Reorganization of neuronal connections following CNS trauma: principles and experimental paradigms

The present review summarizes how the nervous system responds to trauma. The goal is to provide an introduction to the problems, techniques, experimental paradigms, current issues, and future promise. The review is especially designed for basic scientists and clinicians who are not currently involved in research on CNS reorganization, and for students just entering the field. The review characterizes the secondary degenerative events that occur after trauma, and the types of growth that commonly occur. A standard terminology is set forth with criteria for differentiating between related phenomena. Experimental methods are described that can be used documenting reorganization of circuitry. The principles that determine whether a given process will or will not occur are summarized, and some of the factors that may regulate the nature and extent of growth are considered. Research strategies are outlined that have been used to evaluate whether reorganization of circuitry is functionally significant. Finally, future directions in research and clinical application are discussed, focusing especially on the efforts to facilitate regeneration, and the work on transplants of CNS tissue to facilitate growth of surviving connections, and to replace tissue destroyed by trauma.