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Regeneration following traumatic brain injury: Signals, signposts and scaffolds

In this paper, we present a conceptual model of the steps to be taken in nerve regeneration. Starting with early vision we identify the key developmental steps leading to formation functional circuits. We then examine the two main approaches to nerve regeneration — the first centered on activating intrinsic growth restorative functions to injured axons and the second on stem cell based therapies. Guided by the findings in the visual system we propose the early application of patterned electrical stimulation. This has been shown to activate essential signaling pathways, ensure a balance between excitation and inhibition, establish reliable network topography, and provide a supportive framework for experience-driven, electrical activity during the highly plastic critical period. These steps should enhance the effectiveness during a corresponding critical period for motor system rehabilitation and nerve regeneration.