regimen in the context of neurotrauma has yet to be investigated. This long-term experiment evaluated the independent and combined effects of repeated hypoxic exposure and voluntary exercise on functional outcomes within the context of preclinical spinal cord injury (SCI). We hypothesized that combinatorial High-Low training enhances functional recovery, beyond either exercise or repeated exposures to hypoxia alone, to improve outcomes after SCI. Adult female rats (n=62) underwent a high-cervical hemisection (LC2H) to model spinal cord injury. At 6 weeks post-SCI, treatment (access to exercise wheel, repeated exposure to normobaric hypoxia at rest, or alternation of both) began in the surviving subjects (n=49). Despite initiation of treatment beyond the acute post-injury phase, High-Low therapy significantly improved respiratory function and prevented the development of SCI-associated anxiety-like behaviors. Notably, repeated in vivo exposure to normobaric hypoxia induced a shift in peripheral T cell profiles, characterized by increased CD4+ and reduced CD8+ expression. These findings indicate that combining repeated exposure to hypoxia with voluntary exercise as a therapy could promote recovery in the existing spinal cord-injured population. Collectively, this work provides a foundational first step for further investigation of High-Low training as a rehabilitation therapy for individuals living with SCI.

As highly dynamic organelles, mitochondria play an essential role in neuronal survival and synaptic function. Excitotoxicity is as a critical factor that promotes mitochondrial dysfunction after traumatic brain injury (TBI). Intercellular mitochondrial transfer and exogenous mitochondrial transplantation are emerging concepts to understand mitochondrial trafficking in response to mitochondrial dysfunction; however, robust in vivo evidence remains limited on the extent of these processes in the central nervous system (CNS). There is a significant knowledge gap in our understanding of mitochondrial transfer mechanisms under both normal physiological conditions and after experimental TBI. Mouse lines expressing mitochondrial green-fluorescent dendra-2 (mtD2) and GFP (mtGFP) targeted to inner and outer mitochondrial membranes, respectively, were used to study astrocyte-specific (Aldh1l1-CreER; mtD2f/f - AmtD2 and Aldh1l1-CreER; mtGFPf/f - AmtGFP) and neuron-specific (CamK2aCre; mtD2f/f - NmtD2 and CamK2aCre; mtGFPf/f - NmtGFP) mitochondrial dynamics and bioenergetics in acute TBI and excitotoxicity. At 24 hrs following TBI, neurons in the NmtD2 mouse brain exhibited rapid and significant alterations in mitochondrial morphology, including changes in total mitochondrial volume, volume distribution, and sphericity. Synaptic neuronal (SN) mitochondria display robust deficits in mitochondrial bioenergetics and complex protein levels while non-synaptic neuronal (NSN) mitochondria show State III bioenergetics and complex proteins at control levels. These findings are accompanied by a marked increase in astrocyte-derived mitochondria (AmtGFP) transfer to neurons at 24 hrs post-injury, compared to control animals, but no increase in transfer to neuronal synapses. While TBI also altered astrocytic mitochondrial morphology in the cortex, astrocytic mitochondrial bioenergetics remained preserved. Single-cell RNA-seq analysis of astrocytes revealed significant transcriptional reprogramming following TBI, characterized by the upregulation of genes associated with mitochondrial homeostasis and the machinery for organelle trafficking. In vitro co-cultures of primary cortical astrocytes and neurons demonstrated that astrocytes can transfer mitochondria to neurons via direct contact and that NMDA-mediated excitotoxicity further enhanced this astrocyte-to-neuron mitochondrial transfer. Furthermore, astrocytic-derived extracellular vesicles containing mitochondria (EV-mito) deliver mitochondria to neurons and EV-mediated mitochondrial transfer significantly ameliorated NMDA-induced mitochondrial dysfunction in primary cortical neurons. Together, these findings show that astrocytes take on a TBI-related phenotype that facilitates dynamic changes in mitochondrial networks and mitochondrial trafficking to neurons. Astrocytic transfer of respiratory-competent mitochondria support is an intrinsic neuroprotective response to injury that supports mitochondrial function in neuronal soma, dendrites, and axons but not at the neuronal synapse. Finally, we show therapeutic potential of exogenous mitochondrial transfer, particularly via EV-mito, for treating neurological disorders associated with excitotoxicity, such as TBI.

Spinal cord injury (SCI) results in loss of sensory and motor function below the level of damage, with chronic injuries presenting unique challenges for regenerative therapies. While multichannel biomaterial interventions have shown promise in promoting axonal regeneration, circuit restoration, and motor recovery in acute SCI, achieving similar outcomes in chronic injury models remains challenging due to a combination of intrinsic and extrinsic factors. These include the reduced capacity of the neuronal cell body to sustain a growth-activated state and the formation of a physical and chemical barrier at the injury site, preventing axonal growth. To address these challenges and promote motor recovery after chronic injury, we investigated the combinatorial effect of two regenerative approaches: 1) the implantation of poly (lactide-co-glycolide) (PLG) biomaterial bridge to guide axonal growth through the injury site, and 2) the delivery of Epothilone B (EpoB), a microtubule stabilizer that strengthens axons to promote regrowth. We used a transgenic mouse model that selectively expresses a red fluorescent protein variant (tdTomato) reporter throughout the corticospinal tract (CST) under control of the Crym promoter (Crym-tdTomato). We demonstrated that the combination of bridge implantation 60 days after surgical hemisection at C5 with EpoB improved locomotor function. At 12 weeks post-bridge implantation, immunohistology revealed axon regeneration in mice receiving implantation, but not EpoB or no-implant controls. The addition of EpoB significantly increased the volume of both total and CST axons regenerating through the biomaterial channels. Diffusion tensor magnetic resonance imaging (DTI) analysis identified enhanced fractional anisotropy (FA), axial diffusivity (AD), and mean diffusivity (MD) in the bridge region in the combination treatment group, consistent with new intact axons. Furthermore, EpoB enhanced the myelination of regenerated axons in the bridge. Finally, we investigated the proteomic profile of corticospinal neurons ipsilateral and contralateral to the SCI lesion and bridge, comparing the effect of EpoB treatment. Mass spectrometry-based analysis of laser-captured cells in this paradigm identified activation of a regeneration program by corticospinal neurons. These findings present a novel approach to enhance regenerative neural repair and locomotor recovery in chronic SCI.