The Role of Neurotrophic Therapy in Spinal Cord Injury Recovery: Insights and Clinical Applications

Spinal cord injury (SCI) remains one of the most challenging conditions in neurology, affecting millions worldwide. Over decades of clinical and experimental research, scientists have consistently demonstrated that neurotrophic support plays a crucial role in the recovery process following spinal trauma. When the spinal cord sustains damage—especially incomplete injuries—the nervous system attempts to repair itself through a slow but vital process known as axonal sprouting. This refers to the regeneration of damaged nerve fibers, or axons, which gradually reconnect with downstream neural circuits below the injury site.

How Neurotrophic Factors Support Neural Regeneration

Neurotrophic factors, particularly those acting as nerve growth promoters, significantly enhance this natural regenerative capacity. These proteins stimulate surviving neurons to extend new processes and form functional synaptic connections. In environments rich with neurotrophic signaling, such as elevated concentrations of nerve growth factor (NGF), the rate of axonal growth can increase—though still limited to approximately 1 millimeter per month. While seemingly modest, this represents a meaningful improvement over the baseline regeneration speed, which would otherwise be even slower without external biochemical stimulation.

Even in cases where visible functional recovery appears minimal, the theoretical foundation for using neurotrophic agents remains strong. The central nervous system's plasticity allows undamaged pathways—especially from the unaffected side of the body (the "healthy" hemisphere)—to partially compensate for lost functions. This phenomenon, known as neural compensation, is further amplified when neurotrophic support encourages collateral sprouting and synaptic reorganization.

Mouse-Derived Nerve Growth Factor in Human Treatment

Currently, human recombinant nerve growth factors are not widely used in clinical settings for SCI. Instead, many treatment protocols rely on mouse-derived nerve growth factor (mNGF), extracted from murine submandibular glands. Despite its animal origin, mNGF has shown measurable biological activity in human neural tissues and is approved for therapeutic use in several countries.

Clinical evidence suggests that patients receiving mNGF experience improved neurological outcomes compared to control groups, particularly in sensory function and partial motor recovery. Although individual responses vary, consistent administration appears to optimize results. A standard treatment regimen typically involves a four-week cycle, repeated over six consecutive cycles—amounting to a minimum of six months of continuous therapy.

Optimizing Treatment Duration and Outcomes

This extended duration aligns with the slow pace of neural regeneration. Because nerve repair occurs over months rather than weeks, short-term interventions are unlikely to yield significant benefits. Prolonged exposure to neurotrophic stimulation helps maintain a conducive environment for axonal extension, synaptic formation, and myelin remodeling—all essential components of functional recovery.

While more advanced therapies like stem cell transplantation and bioengineered scaffolds are under investigation, neurotrophic pharmacotherapy remains a cornerstone of current rehabilitation strategies. As research progresses, combining mNGF with physical therapy, electrical stimulation, and emerging biologics may unlock greater potential for restoring mobility and independence in individuals living with spinal cord injuries.