Diffusion tensor imaging-based assessment of white matter tracts and visual-motor outcomes in very preterm neonates.

INTRODUCTION: The purpose of this study was to assess the impact of brain injury on white matter development and long-term outcomes in very preterm (VPT) neonates. METHODS: Eighty-five VPT neonates (born <32/40 weeks gestational age (GA)) scanned within 2 weeks of birth were divided into three groups based on the presence of perinatal cerebral injury: (i) no injury, (ii) mild/moderate injury and (iii) severe injury. Diffusion tensor imaging (DTI) was acquired for each neonate and fractional anisotropy (FA), and diffusivity measures were calculated in the posterior limb of the internal capsule (PLIC) and optic radiation (OR). At 2 and 4 years of age, 41 and 44 children were assessed for motor and visual-motor abilities. Analyses determined the relation between GA and DTI measures, injury groups and DTI measures as well as developmental assessments. RESULTS: GA was related to all DTI measures within the PLIC bilaterally, FA in the OR bilaterally and AD in the left OR. The severely injured group had significantly different DTI measures in the left PLIC compared to the other two groups, independent of lateralization of lesions. Group differences in the left OR were also found, due to higher incidence of the white matter injury in the left hemisphere. No differences were found between groups and outcome measures at 2 and 4 years, with the exception of destructive periventricular venous haemorrhagic infarction (PVHI). CONCLUSIONS: DTI measures of the PLIC and OR were affected by injury in VPT neonates. These findings seen shortly after birth did not always translate into long-term motor and visual-motor impairments suggesting compensatory mechanisms.

Accurate segmental motor innervation of human lower-extremity skeletal muscles.

BACKGROUND: There is limited knowledge about accurate segmental motor innervation of the human lower extremity skeletal muscles. The aim of the present study was to explore the truth of segmental motor innervation of the lower extremity. METHODS: Included in this study were 20 patients with unilateral fracture of the sacrum and sacral nerve injury, who underwent internal fixation and decompression of the sacral nerve in our hospital between June 2009 and January 2014. L4-S4 nerve roots of the uninjured side were stimulated during operation. Motor innervation was determined by stimulating the spinal nerves with supramaximal intensity. RESULTS: We found the gluteus medius and the gluteus maximus were both mainly innervated by L5 and S1. In addition, the nerve fibres that innervated the extensor digitorum brevis, the abductor hallucis and the flexor digitorum brevis were mainly from S2 to S3. CONCLUSIONS: Our study provides the electrophysiological mapping of the segmental anatomy of the human lower extremity muscles, which should be clinically useful in helping the diagnosis and treatment of nerve injury and neuropathies.

Differential plasticity of the GABAergic and glycinergic synaptic transmission to rat lumbar motoneurons after spinal cord injury.

Maturation of inhibitory postsynaptic transmission onto motoneurons in the rat occurs during the perinatal period, a time window during which pathways arising from the brainstem reach the lumbar enlargement of the spinal cord. There is a developmental switch in miniature IPSCs (mIPSCs) from predominantly long-duration GABAergic to short-duration glycinergic events. We investigated the effects of a complete neonatal [postnatal day 0 (P0)] spinal cord transection (SCT) on the expression of Glycine and GABA(A) receptor subunits (GlyR and GABA(A)R subunits) in lumbar motoneurons. In control rats, the density of GlyR increased from P1 to P7 to reach a plateau, whereas that of GABA(A)R subunits dropped during the same period. In P7 animals with neonatal SCT (SCT-P7), the GlyR densities were unchanged compared with controls of the same age, while the developmental downregulation of GABA(A)R was prevented. Whole-cell patch-clamp recordings of mIPSCs performed in lumbar motoneurons at P7 revealed that the decay time constant of miniature IPSCs and the proportion of GABAergic events significantly increased after SCT. After daily injections of the 5-HT(2)R agonist DOI, GABA(A)R immunolabeling on SCT-P7 motoneurons dropped down to values reported in control-P7, while GlyR labeling remained stable. A SCT made at P5 significantly upregulated the expression of GABA(A)R 1 week later with little, if any, influence on GlyR. We conclude that the plasticity of GlyR is independent of supraspinal influences whereas that of GABA(A)R is markedly influenced by descending pathways, in particular serotoninergic projections.

Sonographic measurement of diaphragm movement in patients with tetraplegia.

STUDY DESIGN: This was an observational, descriptive case-series study. The magnitude and direction of diaphragm movement during tidal and maximal inspiratory breaths in tetraplegic subjects were measured using B-mode sonography on a single occasion. Data were tabulated for descriptive analysis. OBJECTIVE: There is a paucity of literature reporting dynamic movements of the paralyzed diaphragm. The aim of this pilot study was to investigate and record diaphragm movement in subjects with a cervical spinal cord injury (C1-C5), which had resulted in tetraplegia with partial or complete diaphragm paralysis. Subjects were patients of the Royal Adelaide Hospital in South Australia. RESULTS: Three subjects participated in the study. The magnitude of diaphragm movement was small in two subjects and approached normal in one subject. During tidal inspiratory and maximal inspiratory breaths, the diaphragm moved in a caudal direction in two subjects. In the other subject, the diaphragm moved in a cephalad direction during a maximal inspiratory breath. CONCLUSION: Imaging of diaphragm movement was well tolerated by three subjects with cervical spinal cord injury. The difference in magnitude of diaphragm movement was not fully explained by the level of injury and the American Spinal Injury Association classification.

Undesired effects of a combinatorial treatment for spinal cord injury--transplantation of olfactory ensheathing cells and BDNF infusion to the red nucleus.

Transplantations of olfactory ensheathing cells (OECs) have been reported to promote axonal regeneration and functional recovery after spinal cord injury, but have demonstrated limited growth promotion of rat rubrospinal axons after a cervical dorsolateral funiculus crush. Rubrospinal neurons undergo massive atrophy after cervical axotomy and show only transient expression of regeneration-associated genes. Cell body treatment with brain-derived neurotrophic factor (BDNF) prevents this atrophy, stimulates regeneration-associated gene expression and promotes regeneration of rubrospinal axons into peripheral nerve transplants. Here, we hypothesized that the failure of rubrospinal axons to regenerate through a bridge of OEC transplants was due to this weak intrinsic cell body response. Hence, we combined BDNF treatment of rubrospinal neurons with transplantation of highly enriched OECs derived from the nasal mucosa and assessed axonal regeneration as well as behavioral changes after a cervical dorsolateral funiculus crush. Each treatment alone as well as their combination prevented the dieback of the rubrospinal axons, but none of them promoted rubrospinal regeneration beyond the lesion/transplantation site. Motor performance in a food-pellet reaching test and forelimb usage during vertical exploration (cylinder test) were more impaired after combining transplantation of OECs with BDNF treatment. This impaired motor performance correlated with lowered sensory thresholds in animals receiving the combinatorial therapy - which were not seen with each treatment alone. Only this combinatorial treatment group showed enhanced sprouting of calcitonin gene-related peptide-positive axons rostral to the lesion site. Hence, some combinatorial treatments, such as OECs with BDNF, may have undesired effects in the injured spinal cord.

A comparison of two-dimensional and three-dimensional techniques for the determination of hindlimb kinematics during treadmill locomotion in rats following spinal cord injury.

Of all the detrimental effects of spinal cord injury (SCI), one of the most devastating effects is the disruption of the ability to walk. Therefore, much effort has been focused on developing several methods to document the recovery of locomotor function after experimental SCI. Computerized rat gait analysis is becoming increasingly popular in the SCI research community. The two-dimensional (2D) kinematic approach is by far the most popular technique in rat gait analysis. This is a simple inexpensive procedure, which requires only one camera to record the movement. Our study included an examination of locomotion on a treadmill using 2D and three-dimensional (3D) analysis, in neurologically intact animals and following moderate T9 contusion injury. Despite the overall time course patterns of the curves were identical, we found significant differences between values of the 2D and 3D joint angular motion. In conclusion, maximal precision and accuracy of the kinematic values are expected when the experimental protocol includes a 3D motion analysis methodology. Moreover, a 2D method cannot be used to determine the external or internal rotations of the foot because this movement occurs in the transverse plane.

Pre-existing pathways promote precise projection patterns.

A large body of evidence shows that molecular cues promote specific synapse formation by guiding axons and by mediating their association with targets, but much less is known about the contribution of physical cues (such as mechanical constraints) to these processes. Here we used the peripheral motor system to investigate the latter issue. In living mice, we viewed individual motor axons bearing a fluorescent reporter, and mapped the cohort of muscle fibers that they innervated both before and after nerve damage. When gross trauma was minimized (by a nerve-crushing rather than nerve-cutting procedure), regenerating axons retraced their former pathways, bifurcated at original branch points, and formed neuromuscular junctions on the same fibers that they originally innervated. Axonal growth through tubes of non-neural cells seemed to account for this specificity, and specificity degraded when the tubes were cut. These results suggest that nonspecific guidance cues can be sufficient to generate specific synaptic circuitry.

Acute reactive and regenerative changes in mature cortical axons following injury.

Live-imaging brain slice techniques were utilized to study the acute changes in transected adult mammalian neocortical neuronal processes. Transected distal axons, but not axon segments directly emerging from the cell body or dendrites, undergo rapid morphological changes leading to attempted sprouting within hours after injury. The stereotypical response involved an initial retraction of the severed axon segments, followed by rapid stabilization. Subsequently, the cut-end underwent extensive swelling, forming large singular or multiple bulb-like structures. Two to three hours after transection, sprout-like protuberances emanated from the swollen bulbs. These axonal sprouts were highly dynamic, with many showing increased length over time and a capacity to change direction. These results indicate that damaged mature axons have an intrinsic capacity to react adaptively and attempt regeneration.

Rat motor neurons caudal to a rubrospinal tract (RST) transection remain viable.

In the rat, the rubrospinal tract (RST) is a descending motor pathway involved in the production of skilled reaching movement. The RST originates in the red nucleus in the midbrain and runs down the spinal cord in the lateral most aspect of the dorsolateral funiculus (DLF). The RST makes monosynaptic contact with interneurons within the intermediate laminae of the cord, however a contingent of RST axons constitutes direct supraspinal input for spinal cord motor neurons. The current study investigated the effects of unilateral RST transection at cervical levels C3-4 on the population of motor neurons in both spinal segments C5-6 and L2-3. The total number of large, medium and small motor neurons in these segments was estimated with stereological techniques in both ventral horns at 1, 3, 7 and 14days post-injury. In both spinal cord segments under investigation, no change was detected in mean number of motor neurons over time, in either ventral horn. That the loss of direct supraspinal input resulting from the RST transection does not affect the viability of motor neurons caudal to the injury indicates that these neurons have the potential to be re-innervated, should the RST injury be repaired.

Aggravation of an injured dentato-rubro-thalamic tract in a patient with mild traumatic brain injury: A case report.

RATIONALE: We report on a patient with mild traumatic brain injury (TBI) by follow-up diffusion tensor tractography (DTT), and observed for approximately nine monthsby serial diffusion tensor tractography (DTT). PATIENT CONCERNS: A 66-year-old male patient was injured in a car crash. Approximately four weeks after the crash, he developed a tremor in the right hand and leg. His symptoms worsened over time. DIAGNOSES: Approximately six months after the crash, he developed a mild tremor in the left hand. Nine months after the crash, he manifested severe tremor in his right hand, mild resting and intentional tremor in his left hand and both legs, and mild trunkal ataxia. INTERVENTIONS: N/A. OUTCOMES: On 3-week DTT, well reconstructed DRTTs were observed in both hemispheres, except for the thinned lower portion of the right DRTT. On 9-month DTT, the right lower DRTT had thinned compared with the 3-week DTT and showed a disruption at the upper portion. The left DRTT showed thinning in the lower portion and tearing in the upper portion compared with 3-week DTT. LESSONS: Aggravation of an injured DRTT was demonstrated in a patient with mild TBI, using serial DTT examination.

Locomotor deficits and adaptive mechanisms after thoracic spinal cord contusion in the adult rat.

The rat is widely used for modeling human spinal cord injury (SCI) and paraplegia. However, quadruped animals adapt trunk, forelimb and hindlimb movements to compensate for deficits, improving their behavioral scores and complicating the interpretation of spontaneous and treatment-induced function recovery. The kinematics of locomotion was studied in rats, both normal and after SCI (T9 contusion), and variables indicative of hindlimb function were related to brain-spinal cord connections (BSCC) spared during lesioning. Normal animals showed forward velocities characteristic of fast walking. The hind paw was placed approximately three centimeters in front of the hip at the initial contact. Hip height decreased during the first third of hindlimb stance and increased later. Mild and moderate spinal cord contusions destroyed the gray matter and adjacent axons but spared the ventrolateral tracts to various degrees. Injured animals placed the hindpaw in a more caudal position than normal and showed reduced forward velocity and hip height. Knee extension was also impaired, and both hindlimb and forelimb steps were adapted to compensate for the deficits. BSCC was estimated by averaging the transverse area of white matter at the lesion epicenter and the percentage of brain neurons labeled after peroxidase injection into L2 and L3. Recovery of hindlimb motor function was proportional to the amount of BSCC. On average, injured animals retained 18% of BSSC and recovered 23% of hindlimb function. These findings show that kinematic analysis is a reliable tool for assessing locomotor deficits and compensations and suggest limited spontaneous motor plasticity after SCI.

On the retention of neurotensin in the ventral tegmental area (VTA) despite destruction of the main neurotensinergic afferents of the VTA--implications for the organization of forebrain projections to the VTA.

Neurotensin (NT) modulates ventral tegmental area (VTA) signaling in a manner relevant to psychostimulant drug actions, thus inviting evaluation of psychostimulant effects in conditions of reduced or absent VTA NT. However, in a preliminary study, NT immunoreactivity (-ir) in the VTA was unaffected following destruction of the main concentration of forebrain neurotensinergic VTA afferents in the lateral preoptic-rostral lateral hypothalamic continuum (LPH) and adjacent lateral part of the medial preoptic area (MPOA). This study attempted to determine what measures are necessary to obtain a significant reduction of VTA NT-ir. Large unilateral ibotenic acid lesions were made in several structures containing NTergic, VTA-projecting neurons, including the LPH-MPOA, nucleus accumbens, VTA itself and dorsal raphe. None of these was associated with substantial ipsilateral loss of NT-ir in the VTA, lateral hypothalamus or lateral habenula. Combinations of lesions, such as LPH-MPOA plus VTA and LPH-MPOA plus dorsal raphe, also failed to substantially reduce NT-ir in these structures. Transections of the medial forebrain bundle (mfb) likewise failed to produce a substantial loss of VTA NT-ir measured with immunohistochemistry and radioimmunoassay. Transections of the mfb were carried out in combination with infusions of retrograde and anterograde axonal tract-tracers, revealing that the routes taken by some forebrain NT-ir VTA afferents circumvent mfb transections. All of these results together are consistent with the hypothesis that the connectional organization of forebrain and brainstem, potentially in combination with limited adaptive synaptogenesis, renders the VTA relatively insensitive to moderate losses of neurotensinergic and, perhaps, other peptidergic afferents.

Objective assessment of cervical spinal cord injury levels by transcranial magnetic motor-evoked potentials.

BACKGROUND: The neurologic examination serves as the optimal method to record the level of spinal cord injury (SCI). However, this test is subject to interexaminer variability. To address this shortcoming, we describe a technique that uses transcranial magnetic motor-evoked potentials (tcMMEPs) and dermatomal somatosensory-evoked potentials (d-SSEPs) to more accurately measure the precise level of SCI. METHODS: Two groups of subjects were studied: (1) complete cervical SCI (n = 10) and (2) neurologically intact volunteers (n = 10). Two additional patients were evaluated: one with a cervical central spinal cord syndrome and another with a head injury with a suspected cervical SCI. Each subject underwent upper extremity tcMMEPs and d-SSEPs. RESULTS: Transcranial magnetic motor-evoked potentials were elicited from all upper limb myotomes (C4-T1, bilaterally) in neurologically intact volunteers (20 sides). The level of injury was determined using tcMMEPs by observing the lowest level of measurable response. The level of injury obtained using tcMMEPs was the same as that determined by neurologic examination in 13 (65%) of the 20 sides. In 7 sides, tcMMEP responses were obtained 1 level lower than that assessed by physical examination. Dermatomal somatosensory-evoked potentials were obtained from all dermatomes of volunteers tested in the laboratory compared with only 5 of the 9 patients with SCI who underwent d-SSEP testing. CONCLUSION: Testing using tcMMEPs provides an objective supplement to the neurologic examination after acute cervical SCI. Dermatomal somatosensory-evoked potentials were of limited value in determining the level of cervical SCI.

Reorganization of Intact Descending Motor Circuits to Replace Lost Connections After Injury.

Neurons have a limited capacity to regenerate in the adult central nervous system (CNS). The inability of damaged axons to re-establish original circuits results in permanent functional impairment after spinal cord injury (SCI). Despite abortive regeneration of axotomized CNS neurons, limited spontaneous recovery of motor function emerges after partial SCI in humans and experimental rodent models of SCI. It is hypothesized that this spontaneous functional recovery is the result of the reorganization of descending motor pathways spared by the injury, suggesting that plasticity of intact circuits is a potent alternative conduit to enhance functional recovery after SCI. In support of this hypothesis, several studies have shown that after unilateral corticospinal tract (CST) lesion (unilateral pyramidotomy), the intact CST functionally sprouts into the denervated side of the spinal cord. Furthermore, pharmacologic and genetic methods that enhance the intrinsic growth capacity of adult neurons or block extracellular growth inhibitors are effective at significantly enhancing intact CST reorganization and recovery of motor function. Owing to its importance in controlling fine motor behavior in primates, the CST is the most widely studied descending motor pathway; however, additional studies in rodents have shown that plasticity within other spared descending motor pathways, including the rubrospinal tract, raphespinal tract, and reticulospinal tract, can also result in restoration of function after incomplete SCI. Identifying the molecular mechanisms that drive plasticity within intact circuits is crucial in developing novel, potent, and specific therapeutics to restore function after SCI. In this review we discuss the evidence supporting a focus on exploring the capacity of intact motor circuits to functionally repair the damaged CNS after SCI.

Serotonin-related enhancement of recovery of hind limb motor functions in spinal rats after grafting of embryonic raphe nuclei.

Recently, we demonstrated improvements in hind limb locomotor-like movements following grafting of embryonic raphe nuclei cells into the spinal cord below the level of total transection in adult rats. The purpose of the present study was to clarify whether this improvement was due to newly established serotonergic innervation between the graft and the host. Two months after intraspinal grafting of the embryonic raphe nuclei, the spinalized rats, when put on a treadmill, could be induced to walk with regular alternating hind limb movements with the plantar contact with the ground during the stance phase, and ankle dorsiflexion during the swing phase of each step cycle. In the same situation the spinal rats, that did not receive the graft, were not able to initiate the dorsiflexion of the ankle joint during the swing phase and very often the dorsal surface of the foot was dragged along the ground. Intraperitoneal application of directly acting 5-HT2 antagonist Cyproheptadine (1 mg/kg) impaired reversibly the hind limb locomotor-like movements in grafted rats. This impairment lasted for 2-3 h. The same procedure in control rats did not markedly alter the hind limb locomotor-like movements. The effect of Cyproheptadine in grafted rats was reversed by i.p. injections of the 5-HT2 agonist Quipazine (0.5 mg/kg). These results show that the graft-induced restitution of hind limb locomotor abilities in adult spinal rats is brought about by the new serotonergic innervation of the host spinal cord circuitry from the grafted neurons and is mediated by 5-HT2 receptors.

Effect of neonatal spinal transection and dorsal rhizotomy on hindlimb muscles.

The purpose of this study was to elucidate the effect of deafferentation on spinal motoneurons. We studied the effects of spinal cord transection and/or dorsal rhizotomy upon the contractile properties of EDL and soleus muscle, as well as on the number of motoneurons corresponding to these muscles. Neonatal Wistar rats were randomly divided into four groups in which spinal midthoracic section (T8-T10), unilateral dorsal lumbar rhizotomy (L3-S2) or both procedures were performed on the second postnatal day (PND2). Another group served as unoperated control. At 2 months of age, the animals were evaluated for the contractile properties of a fast (EDL) and a slow (soleus) muscle. Isometric tension recordings were elicited by way of sciatic nerve branches stimulation. In addition, the incremental method was applied for the determination of the number of motor units supplying the two muscles, which was also verified by using the horseradish peroxidase (HRP) method of reverse labeling of motoneurons. Muscle alterations were confirmed by the usual biochemical staining. Our results, in agreement with the data from other researchers, show that significant muscle atrophy takes place after all experimental procedures. Additionally, spinal cord section alters the development of the dynamic properties of soleus muscle, which attains a fast profile. Following transection, the number of motor units remained unaltered, while rhizotomy affected only the soleus by reducing its motor units. The combined procedure affected both muscles, indicating that adequate synaptic input is essential for motoneuron survival.

Detection of hand and leg motor tract injury using novel diffusion tensor MRI tractography in children with central motor dysfunction.

PURPOSE: To examine whether an objective segmenation of corticospinal tract (CST) associated with hand and leg movements can be used to detect central motor weakness in the corresponding extremities in a pediatric population. MATERIAL AND METHODS: This retrospective study included diffusion tensor imaging (DTI) of 25 children with central paresis affecting at least one limb (age: 9.0±4.2years, 15 boys, 5/13/7 children with left/right/both hemispheric lesions including ischemia, cyst, and gliosis), as well as 42 pediatric control subjects with no motor dysfunction (age: 9.0±5.5years, 21 boys, 31 healthy/11 non-lesional epilepsy children). Leg- and hand-related CST pathways were segmented using DTI-maximum a posteriori (DTI-MAP) classification. The resulting CST volumes were then divided by total supratentorial white matter volume, resulting in a marker called "normalized streamline volume ratio (NSVR)" to quantify the degree of axonal loss in separate CST pathways associated with leg and hand motor functions. A receiver operating characteristic curve was applied to measure the accuracy of this marker to identify extremities with motor weakness. RESULTS: NSVR values of hand/leg CST selectively achieved the following values of accuracy/sensitivity/specificity: 0.84/0.84/0.57, 0.82/0.81/0.55, 0.78/0.75/0.55, 0.79/0.81/0.54 at a cut-off of 0.03/0.03/0.03/0.02 for right hand CST, left hand CST, right leg CST, and left leg CST, respectively. Motor weakness of hand and leg was most likely present at the cut-off values of hand and leg NSVR (i.e., 0.029/0.028/0.025/0.020 for left-hand/right-hand/left-leg/right-leg). The control group showed a moderate age-related increase in absolute CST volumes and a biphasic age-related variation of the normalized CST volumes, which were lacking in the paretic children. CONCLUSIONS: This study demonstrates that DTI-MAP classification may provide a new imaging tool to quantify axonal loss in children with central motor dysfunction. Using this technique, we found that early-life brain lesions affect the maturational trajectory of the primary motor pathway which may be used as an effective marker to facilitate evidence-based treatment of paretic children.

Remodeling of the proximal segment of crayfish motor nerves following transection.

Transected crustacean motor axons consist of a soma-endowed proximal segment that regenerates and a soma-less distal segment that survives for up to a year. We report on the anatomical remodeling of the proximal segment of phasic motor nerves innervating the deep flexor muscles in the abdomen of adult crayfish following transection. The intact nerve with 10 phasic axons and its two branches with subsets of 6 and 7 of these 10 axons undergo several remodeling changes. First, the transected nerve displays many more and smaller axon profiles than the 6 and 7 axons of the intact nerve, approximately 100 and 300 profiles in the two branches of a preparation transected 8 weeks previously. Serial images of the transected nerve denote that the proliferation of profiles is due to several orders of axon sprouting primary, secondary, and tertiary branches. The greater proliferation of axon sprouts, their smaller size, and the absence of intervening glia in the one nerve branch compared with the other branch denote that sprouting is more advanced in this branch. Second, the axon sprouts are regionally differentiated; thus, although in most regions the sprouts are basically axon-like, with a cytoskeleton of microtubules and peripheral mitochondria, in some regions they appear nerve terminal-like and are characterized by numerous clear synaptic vesicles, a few dense-core vesicles, and dispersed mitochondria. Both regions possess active zone dense bars with clustered synaptic vesicles found opposite other sprouts, glia, hemocytes, and connective tissue, but because the opposing membranes are not differentiated into a synaptic contact, the active zones are extrasynaptic. Third, some of the transected axons display a glial cell nucleus denoting assimilation of an adaxonal glial cell by the transected axons. Fourth, within the nerve trunk are a few myocytes and muscle fibers. These most likely originate from adjoining and intimately connected hemocytes, because such transformation occurs during muscle repair. In a crustacean nerve, however, where muscle is clearly misplaced, its presence implies an instructive role for motor nerves in muscle formation.

Recovery of locomotion correlated with axonal regeneration after a complete spinal transection in the eel.

This research has examined the relationship between axonal regeneration and the return of normal movement following complete transection of the spinal cord. We made measurements of tail beat frequency and amplitude of the caudal body wave from video recordings of eels (Anguilla anguilla) swimming in a water tunnel at several speeds. Each eel was then anaesthetised and the spinal cord cut caudal to the anus; in some animals the resulting gap was filled with a rubber block. All animals were kept at 25 degrees C for recovery periods ranging from 7 to 128 days, during which their swimming performance was monitored regularly. Each fish was then re-anaesthetised and perfused with fixative and the regrowing descending axons labelled with 1,1'-diotadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate. For all animals and at all speeds after surgery, tail beat frequency increased, while amplitude decreased. In non-blocked animals, an improvement in performance was first seen from 8 days following transection and thereafter tail beat frequency decreased progressively until it had returned to normal after 35 to 45 days, while amplitude remained below baseline until at least 45 days. In these animals, few axonal growth cones had penetrated the caudal stump by 7 days, but some had extended as much as 3 mm by 15 days. Many had reached as far as 6 mm between 25 and 36 days, while by 128 days they had progressed up to 10.5 mm. Contralateral crossing was never observed. Functional recovery was never witnessed in animals in which the cord had been blocked and these eels swam at all times with elevated tail beat frequency and reduced caudal amplitude. No labelled axons could be traced into the caudal spinal cord at any recovery stage in such animals. We conclude that re-innervation of only 1-2 segments caudal to the injury is necessary for functional recovery, although continued axonal growth may be important for the refinement of some aspects of movement.