The role of the serotoninergic system in functional recovery after spinal cord injury

The serotoninergic system plays an essential role in the modulation of the spinal networks activity involved in the control of motor, sensory, and visceral functions. Spinal cord injury (SCI) can induce a state of overexcitation that contributes to pain, spasticity, and dysregulation of autonomic functions. At the same time, 5-NT axons are known to adapt faster than others to pathophysiologic changes and leave the ability to sprout and regenerate after injury. A number of experimental animal studies as well as some clinical observations suggest that the serotoninergic system is a key endogenous resource for posttraumatic recovery after SCI. Specific therapy may include administration of serotoninergic drugs and intraspinal transplantation of 5-NT neurons. This review discusses the role of the serotoninergic system in functional recovery after SCI and the prospects for the use of serotoninergic drugs in neurorehabilitation.