Central nervous system regeneration: mission impossible?

1. Attempts to induce clinical repair after central nervous system injury, such as spinal cord damage, are likely to involve several protocols because eliciting a regenerative response from an injured central neuron is a complex task. Future treatments, applied when a window of opportunity exists, address the requirements for regeneration. 2. Application of trophic support to the lesion site for axotomized neurons aims to initiate and maintain a cell body response conducive to axonal regrowth. 3. Surgical intervention may provide a bridge across the injury site that contains either Schwann cells or olfactory bulb ensheathing cells derived from the patient's own tissue. 4. The application of antibodies may block the inhibitory action of myelin-associated molecules and other glial elements. 5. Gene therapy may induce the correct cascade of guidance molecules to be released at appropriate times. 6. Physical rehabilitation may ensure that muscle wastage is reduced and encourages functional reconnection.