Degeneration and Regeneration of the Nervous System

Abstract

DEGENERATION AND REGENERATION IN THE NERVOUS SYSTEM Edited by Norman R. Saunders and Katarzyna M. Dziegielewska 2000. Amsterdam: Harwood Academic Publishers Price £39. pp. 348. ISBN 90‐5823‐022‐8 Repair of the damaged human central nervous system (CNS) remains a much sought after but still elusive goal of patients, clinicians and scientists. As noted by Douglas Brown, in the opening chapter of this book, patients and their families have been alternately excited by the prospect of cure and frustrated by the delays in achieving this. Clinicians have found themselves in an awkward position trying to bridge the gap between the expectations of patients, the enthusiasm of researchers, and the limitations of available treatment. This book comprises 14 reviews of different aspects of degeneration, regeneration and adaptation to injury in the nervous system, with an emphasis on interventions that promote the regrowth of damaged axons. Most of the reviews relate to degeneration and regeneration in the CNS but three of the chapters focus on the peripheral nervous system. In the first chapter, Brown analyses the findings in several studies of high‐dose methylprednisolone for the treatment of patients with acute spinal cord injury. The results of the US National Acute Spinal Cord Studies suggest that high‐dose methylprednisolone may improve neurological outcome. However, methylprednisolone significantly increased the risk of severe sepsis, and several methodological problems, including the use of historical controls, limit the value of these trials as a guide to treatment. Brown also briefly considers other potential treatments for acute injury, such as GM‐1 ganglioside and thyrotropin releasing hormone, and the possible role of the potassium channel‐blocking agent 4‐aminopyridine in patients with chronic spinal cord injury. Saunders and Dziegielewska give a detailed account of studies demonstrating the enabling effect of embryonic spinal cord tissue in promoting (limited) axonal growth across transected neonatal spinal cord. …