Role and limitations of rehabilitation-induced neural network remodeling after stroke

There is plenty of evidence that proves the beneficial and reliable effects of rehabilitation therapy,making it the most common treatment for patients with chronic stroke.It is believed that rehabilitation improves functional recovery through neural network remodeling,which is observed as a motor map reorganization or functional connectivity change assessed by intracortical microstimulation or functional magnetic resonance imaging（MRI）.

Remodeling of skin nerve fibers during burn wound healing

Burn wound healing involves a complex sequence of processes. Recent studies have revealed that skin reinnervation may have an impact on physiological wound repair. Few studies have addressed the process of reinnervation and morphological changes in regenerated nerve fibers. The regeneration of neurites during full-thickness burn wound healing was determined by immunofluorescent staining using an anti-neurofilament protein monoclonal antibody, and three-dimensional morphology was observed under a laser scanning confocal microscope. Morphology and the volume fraction of collagen and nerve fibers were measured. Skin reinnervation increased during wound healing, peaked during the proliferative scar stage, and then decreased to lower levels during the maturation period. The results from the skin nerve fibers correlated with those from collagen using semi-quantitative analysis. Disintegration and fragmentation were observed frequently in samples from the proliferative stage, and seldom occurred during the maturation stage. There was a remodeling process of regenerated nerve fibers during wound healing, which comprised changed innervation density and topical morphology. The mechanism of remodeling for nerve fibers requires further investigation.

Neural regeneration after peripheral nerve injury repair is a system remodelling process of interaction between nerves and terminal effector

In China, there are approximately 20 million people suffering from peripheral nerve injury and this number is increasing at a rate of 2 million per year. These patients cannot live or work independently and are a heavy responsibility on both family and society because of extreme disability and dysfunction caused by peripheral nerve injury （PNI）. Thus, repair of PNI has become a major public health issue in China.

Supplementary motor area deactivation impacts the recovery of hand function from severe peripheral nerve injury

Although some patients have successful peripheral nerve regeneration,a poor recovery of hand function often occurs after peripheral nerve injury.It is believed that the capability of brain plasticity is crucial for the recovery of hand function.The supplementary motor area may play a key role in brain remodeling after peripheral nerve injury.In this study,we explored the activation mode of the supplementary motor area during a motor imagery task.We investigated the plasticity of the central nervous system after brachial plexus injury,using the motor imagery task.Results from functional magnetic resonance imaging showed that after brachial plexus injury,the motor imagery task for the affected limbs of the patients triggered no obvious activation of bilateral supplementary motor areas.This result indicates that it is difficult to excite the supplementary motor areas of brachial plexus injury patients during a motor imagery task,thereby impacting brain remodeling.Deactivation of the supplementary motor area is likely to be a serious problem for brachial plexus injury patients in terms of preparing,initiating and executing certain movements,which may be partly responsible for the unsatisfactory clinical recovery of hand function.

Pancreatic cancer-related pain:mechanism and management

Pancreatic cancer-related pain(PCRP)gains widespread attention for its high prevalence,extreme complexity,poor prognosis,and decreased survival rate.Current treatment of PCRP remains unsatisfactory since the underlying mechanism is not clear.The occurrence of PCRP is mainly related to the neurotropic nature of pancreatic cancer,and perineural invasion,neural remodeling and plasticity play important roles.Upon the understanding of PCRP mechanism,the management of PCRP is a multidisciplinary and multifaceted strategy.Traditional pain medications,invasive or intervention treatment,psychological support,integrative therapy,and palliative care are all the potential aspects for the management of PCRP.