Pharmacological Approaches to the Treatment of Brain and Spinal Cord Injury

Although there are over 400,000 people each year in the United States alone who suffer from traumatic injury to the central nervous system (CNS), no phar macological treatment is currently available. Considering the enormity of the problem in terms of human tragedy as well as the economic burden to families and societies alike, it is surprising that so little effort is being made to develop treatments for these disorders. Although no one can become inured to the victims of brain or spinal cord injuries, one reason that insufficient time and effort have been devoted to research on recovery is that it is a generally held medical belief that nervous system injuries are simply not amenable to treatment. At best, current therapies are aimed at providing symptomatic relief or focus on re habilitative measures and the teaching of alternative behavioral strategies to help patients cope with their impairments, with only marginal results in many cases. Only within the last decade have neuroscientists begun to make serious inroads into understanding and examining the inherent "plasticity" found in the adult CNS. Ten years or so ago, very few researchers or clinicians would have thought that damaged central neurons could sprout new terminals or that intact nerve fibers in a damaged pathway could proliferate to replace inputs from neurons that died as a result of injury.

Inhalt

1. Therapeutic Approaches in Subjects with Brain Lesions.- 2. Arachidonic Acid Metabolites and Membrane Lipid Changes in Central Nervous System Injury.- 3. Experimental Spinal Cord Injury: Strategies for Acute and Chronic Intervention Based on Anatomic, Physiological, and Behavioral Studies.- 4. Serotonin Antagonists Reduce Central Nervous System Ischemic Damage.- 5. Opiate Antagonists in CNS Injury.- 6. Adaptive Changes in Central Dopaminergic Neurons after Injury: Effects of Drugs.- 7. Catecholamines and Recovery of Function after Brain Damage.- 8. Ganglioside Involvement in Membrane-Mediated Transfer of Trophic Information: Relationship to GM1 Effects following CNS Injury.- 9. Anatomic Mechanisms whereby Ganglioside Treatment Induces Brain Repair: What Do We Really Know?.- 10. Gangliosides and Functional Recovery from Brain Injury.- 11. Acute Ganglioside Effects Limit CNS Injury: Functional and Biochemical Consequences.- 12. A Rationale for the Use of Melanocortins in Neural Injury.- 13. Developmental Neurobiology and Physiopathology of Brain Injury.- 14. Growth-Associated Triggering Factors and Central Nervous System Response to Injury.- 15. Growth Factor Induction and Order of Events in CNS Repair.- 16. Nerve Growth Factor: Effects on CNS Neurons and on Behavioral Recovery from Brain Damage.- 17. Recovery from Stroke.